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Acne is a common skin condition that affects millions of people worldwide. While it can be distressing during its active phase, the aftermath of acne can often leave behind scars, affecting one’s self-esteem and confidence. Acne scars come in various forms, each requiring specific treatment approaches. In this article, we will explore the different types of acne scars and the available treatment options, with a focus on acne scar removal treatments in Singapore.

Atrophic Acne Scars

types of acne scars

Atrophic acne scars are the most common type and result from a loss of tissue during the healing process. There are three subtypes of atrophic scars: ice pick, boxcar, and rolling scars. Ice pick scars are small, deep, and narrow, resembling a puncture mark on the skin. Boxcar scars have well-defined edges and appear as shallow depressions with a box-like appearance. Rolling scars, on the other hand, have a wave-like or rolling appearance due to fibrous bands that pull down the skin.

Boxcar Scars

box scars

Boxcar scars are characterized by broad depressions with well-defined edges. These scars often give the skin a pitted appearance of “larger holes” and can be challenging to conceal with makeup. Fractional CO2 laser treatments, Subscision and Microneedle Radiofrequency are effective treatments for reducing the appearance of boxcar scars. These treatments help to destroy the scar tissue, stimulate collagen and to give a smoother appearance.

Rolling Scars

rolling scars

Rolling scars appear as undulating waves on the skin’s surface and can be especially challenging to treat. Subcision, a minimally invasive procedure that involves breaking the fibrous bands that cause rolling scars, is a popular treatment option. Additionally, Microneedle Radiofrequency, Fractional CO2 laser resurfacing and Dermal Fillers can be used simultaneously to further improve skin texture, stimulate collagen production and to “fill” up these scars.

Ice Pick Scars

ice pick scars

Ice Pick Scars are characterized by small entry points with deep depths just like small deep “holes”.  The treatment of choice are typically TCA CROSS which is ultra high concentration of TCA Acid and Fractional CO2 Laser Resurfacing.  Due to the intensely high concentration of the TCA Acid, it is advised to consult an experienced medical professional so as to minimize/ avoid potential side effects.  

Hypertrophic and Keloid Scars

Hypertrophic and Keloid Scars

Unlike atrophic scars, hypertrophic and keloid scars result from an overproduction of collagen during the wound-healing process. Hypertrophic scars are raised and red but remain within the boundaries of the original wound. Keloid scars, on the other hand, extend beyond the wound’s edges and can be itchy, painful and continue to “grow” in size. Corticosteroid injections and silicone gel sheets are commonly used treatments for these types of scars, helping to flatten and soften their appearance.  Fractional CO2 lasers can also help to increase the effectiveness of treatment and results.

Post-Inflammatory Hyperpigmentation

Post-Inflammatory Hyperpigmentation

Post-inflammatory hyperpigmentation (PIH) is not a true scar but a discoloration of the skin that occurs after acne lesions have healed. This occurs due to inflammation and damage to the skin resulting in over production of melanin in those areas.  PIH appears as flat, dark spots or patches and is more common in individuals with darker skin tones. 

First line treatment is pigment-specific lasers that target these pigmented scars specifically.  Topical treatments containing ingredients like, alpha-arbutin, niacinamide, vitamin C and retinoids can also help fade PIH over time, revealing a more even skin tone.

Acne Scar Removal in Singapore Medical Clinics

At M-Aesthetic Clinic, we offer the full range of acne scar removal treatments to treat all kinds of acne scars; raised and red, flat, pigmented or depressed.

Dr Ho Rui Ming has performed countless Acne Scar Treatments and is an expert in the field of Acne Scars and its’ treatments. 

Having done his Masters in Dermatology from the prestigious St John’s Institute of Dermatology, UK, Dr Ho has in-depth knowledge on Acne Scars, the “know-how” in acne scar removal procedures and can help to restore your skin to its original condition.

Here are our list of treatments.



Scar tissue is manually loosened by using a needle. It is needed to treat certain scar types and is commonly used in combination with other treatment modalities such as collagen stimulators/ spacers. 

Subcision may look simple but it is a manual method that really requires good technique and when done correctly, can yield effective results.

CO2 Fractional Laser

CO2 Fractional Laser

The CO2 laser is the premier fractional ablative laser that delivers exceptional, effective results using advanced technology to minimize downtime, increase patient safety and maximize comfort. 

Multiple Micro-Ablative Columns are emitted to destroy and break up scar tissue and regenerate collagen so as to smoothen the skin and remove acne scars.

Controlled Chaos Technology (CCT™) creates Micro-Ablative Columns deep into the scars to achieve excellent results.

Results can be seen with each session and subsequent sessions may be required to achieve optimal results. The optimum interval is 4 – 6 weeks between eCO2 laser treatments.

TCA CROSS Technique

TCA CROSS Technique

This is a technique whereby extremely high concentration of TCA acid is carefully applied to individual acne scars to “fill” up the depression and make the scar less depressed. This technique targets Ice-pick scars and some Box-car scars.

As the concentration of acid used in this technique is very high, it should only be administered by a medical professional to ensure maximum safety.

Micro-Needle Radiofrequency treatment

Micro-Needle Radiofrequency treatment

For deeper/ rolling scars, the Micro-Needle Radiofrequency Treatment can be used. This method of treatment is effective for stubborn/ deeper rolling acne scars as it can penetrate more deeply into the skin

Gold-plated ultra-fine needles first smoothly penetrate deep acne scars before emitting radiofrequency energy to break up the scar tissue and stimulate collagen.

It is a great treatment for acne scars that requires deeper penetration of energy and a more intense approach.

Despite being able to penetrate more deeply, downtime is actually still kept to a minimum of a few days to a week.



In certain cases, fillers can be used to fill up depressed scars to smoothen out the skin surface. This is especially effective for Rolling Scars and certain Box Scars.

Anaesthetic is first administered to the entry point of the area that is to be filled, and then the filler is administered via the entry point to raise the depressed scar.

The advantages of fillers are that effects are seen immediately, and MINIMAL to NO downtime is required.

Filler results generally lasts up to 12 months depending on the filler brand.

Acne Pigment Laser

The procedure is safe on all skin types and is a fantastic way to treat Acne Scar pigmentation and redness without downtime as compared to other acne laser treatments.


  • Brightens & lightens acne scar pigmentation and redness
  • Reduces all types of acne
  • Controls sebum production
  • Reduces redness from inflamed acne


Acne scars can be a lasting reminder of the challenges faced during an acne outbreak, but they don’t have to be a permanent feature. Identifying the specific type of acne scar is crucial in determining the most suitable treatment approach. From atrophic scars to post-inflammatory hyperpigmentation, there are various options available to help individuals achieve smoother and more even-looking skin. 

In Singapore, the advancements in acne scar removal treatments offer hope to those seeking to restore their skin’s natural beauty and confidence. If you are struggling with acne scars, send us a message to explore the best treatment plan for your unique needs. With the right approach, you can regain your confidence and embrace your beautiful skin once again.


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