Acne scars are created when a breakout penetrates the skin deeply and damages the underlying tissues. The body responds to this damage by engaging its natural healing mechanism and producing collagen to rebuild the affected tissue. However, it is not a perfect system. If the body produces too much collagen or too little collagen, a scar forms.
This scar remains after the acne itself has cleared. Acne scars can be stubborn, but there are many treatments available to improve their appearance. In the vast majority of cases, it is necessary to use a combination of treatment modalities to completely address a patient’s scarring. Tailoring the treatment to the individual is essential to achieve the best outcome
FAQs
What can I do?
The key to managing acne scarring is, first and foremost, controlling the inflammatory acne that can further scar. We highly recommend medical treatment or laser treatment (AviClear) of your acne first before treating scarring.
Ice Pick Scars: deep, narrow, pitted scars
Boxcar Scars: broad depressions with sharply defined edges.
Atrophic and Rolling Scars: broad depressions with gently sloping edges.
Hypertrophic Scars: thick, raised, lumpy scars.
Red scars
Hyperpigmented scars
Hypopigmented scars
TCA CROSS
Punch excision
Co2 laser
TCA CROSS
Punch elevation
CO2 laser
Subcision
Biostimulatory injections
Dermal fillers.
Subcision
CO2 laser
Fractional resurfacing RF
Biostimulatory injections
Dermal fillers
Intralesional injections with prescription medications
Vascular Laser
CO2 resurfacing Laser
CO2 laser-assisted medication delivery
Vascular Laser
Nanofractional RF resurfacing
Chemical peels
Pigment-inhibiting creams
Q-switched Laser
Picosecond laser (Picosure Pro)
Superficial resurfacing Laser
These tend to be challenging to treat. The dermatologists use resurfacing Laser in combination with pigment-stimulating medication.
Procedural modalities to treat acne scars include TCA CROSS, TriChloroacetic Acid Chemical Reconstruction of Skin Scars (TCA CROSS) is our treatment of choice for ice pick acne scars and large, deep pores.
Subcision is a procedure that uses either a blunt or a sharp needle to separate the thickened scar tissue from the underlying tissue. Subcision is a highly effective treatment for tethered scars.
Laser Resurfacing: treatment with fractional CO2 laser and or 1927nm thulium laser that removes damaged cells and stimulates collagen production.
Radiofrequency resurfacing: an energy-based device associated with little downtime that stimulates collagen remodelling to treat rolling scars; suitable for both light and dark skin types
Punch Elevation: a surgical procedure in which the scar is lifted to match the surface level of the skin, making it less noticeable; best for boxcar scars with sharp edges
Punch Excision: a surgical technique that excises the scar using a small punch tool; ideal for deep ice pick scars and narrow, deep boxcar scars
Vascular Laser: a laser that improves red marks left behind by old acne lesions; recommended for predominantly red scars
Biostimulatory injections: these injections use either hyaluronic acid or polynucleotides to stimulate fibroblasts to produce collagen in the skin.
Dermal Fillers: dermal fillers can be injected into the scarred area to fill in an indented scar and create a smoother surface; recommended for persistently depressed scars
Pigment Laser: a laser that specifically targets post-inflammatory pigmentation left by acne.
Intralesional injections involve administering steroids or 5-fluorouracil directly into a thickened/raised scar to break down excess collagen and prevent further collagen growth.
Skin Needling: a gentle, lower-cost treatment that stimulates the body’s natural healing and collagen production processes by using ultrafine needles to create tiny wounds in the skin; Results are less reliable than lasers or energy based devices. Can we used for early scarring
General management of scars may consist of the following:
Prescription Topical Cream: topical prescription treatments that can improve acne scarring include retinoids (derived from vitamin A), pigment lightening cream and steroid cream
Silicone Gels: The application of medical-grade silicone products can help flatten and soften raised scars by increasing hydration and regulating collagen synthesis
Sun Protection: Fresh scar tissue is delicate and vulnerable to a condition called post- inflammatory hyperpigmentation; use sunscreen and protective clothing to shield new scars from UV exposure.
For effective acne scar treatment with minimal downtime, we look at the followings:
Dermal fillers
Collagen stimulatory injection
Vascular Laser
RF resurfacing
Skin needling
In order of collagen stimulatory potentials, from the highest to the lowest:
Co2 laser, by far, gives the most reliable results
Non-ablative resurfacing laser
RF resurfacing
Biostimulatory injections
Vascular Laser
Skin Needling
It’s critical to undergo an assessment by a specialist dermatologist to determine the best option for your circumstances. Your treatment must be tailored to your scars, and different scars may require different approaches. Your specialist dermatologist may recommend subcision for one scar and TCA CROSS and CO2 laser for another. Every scar is different. The key to treatment success is to use the right tool for the right scar.
Every scar is different. There is no “best way” to treat acne scars. Accurate assessment of your scar, taking into account of your circumstances/tolerance of downtime, and your medical history, the specialists who consult with us will formulate a treatment plan that is tailored to you.