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Acne Scars

What Are Acne Scars?

Acne occurs when a sebaceous gland or hair follicle becomes clogged and subsequent inflammation ensues. This skin injury initiates a series of biochemical and immunoinflammatory reactions, which ultimately lead to the damage of the skin’s extracellular matrices. This remodelling can result in the formation of a scar. Nodular and cystic acne are particularly prone to causing scarring.

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What Are The Types Of Acne Scars?

Atrophic Scars

Atrophic scars (or depressed scars) develop when an imbalance in biochemical processes causes more inhibition than formation of extracellular matrix metalloproteinases (MMPs), leading to a net loss of collagen. Atrophic scars are twice as common as hypertrophic scars and keloids.

  • Ice pick scars (60 – 70%) are deep, V-shaped, puncture-like depressions with a wide opening and narrow infundibulum.
  • Boxcar scars (20 – 30%) are wide, oval-shaped scars, defined by sharply vertical edges
  • Rolling scars (15 – 25%): 2 wider, U-shaped undulations, with sloping edges

Hypertrophic Scars

Hypertrophic and Keloid scars develop when excess collagen deposits in the skin.

Hypertrophic scars are typically raised, firm, with thick bundles of hyalinized collagen lodged within the original site of the inflammation (or pimple).

Keloids form as small reddish-purple lumps proliferating well beyond the confines of the original injury.

Pigmented Scars

Pigmented scars appear as a flat, coloured area left behind after the acne has cleared. These can last for months to years if left untreated. 

  • Post Inflammatory Erythema – These are red marks left behind after the acne heals
  • Post Inflammatory Hyperpigmentation – These are brown marks left behind after the acne heals

How Do I Manage Acne Scars?

Preventing acne is the first step in avoiding post-acne scars. The next best step is to reduce the duration and severity of inflamed acne as much as possible. Once pimples appear, seek treatment early to avoid aggravating the condition further as it can cause more scarring. As a stop-gap measure for emergencies, your doctor may inject steroids into severely inflamed pimples, which rapidly reduce swelling, limit blood flow feeding scar tissue and inhibit keratin proliferation.
Read our page on Acne here.

Chemical Peels

Acids can exfoliate keratin and trigger new collagen production. Chemical Peels such as 50% TCA peels initiate keratocoagulation and can give significant results for both shallow boxcar and deep icepick scars. While pyruvic acid is known to be effective for moderate scars.

Ablative & Non Ablative Lasers

Lasers work best for treating shallow acne scar types like boxcar and rolling scars.
  • Ablative lasers (eg. CO2 laser and er:YAG laser) work by vaporizing damaged scar tissue, while tightening the collagen fibre bands beneath.
  • Nonablative lasers (eg. nd:YAG laser) generate new collagen and contract skin tissue to raise scars closer to the surface.
  • Pigment and vascular lasers can help lighten pigmented scars quicker
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Radiofrequency Microneedling

Radiofrequency microneedling stimulates the fibroblasts within the dermis to stimulate collagen production for scar remodelling. As with most acne scar treatments, multiple treatment sessions are required to see an improvement in the scar condition.

Polynucleotides

Polynucleotides are derived from salmon DNA and help to induce skin remodelling for increased collagen production and skin healing. Combining laser treatments with polynucleotides often potentiate the effect of wound healing and lead to better skin remodelling.

Hyaluronic Acid (HA) Fillers

HA fillers can augment indented scar tissue and restore volume to the face where collagen fibres have degenerated with inflammatory damage. These are most effective for deep pitted scars which may not respond well to ablative fractional laser treatment alone.

It is best to seek the advice of an experienced aesthetic doctor to decide on the right acne scar treatment for your skin. At VIDASKIN, we have a diagnostic VISA analysis machine for assessing your skin and a myriad of options to select from when it comes to treating acne scars.

Frequently Asked Questions

The best acne scar treatment for your skin will depend on your skin type, the scar type, the severity of the scar and more. It is best to seek the advice of an experienced aesthetic doctor to decide on the appropriate treatment. At VIDASKIN, we have a diagnostic VISA analysis machine for assessing your skin and a myriad of options to select from when it comes to treating acne scars.

Chat with our doctors, for advice on the best treatment options for your skin for optimal results.

After each laser treatment, your skin will be more vulnerable to damage from UV rays. Take extra caution in protecting your skin through the following:
  • Apply sunscreen every day, even in indoor settings
  • Avoid tanning or other outdoor activities
  • Stop using skin care products that contain retinoids or acids for at least 1 -2 weeks till your skin heals
  • A topical antibiotic may also be prescribed to prevent infection and aid with healing.
  • Cleanse your skin regularly

    • The result of acne scar treatment varies between people and also depends on your scar type and treatment done. Usually a combination of different treatment modalities can get good results in terms of shallowing out acne scars.

    Reddish or brownish acne marks left behind by acne lesions usually fade eventually, but it can take a year or longer. Mild or moderate scarring may also fade over time, but in general, unless acne scars are treated — especially severe scarring — they're permanent.
    Coloured acne scars such as post-inflammatory erythema (PIE) and post-inflammatory hyperpigmentation (PIH) can respond to topical treatments to help them fade quicker. These include brightening agents such as vitamin c, kojic acid, glycolic acid or even retinoids.
    Even with treatment, acne scars are difficult to heal. There's no 100% guarantee that the acne scars will be completely gone. But most treatments reduce the size of the acne scars and make them less visible.

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