Acne is a common skin condition that many people struggle with at some point in their lives. If left untreated, severe forms of acne can result in deep acne scarring such as boxcar scars, ice pick scars or hyperpigmentation such as blemishes which can be difficult to be rid of unless you opt for an acne scar removal treatment.
Not all skin conditions are the same, and different types of acne scars may respond differently to certain acne scar removal treatments. By understanding your skin condition and the type of acne scars that you have, you will be able to heal and repair your skin based on your skin’s specific needs.
In this article, we will explore these treatments available in Singapore for specific acne scars, and some options to achieving healthier, smoother skin.
Atrophic acne scars
The appearance of acne scars depends on the type of skin inflammation that caused it, and hence may result in either a depressed or raised scarring in the skin.
Atrophic scars go deep into the skin’s surface, often sharing the characteristics of shallow, irregularly-shaped depressions. Some common types of atrophic scars are boxcar scars, ice pick scars and rolling scars.
Atrophic acne scar treatment
Two phases are required to treat deep atrophic scars, where the first one focuses on shrinking the depth of these scars, such as chemical peels or surgery.
The overall appearance or discolouration of the atrophic scars are then reduced in the second phase, where non-ablative treatments like laser and resurfacing treatments are introduced.
Types of acne scars (source).
Boxcar acne scars
Boxcar scars have a deep angular shape underneath the skin’s surface, and are often formed around the cheeks or temples. These are commonly caused by severe forms of acne.
Boxcar acne scar treatment
This type of scar is easily treated with traditional acne scar removal treatments such as a subcision or a punch excision.
A subcision is a simple outpatient treatment that involves penetrating the skin with a needle to promote collagen production, and results may be visible after 1 or 2 days.
A punch excision, however, is a slightly more invasive surgical treatment where the affected skin is cut out using a special device and then stitched shut to promote healing.
A good non-ablative treatment that can help treat boxcar scar wounds is a laser treatment. The pico laser is the latest laser treatment to remove shallow acne scars effectively using intense laser technology targeted directly at the scars.
With the speed of 1 trillionth of a second, it can help to reduce the appearance of boxcar scars with little to no downtime, unlike traditional acne scar removal treatments.
Ice pick acne scars
Icepick scars are the deepest type of acne scarring, but small in appearance with up to 2mm in diameter. Due to its depth, it may be difficult to remove with traditional acne scar removal methods.
Ice pick acne scar treatment
The nature of the acne scar may require a more intensive and consistent treatment, such as a punch excision or chemical peel.
Modern chemical peels can target deep acne scars like ice pick scars, and peel away the affected areas of the skin using a chemical substance.
New, healthier skin cells will rise to the surface, giving the outer surface of the skin a smoother and more even texture. Unlike traditional chemical peels, the latest peels can be done as a walk-in treatment and have zero downtime.
Rolling acne scars
Rolling scars are the widest form of atrophic acne scars, and may appear as wide as 5mm in diameter. Similar to boxcar scars, rolling scars are a result of severe inflammation deep in the skin.
Rolling acne scar treatment
A popular and effective way to treat rolling scars is with a laser and resurfacing treatment or the pico laser treatment.
By eliminating the damaged skin tissues with intense laser technology, this also boosts the production of new skin cells to replace the outer skin layer, reduces the bumpy texture and rejuvenates the skin for a smoother appearance.
Similar to the laser treatment for boxcar scars, the latest pico laser treatment can also treat rolling scars, and significant improvements can be seen in subsequent sessions.
Hypertrophic and keloid acne scars
Bearing the opposite characteristics of atrophic scars, hypertrophic and keloids scars may develop above the skin surface and look like small, raised bumps. This is a result of healing scar tissue, usually in the areas where acne once was.
Hypertrophic and keloids scars differ in size. Where hypertrophic scars may form around the same size as the acne that healed, keloid scars may develop and spread around the surrounding tissue.
Hypertrophic acne scar treatment
Similar to atrophic scars, hypertrophic scars can be treated with a simple laser treatment. The excess skin tissue can be successfully reduced using medical-grade laser technology without causing damage to the surrounding skin. After the excess skin is removed, the skin is left to heal and repair by producing new skin cells.
Keloid acne scar treatment
Large keloid scars may require 2 phases of treatments involving steroidal shots or injections. While laser treatments may still be effective for smaller keloid scars, steroid injections such as cortisone are effective in relieving inflammation, hence flattening larger keloid scars and thus allowing for the laser treatment to take effect.
Post-inflammatory hyperpigmentation (PIH)
Hyperpigmentation can occur after any type of acne, including small pimples or zits. It is a natural part of healing in the skin, and comes in the form of small, discoloured patches. However, it can worsen and remain permanent if left untreated.
Hyperpigmentation can be easily treated with consistent, regular treatment and a good sun protection regime. On top of your personal skincare routine, skincare products that contain salicylic acid can greatly improve the skin complexion and reduce the reddening of the scars. A pico laser treatment can also be effective in treating hyperpigmentation by targeting the excess melanin (pigments) in the skin and stimulating the production of collagen that is needed to restore the skin’s natural complexion in its healing process.
Schedule an assessment with our acne scar doctor to find out what acne scar treatments are suitable for your condition.