Acne scar treatment in Singapore as told by a doctor with no affiliations. On this occasion, I also had the pleasure of picking the brains of my dermatologist colleague, Dr Yew.
Why am I writing this post? Primarily because I'm that clichéd long-time acne sufferer myself, with a vested interest in this kind of stuff.
(For a more comprehensive overview of your treatment options, see Guide To Best Acne Scar Treatments In Singapore)
As with my acne treatment guide, my answer above is simply based on acne scar removal treatments I've tried myself, and know to be the most effective as a doctor.
Below is an FAQ, cobbled together with the most common questions I've come across regarding acne scar removal in Singapore:
1. I have active acne and some acne scarring, can I treat both at the same time?
No, treat your acne first. Many acne scar removal treatments can make your acne worse.
Also, prevention is better than cure, so I would worry more about preventing new acne scars from forming if I were you.
2. Okay. My acne is gone. Hallelujah. I now have these butt ugly acne scars that have squatted on my face for too long. I want them gone. Where do I start?
Congratulations. Before you start Googling "how to get rid of acne scars", you need to first identify the type of scars. They broadly fall under two types:
The first type is post inflammatory hyperpigmentation (PIH), or the reddish/discoloured skin that a pimple leaves behind after it disappears. A retinoic acid such as Differin cream will get rid of this. PIH also resolves by itself with time.
The second type is superficial or deeper scars, of which there are four types: Ice pick, boxcar, rolling and keloid scars. (Google image is your friend).
Keloid scars are caused by too much skin growth when your skin recovers. This is treated by a steroid injection if it's a big lump, or Pulse Dyed Light if it's only red and mildly elevated. The latter tends to be more responsive to acne scar removal treatments.
3. I have a mix of the other three scars - ice pick, box car and rolling. Which acne scar treatment works?
Lucky for you, Fractional C02 laser is very effective at treating these three kind of scars. I know - Dr Yew and I both underwent fractional laser ourselves.
Incidentally, it's commonly used by celebrities and older folks to reduce wrinkles and sun-damaged skin too.
One disclaimer: Acne scar treatments all carry a risk of causing PIH themselves, especially if you are not consistent with using sunblock after treatment.
4. What about chemical peels? I've heard they are pretty awesome too, where acne scar removal is concerned.
They can work well too, but I prefer Fractional lasers. Much more effective and less risks of side effects, IMHO.
5. Why Fractional laser > Chemical peels with acne scar treatment?
Chemical peels rely on a chemical reaction with your skin, where the length of time your skin is exposed to the peel is crucial (too long = burnt skin).
Fractional laser allows the operator to target your acne scars with exactly how much laser energy he desires - hence giving him more precision and control.
A deeper chemical peel can achieve a similar effect as a laser, but the risks are higher.
6. How does Fractional C02 work? I need some evidence that it's effective for acne scar removal.
Shafts of laser target the deeper layers of your skin.
Your skin then repairs these tiny shafts by pushing out the old damaged skin and replacing it with new skin.
It's widely acknowledged in multiple studies as the gold standard for treating acne scars.
7. Okay I'm sold on the Fractional laser. How do I choose between all the different skin clinics available?
The main difference between clinics is in the Fractional laser settings, and the doctor's experience in identifying types of skin vs acne scars.
He also needs to be familiar with managing the side effects and complications of treatment.
Skin clinic wise, I'd recommend going with a reliable word of mouth referral. Check the doctor's experience and qualifications too.
Some questions to consider asking the doctor before you decide: What sort of results he can achieve, and how many treatments that would take.
If he's willing to show you before and after results he's had, all the better.
You can read this post to get some idea of Fractional laser costs in Singapore.
8. You mentioned laser machine settings - How do I know if the clinic is using a laser with too low energy settings to achieve results?
A laser with too low an energy setting will not reach a deep enough depth to have an effect. I would be suspicious if the clinic offers to do lasers on you too often.
Personally, I would only go for Fractional laser once per 2-3 months - your skin needs time to heal and regenerate new skin.
Higher laser energy settings is generally more effective, but also results in more downtime and side effect risks.
9. How much improvement can I expect, and when can I see results?
Improvement ranges from 40-60%, before plateauing out.
It also depends on the extent of your acne scarring - if it's not too severe, and you can tolerate 7 days of downtime, you will need only 1 or 2 treatments.
You will see some immediate results, but you won’t see the full results until 3-6 months later as your skin needs time to turnover and produce new collagen.
10. What's fractional laser like?
Pain wise, Fractional laser feels like someone snapping rubber bands against your skin. Popping a pimple probably hurts more.
Your skin will look very red and feel very tight a couple of hours after the procedure, just like a bad sunburn (hence the downtime).
It may also start peeling in a couple of days.
Be prepared to hide indoors away from the sun, or to use lots and lots of sunblock! Your doctor will also give you a regime of skin repair cream/moisturisers/sunblock to use after.
Anyhow, that sums up my first acne scar treatment FAQ, and I hope it's given you a place to start when thinking about treatment.
Do note as I previously mentioned that although there are dozens of acne scar removal treatments available, I am only talking about what I would use myself, as well as what I would personally recommend to friends and family. See below:
Mom's personal lab rat, circa Feb 1988.