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from Singapore asked a question

How can I get rid of superficial acne scarring?

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Acne & Scars Aesthetic Medicine

How can men get rid of superficial acne scarring? Can any doctor advice please?

DOCTOR’S ANSWER (4)

Dear Miaoz Legato,

Thank you for your question.

There are several treatment options for Superficial Acne Scarring.

I tailor my treatments according to the type of scars that my patients have.


Rolling/ Atrophic Scars 



Treatments of choice:

  • Fractional CO2,
  • Infini RF,
  • Fractional PicoLaser

Ice-pick and Boxcar Scars

Ice pick and boxcar scars are deep scars and tethered down by fibrous tissue

Ice pick scars

Boxcar scars

Treatment of choice:

  • Subcision with fillers,
  • TCA cross,
  • Fractional CO2

Pigmented Brown scars – also known as Post-inflammatory Hyperpigmentation

Treatment of choice: Picosecond Laser


Hypertrophic Scars/ Keloid

 

Treatment of choice: Corticosteroid Injection


In my experience, most patients have a combination of scars.

As such, a combination of treatments are needed to target the various types of scars precisely.

I usually combine several types of lasers and peels in each treatment session to achieve optimal results.


Hope that this helps!

Regards,

Dr Justin Boey

Consult Doctor
0 1250 views 0 Doctors agree 21 May 2018

Hi Miaoz,

There are multiple types of scars, broadly characterised into atrophic and hypertrophic scars. Most commonly are atrophic scars, which include deep, narrow ones (ice-pick scars), wide broad based scars (Box scars) and rolling scars.

Scars are fibrosed tissue that require remodelling of the dense collagen network to improve its appearance, and multiple forms of treatment are typically required. Improvements of up to 70% are typically expected over a course of 6 months to a year of monthly treatments.

Treatments include the following:

1. Scar resurfacing: With ablative, non ablative lasers and radio-frequency devices. This is the most technique for general scar revision. It is particularly good for box and rolling scars, as well as for general facial rejuvenation.

2. Subscision: Using a sharp needle, some scars can be detached from the dermis to which they are stuck down to. This is particularly useful for ice pick or dense scar tissue with excessive adhesions.

3. Fillers: Fillers can, especially after subcision, assist with keeping freed scar tissue from getting stuck back down to the deeper dermis. This might need to be done several times to ensure a long lasting, softer looking scar.

4. TCA Cross: Using a strong acid, difficult-to-resurface scars such as ice pick scars can effectively be managed. Resurfacing lasers are typically advised in combination with TCA cross, though at separate settings.

The above list is non-exhaustive, and a combination of treatments typically produce the best results. It is advisable to speak to a doctor about your expectations and cost in mind.

I do like to inform my patients that treatment for acne scarring is indeed a good investment for the face as treatment done is largely permanent, and unlike other aesthetic procedures, will not require too much repeat treatment after scars have resurfaced well.


For a bit more detailed an answer, you can refer to my answer here: https://www.doctorxdentist.com/questions/how-much-recovery-can-i-expect-for-my-acne-scars-photos

Cheers.

Dr Shane Abucewicz Tan

Consult Doctor
0 1246 views 0 Doctors agree 21 May 2018

Hello Miaoz Legato 

There are many acne scar treatments in the market right now and it really depends on the type of acne scar you have. It will be very helpful if you can attach a picture of your acne scars. 

  • Topical retinoid (Differin/ Retin A) 
  • Chemical peel (TCA cross/ TCA peel) 
  • Fractional laser resurfacing 
  • Microneedling radiofrequency
  • Subcision

You can always start with topical retinoid at night for superficial acne scars. I will usually recommend fractional laser resurfacing or microneedling radiofrequency for box car and rolling scars. Subcision for tethered scars. TCA cross for ice pick scars.

You should consult a doctor to get an accurate assessment of your acne scar first as treatment is usually customised.  

Regards,

Dr Jiwei Wu 

Consult Doctor
0 1239 views 0 Doctors agree 21 May 2018

Dear Miaoz Legato,

There are quite a few treatments available for acne scarring.

Resurfacing lasers or "laser peels" are best for most people and great for superficial acne scars. Commonly used lasers include the Fractional CO2 laser, Fractional Erbium laser, and Fraxel Dual laser.

Recently, the PicoSure laser with its new focus lens has also shown to be effective for treating acne scars. Most people who see me prefer the Fraxel Dual or PicoSure laser as they have little to no downtime.

Three or more treatments are needed for most people. An experienced aesthetic doctor will be able to prescribe what is most suitable for your skin condition. I hope this helps.

Cheers!

Dr. Terence Tan

Consult Doctor
0 1139 views 0 Doctors agree 24 May 2018
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