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J from Singapore asked a question

How to get rid of acne marks? (photo)

I'm a 19 year old female and previously suffered from cystic acne from the age of 15 - 18 years old. My acne was so bad till the extent where I would wear foundation to school as a result of my low self-esteem. That made things worse. When I was 18 years old, I finally decided to go to see a dermatologist (on my own without my parents knowing) and was prescribed with an antiobiotic called doxycycline (2 tablets/day for 9 months) as well as a topical cream called Epiduo. My skin has now recovered, and I only have one pimple breakout every 1 - 2 weeks. I'm concerned over my acne marks that are still all over my face. The epiduo that my dermatologist said would help with fading the marks isn't doing much of a job (PS due to lighting and flash, the marks do not look obvious in the picture, but it is much redder in person). What should I do? 

DOCTOR’S ANSWER (3)
Dr Chua Cheng Yu
Aesthetic
Singapore
(8 Ratings)
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Dr Chua Cheng Yu
Aesthetic
Singapore
(8 Ratings)
Answered on Sun Mar 18 2018 14:32:09 GMT+0000 (UTC)

Hi J,

If I hear you correctly, you have red marks left from previous acne. These are not obvious on your picture indeed, but they are a very common sequela of acne vulgaris.
 
The name of that condition is post inflammatory erythema (PIE for short) and it is usually accompanied by post inflammatory hyperpigmentation (PIH).
 

Whereas Epiduo could help with PIH, it doesn't do very much for PIE. Proper treatment of PIE (your condition) includes the proper use of skincare, and the correct type of lasers to speed up their removal.

Sunblock is of paramount importance as those PIE spots can darken very badly when exposed to sun.

Using the correct lasers to deal with acne and acne scarring is important as there are many different types of acne as well as acne scars.

Scars don't just present as marks, they can be bumpy (hypertrophic/keloid) as well as depressed (atrophic box, rolling or icepick). This is why I have a wide variety of lasers and skin treatments.

Red acne marks will usually require long pulse lasers to handle as the long pulse duration properly targets hemoglobin that is causing the redness. 

Hope this was helpful!

0 270 views 0 Doctors agree Sun Mar 18 2018 14:32:09 GMT+0000 (UTC)
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Dr Jiwei Wu
Aesthetic
Singapore
(3 Ratings)
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Dr Jiwei Wu
Aesthetic
Singapore
(3 Ratings)
Answered on Sun Mar 18 2018 08:04:58 GMT+0000 (UTC)

Hello J,

Thank you for your question. Good to hear that your acne is now under control. There are different types of acne scars and they can be treated in a few ways: 

  • Topical retinoids (differin/ retin A)
  • Chemical peels (glycolic acid/ TCA/ Jessner)
  • Fractional ablative laser resurfacing (CO2/ Erbium)
  • Microneedling fractional radiofrequency device (Infini RF)
  • Needle subcision
  • PDRN microinjection (Rejuran Healer) 

Treatments can be combined for better/ faster results.

The entire treatment process usually takes a few months as collagen remodelling and new collagen formation takes time. 

Most people will have a combination of scars (boxcar + atropic + ice pick), and hence each treatment is customised based on your scar type. 

Consult a doctor/ dermatologist to get a thorough examination of your acne scar marks first before deciding on your treatment plan. All the best!

Regards,

0 311 views 0 Doctors agree Sun Mar 18 2018 08:04:58 GMT+0000 (UTC)
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Dr Jason Pek
Aesthetic
Singapore
(1 Ratings)
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Dr Jason Pek
Aesthetic
Singapore
(1 Ratings)
Answered on Sun Mar 18 2018 09:25:33 GMT+0000 (UTC)

Hello J,

Your picture is not very clear but it does look like post-inflammatory hyperpigmentation (PIH) marks from old acne.

Use of topical retinoids such as tretinoin or epiduo may help but they usually take a longer time to work.

I prefer to use a combination of bleaching agents (hydroquinone/arbutin) and laser treatment 1064nm wavelength on the spots for quicker results. As Dr Wu also mentioned, PDRN injections into the PIH marks will also speed up the recovery. 

0 301 views 0 Doctors agree Sun Mar 18 2018 09:25:33 GMT+0000 (UTC)
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