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How to smoothen acne scars? (photo)

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Doctor’s Answer (2)

Hi Ruzaini 

From your photo, it appears that you do have some shallow box car (crater type) and ice pick scars on your cheek.  

For treatment of the box car scars, the fractional CO2 laser is a good choice. This creates micro-columns of heat injury in the skin to stimulate new collagen. As a result, the scars will gradually become shallower and less prominent. At least 3-5 sessions spaced 6 weeks apart are needed to see improvement, and there is downtime to be expected of at least 4-6 days with post treatment redness. The SMARTXIDE will be a good example of a fractional CO2 as it is combined with RF simultaneously for increased effectiveness. 

You can also consider a fractional PICO laser (e.g. PICO Discovery) , which is newer in the industry. It creates special light induced breakdown in the skin to stimulate new collagen production in the scars. Similarly, a few sessions will be needed to see improvement. 

Any larger box car scars can be treated with subcision, where a needle is inserted under the scar to break down and release the scar tissue. This can also be combined with fillers to get the scar as shallow as possible. 

For small ice pick scars, TCA cross can be considered.

On a sidenote, it is also important to control any active acne you may currently be having as you do not want to get any new scars whilst on treatment. This can be done by either topical or oral medications. Please see your doctor to discuss the most suitable treatment for you.

I hope you find this helpful!

Wei Sheng

Dermatologist 

"Doctor with interest in Aesthetics and Lasers"

You have a combination of rolling scars and boxcar acne scars. From your photo, you do seem to have ice-pick acne scars as well.

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

For your Rolling/ Atrophic Scars, the treatments of choice are: 

  • Fractional CO2, 
  • Micro-needling Radiofrequency (Infini RF), 
  • Fractional PicoLaser

For your Boxcar Scars, I suggest:

  • Subcision with fillers, 
  • Fractional CO2

For ice-pick acne scars, I suggest:

  • TCA Cross 

The dark brown spots that you see are Post-inflammatory Hyperpigmentation (PIH). These tend to fade over time. However, if you would like to speed up the removal of post-inflammatory hyper-pigmentation, you can consider a Picosecond Nd-YAG Laser.

Several sessions of each treatment are required for optimal scar improvement results. I usually combine several types of treatments in 1 treatment session to target each scar specifically.

Treatment intervals are usually 1 month apart.

For more details, see these 2 posts on Acne Scar Treatment Costs in Singapore and Pico Lasers in Singapore.

Hope that this helps!

Warmest regards,

Dr Justin Boey

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