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Treating Active Acne Versus Acne Scars: The Differences Explained

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Treating Active Acne Versus Acne Scars: The Differences Explained  undefined

No two outbreaks of acne are exactly alike and may require customised treatment plans. Similarly, the management of active acne versus acne scars requires different approaches. A DoctorxDentist reader asked how doctors determine treatment for active acne and acne scars, and recalled how some clinics offer one-size-fits-all treatment packages. In reply, Dr Justin Boey discussed the treatments for different stages and types of acne available to patients in Singapore. Here’s our round-up.

Active acne is treated first before anything else

a woman looking into a small mirror


Left unchecked, active acne can cause more severe scarring. This is why your active acne can be treated first before any scars left by previous breakouts. [1]

In addition, certain acne scar treatments such as ablative lasers could potentially trigger active acne flares.

Creams are considered a first-line treatment for active acne

a woman applying cream to her face

In Singapore, active acne is usually managed through the use of creams first. Creams such as benzoyl peroxide gel, clindamycin gel, Differin cream, retinoic acid, and even Epiduo (a combination of retinoic acid and benzoyl peroxide) are effective for many. [2]

If topical creams do not work, oral medication may be added

a pack of red pills for medical treatment

If skin creams for acne are not sufficient, ask your doctor if antibiotics such as doxycycline and erythromycin are appropriate for your situation. If your acne symptoms do not improve, oral isotretinoin (commonly known as Roaccutane) may help. [3]

Acid peels and nonablative radiofrequency may help to reduce active acne

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Chemical peels such as glycolic acid peels and salicylic–mandelic acid combination peels have been shown to be effective against the emergence of active acne and scarring. [4]

Another option for active acne besides these chemical peels is nonablative radiofrequency treatment, which uses radiofrequency as a source of energy to treat the skin with minimal downtime. [5]

How are acne scars treated?

a woman with acne scars on her chin and cheeks

There are many options available for acne scar removal that range from lasers and fillers to injections. Methods can be combined. Ask your doctor how he or she customises your treatment plan for each scar type you have. [6]

Lasers are effective for rolling scars

closeup of rolling acne scars on skin

Atrophic acne scars can be effectively treated with laser treatments such as Fractional CO2, INFINI Fractional RF, and Fractional PicoLaser procedures. [7]

Fillers can deal with ice pick scars and boxcar scars

a cheek with ice pick scars

These are deep scars that have been tethered down by fibrous tissue. They can be managed through the use of a subcision procedure with fillers. Alternatively, TCA Cross and Fractional CO2 treatments work just as well. [8]

There are treatments for less common scars too

a woman having skin treatment with medical equipment

Pigmented brown scars (such as post-inflammatory hyperpigmentation) can be treated with the application of the PicoPlus laser, while hypertrophic scars such as keloids can be managed with corticosteroid injections applied by an experienced doctor. [9]

A combination of treatments may be required

a woman pointing to acne on her face

Dr Boey mentioned that most patients have a combination of scars, which is why a combination of treatments may be needed in order to target various types of scars with precision. He combines several types of lasers and peels in each session for optimal results. [10]

an asian man smiling at the camera

Both active acne and acne scars can be effectively treated through the use of medically tested medications and technologies. Consult your doctor and get a proper evaluation of your condition before opting for any of these procedures, and remember to plan for possible downtime after each round of treatment.

Treatment results may be gradual instead of immediate, so patience is much advised before you can see long-term improvements.


Dr Justin Boey’s practice of aesthetic medicine centres around the busy modern individual. He is experienced in Facial Aesthetics (lasers and injections) and hair loss treatments. Learn more about him here. You can also check out his website here.



References:

1. Treatment of Acne Scarring. Skin Therapy Letter. Published September 21, 2018. Accessed May 3, 2019.

2. H. Jones, D. Blanc, WJ Cunliffe. 13-CIS RETINOIC ACID AND ACNE. The Lancet. 1980;316(8203):1048-1049. doi:10.1016/s0140-6736(80)92273-4  Accessed May 3, 2019.

3. Skidmore R, Kovach R, Walker C, et al. Effects of Subantimicrobial-Dose Doxycycline in the Treatment of Moderate Acne. Archives of Dermatology. 2003;139(4). doi:10.1001/archderm.139.4.459 1 Accessed May 3, 2019.

4. GARG VK, SINHA S, SARKAR R. Glycolic Acid Peels Versus Salicylic-Mandelic Acid Peels in Active Acne Vulgaris and Post-Acne Scarring and Hyperpigmentation: A Comparative Study. Dermatologic Surgery. 2009;35(1):59-65. doi:10.1111/j.1524-4725.2008.34383.x  Accessed May 3, 2019.

5. Ruiz-Esparza J, Gomez JB. Nonablative Radiofrequency for Active Acne Vulgaris: The use of Deep Dermal Heat in the Treatment of Moderate to Severe Active Acne Vulgaris (Thermotherapy): A Report of 22 Patients. Dermatologic Surgery. 2003;29(4):333-339. doi:10.1046/j.1524-4725.2003.29081.x Accessed May 3, 2019.

6. Rivera AE. Acne scarring: A review and current treatment modalities. Journal of the American Academy of Dermatology. 2008;59(4):659-676. doi:10.1016/j.jaad.2008.05.029  Accessed May 3, 2019.

7. Sardana K, Manjhi M, Garg VK, Sagar V. Which Type of Atrophic Acne Scar (Ice-pick, Boxcar, or Rolling) Responds to Nonablative Fractional Laser Therapy? Dermatologic Surgery. 2014;40(3):288-300. doi:10.1111/dsu.12428 Accessed May 3, 2019.

8. Hoenderkamp, Renee. Treating Acne Scarring With Fillers. Aesthetics Journal.  Published 2015. Accessed May 3, 2019.

9. Lee H-J, Lee SH, Yoon SY, Lee JW, Kim YK, Choi EH. Postinflammatory Hyperpigmentation Successfully Treated with 1,064-nm Picosecond-Domain Neodymium:Yttrium-Aluminum-Garnet Laser. Medical Lasers. 2018;7(1):52-54. doi:10.25289/ml.2018.7.1.52 Accessed May 3, 2019.

10. Fabbrocini G, Annunziata MC, D’Arco V, et al. Acne Scars: Pathogenesis, Classification and Treatment. Dermatology Research and Practice. 2010;2010:1-13. doi:10.1155/2010/893080  Accessed May 3, 2019.

 


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1470 views 3 May 2019 Medically reviewed by Dr Justin Boey on 15 Nov 2019.
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Disclaimer: Any answers provided are for general informational purposes only and is not a substitute for professional medical advice. If you think you may have a medical emergency, call your doctor immediately. Always seek the advice of your doctor before starting or changing treatment.

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Disclaimer: Any answers provided are for general informational purposes only and is not a substitute for professional medical advice. If you think you may have a medical emergency, call your doctor immediately. Always seek the advice of your doctor before starting or changing treatment.

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