Acne Scar Removal: Types of Scars and Treatments
Acne or pimples can leave behind a lot of marks and scars.
For a lot of doctors who see and manage acne on a daily basis, our principal consideration is to reduce the scars and the future impact of scars.
To find out more about acne and the treatment of acne in Singapore, read this article here.
What are the types of acne scars that could occur after acne heals? In this article, we will talk more about the different types of scars and the treatment methods available in Singapore.
Types of Acne scars
1) Pigmented acne marks
These are what we call PIH or post inflammatory hyperpigmentation. These pigment spots occur due to the skin reacting to the inflammation of the pimple.
They tend to occur in darker skinned individuals and in our tropical climate in Singapore, the risk of PIH happening can be as high as 30%-40% [1]
These marks are relatively easy to treat. A combination of creams and lasers will do the trick. Creams that we often recommend includes:
- Sunblocks – these help to reduce sun induced skin pigmentation
- Topical depigmentation cream – Hydroquinone, azelaic and kojic acid
- Topical retinoids
In addition, for recalcitrant PIH, some further treatments that are often done in Singapore clinics includes:
- Nd:yag laser
- IPL
- Gentle chemical peels
2) Post Pimple Redness or Erythema
Occasionally after the pimple recovers, it leaves behind a red bump on the skin which may take 3-4 months to resolve due to prolonged inflammation and skin healing.
From my experience, as we age, these red marks may take longer and longer to resolve.
Treatment of these red marks also includes creams and in severe cases, procedures. [2]
Creams that can help with the redness are
- Steroid creams – These can help to reduce inflammation. But these are doctor prescriptions only.
- Niacinamide – This is a form of vitamin B3. It reduces inflammation and helps skin retain moisture.
Consider medical treatments if you are not satisfied with topical medications. Again, some of the treatments that we do in Singapore clinics are
- Laser and Light treatments IPL ( intense pulsed light).
- lasers like Nd:Yag and pulsed dye lasers can be used to treat prolonged redness from pimples.
3) Hypertrophic scars and Keloid scars.
These are the worst scars to have. Singaporeans, being Asians, Singaporeans have a high risk of developing keloids and hypertrophic scars. [3]
Due to the damage from the infection and inflammation of the pimple – these lumpy scars develop. They may be itchy at times. Complete cure of keloid scars may not be possible.
Treatment options in SIngapore includes
- Topical steroid cream
- Steroid injection
- Pulse dye lasers
One of the most effective ways of treating keloid is via steroid injections – and a series of injections may be required.
Even then, we may not be able to achieve complete resolution in many cases. Speak to your doctor to find out more about the treatment options.
4) Sunken scars
Sunken scars, I believe, are the most common type of scars that we see from pimples. [4]
There are a few variations of them, including box scars, rolling scars, ice pick scars. These scars develop due to the breakdown of skin collagen fibres and fat from the pimple infection.
Common Acne Scar Removal & Treatment in Singapore
#1. Fractional resurfacing lasers
These lasers work by creating “ controlled micro damage “ to your skin to push the skin into a repair mode. It is during this repair phase where new skin and new support structures are formed and scars are improved.
Examples of fractional lasers include
- Fraxel
- BB thulium laser
- Venus viva fractional Rf
Injections to fill and boost the collagen growth to encourage new skin growth.
Examples of the injections include
- fillers to boost the volume of the sunken skin
- Bio-stimulators of collagen like salmon PDRN (polydeoxyribonucleotide)
#2. Chemical peels
Strong chemical peels may be used in certain type of scars like the ice pick scars to intentionally burn the skin to trigger a recovery process.
In Singapore, chemical peels are not done as often as other methods as risks of complications like burns and PIH are common.
#3. Subscisions
More invasive procedures that we do include subcision of scars.
You can think of subcision like a micro-knife to gently separate our skin from the underlying adhesion scars – so that the scars appear less stuck down and less deep.
By : Dr Chen Yiming- Family Physician, MBBS (Singapore), GDFM (NUS), GDFP Dermatology (NUS)
Links :
[-] -https://fitivate.com/acne-treatment-singapore/
[1] https://pubmed.ncbi.nlm.nih.gov/11807471/
[2] https://www.healthline.com/health/acne/post-inflammatory-erythema#treatments
[3] https://www.aafp.org/afp/2009/0801/p253.html#afp20090801p253-b6
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