Did you know that scars are a part of your body’s attempt to heal the skin? It is formed as a result of wound repair in the skin. Unfortunately, acne scars resulting from severe acne may last a lifetime without treatment and are not easy to remove. With over 40 years of rich experience in medical and aesthetic practice, our doctors are pleased to offer answers to frequently asked questions about acne scar treatments and scar laser removals.
The Eeva Approach is a holistic and personalized strategy for ensuring successful acne scar removal in Singapore outcomes, allowing our patients in Singapore to feel assured they are in good hands. Our doctors start your acne treatment with a thorough evaluation of your acne scars. Following that, we design a treatment plan to heal and remove your acne, followed by a long-term plan to avoid recurrence and keep your skin clear.
Continue reading to find out everything you need to know about your acne scars and what you can do about them.
How Do Acne Scars Form?
Most wounds heal without a scar, but they form when the dermis is damaged. Acne scars arise due to inflamed lesions such as cysts, papules, or pustules. When the follicle becomes swollen due to excess oil, bacteria, and dead skin cells, the pore swells and causes the follicle wall to break. This results in an inflamed blemish. If the rupture is superficial, the wound will heal quickly. However, if the rupture in the follicle wall is deep, the infected material spills into the dermis and destroys healthy tissue.
The skin attempts to form new collagen fibres to repair the damage to the dermis, resulting in a scar. The new scar tissue will have a different texture and quality compared to normal skin.
Thus, the greater the inflammation, the higher the chances of scarring. Acne breakouts that take a long time to heal may also result in scarring.
Are There Different Types of Acne Scars?
Yes, here are the different types of acne scars:
- Atrophic scars
Atrophic scars are shallow and flat depressions just below the skin’s surface. There are three types of atrophic scars:
- Boxcar scars – box-like depressions with defined borders caused by widespread acne and frequently occurs on the lower cheeks and jaw.
- Ice pick scars – deep and narrow scars pointing downwards into the skin’s surface, which are very hard to treat. Commonly found on the cheeks.
- Rolling scars – Has sloping edges making the skin appear uneven, with rolling depressions.
- Keloid and hypertrophic scars
These form as raised lumps of scar tissue in place of the acne. It is the result of scar tissue buildup. Keloid scars are much larger than the original acne, while hypertrophic scars are the same size. Keloids are a more severe type of raised scar that continue growing even after the initial wound healing. Hypertrophic scars might be caused by deep wounds and are formed due to collagen overproduction.
Both scars commonly appear on areas like the back, chest, jawline, and shoulders. Darker-skinned patients are more prone to this type of scarring.
- Post-inflammatory hyperpigmentation
This isn’t a true acne scar, but it is a dark mark left behind after the acne has healed. It’s quite common in people with acne and appears as a flat area that varies in colour, depending on your skin type.
Which Parts of the Body Do They Occur On?
Acne scars can happen anywhere you have acne, most commonly found on your face, back, shoulders, neck, and arms. There are some hard to reach areas on your face, like the nose. Depending on the severity, nose scars are sometimes treated with Venus Viva RF with PDRN penetration, microinjection of Rejuran or Sylfirm treatment. Check out our article to find out more about how to treat acne scars on your nose.
Are Acne Scars Preventable?
Yes, not to worry, you can prevent acne scars. The first step is to see a doctor for your acne as soon as possible. It will prevent acne from getting more severe, resulting in blemishes. Don’t pop your pimples, as it will worsen inflammation and increase the chances of scarring. Please don’t pick a scab off a wound, too, as it will extend healing time. Avoid irritating your skin, and always avoid harsh skincare or aggressive scrubbing. In the event of deep breakouts, do not waste time on OTC treatments and seek expert medical help immediately.
What Are The Most Effective Acne Scar Removal Treatments Available?
Our doctors have curated a list of acne scar removal treatments in Singapore:
- Subcision with Rejuran Healer, skin boosters, or fillers
Deep acne scars are caused by fibrous bands formed during inflammation. These fibrous bands “pull” the skin’s surface downwards. A subcision breaks the bands releases the skin from being tethered downwards, allowing healthy tissue formation and collagen regeneration.
Rejuran Healer can then be injected for collagen repair, regeneration, and remodelling. This results in the progressive lifting of depressed scars with smoother skin. It is a type of filler containing Polynucleotide derived from Salmon DNA, promoting skin regeneration, elasticity, and a healthy glow.
Apart from the Rejuran Healer, patients may choose to do skin boosters or soft fillers for an immediate scar lift, especially very deep stubborn scars. A skin booster is a type of soft filler treatment that micro-injects hyaluronic acid into the skin to hydrate and plump the skin. This raises depressed scars and stimulates collagen production. Check out our article on how fillers or skin boosters can improve acne scars.
Sylfirm is a Silicon Valley technology that uses an ultra pulsed microneedling radiofrequency device for scar repair and collagen remodelling. By repairing the skin’s basement membrane, it can restore skin structure and remove skin abnormalities.
- Venus Viva NanoRF
Venus Viva NanoFractional Radiofrequency is an FDA-approved Israeli Technology for scar repair. It uses radiofrequency to damage the existing collagen in your skin to trigger the rebuilding of newer and more collage. This results in skin resurfacing, with acne scarring becoming less noticeable. Your skin also becomes smoother and clearer.
- Microinjection of Rejuran S (the concentrated version of Rejuran Healer)
Rejuran Scar contains long-chain polymeric nucleotides that are derived from salmon DNA. These nucleotides can bind water, induce collagen production, and restore skin structure by plumping up depressed acne scars. Please read this article to find out why our patients like Rejuran Scar Treatment.
- Long pulsed laser treatment
A long-pulsed laser treatment breaks apart scar tissue, improving blood flow and reducing skin inflammation. It also stimulates collagen production and encourages the remodelling of collagen to replace damaged and scarred tissue. After treatment, your scars look less raised and red. The therapy also promotes skin healing.
In a microneedling treatment, tiny needles are glided over the skin to break down collagen, which has resulted in uneven scars. It then stimulates the repair process by immediately boosting collagen production. This results in plumped up and even skin tone and texture and less obvious acne scars.
- Korean CuRAS Laser
This is especially useful for removing acne marks. It is effective in pigmentation reduction and skin brightening, resulting in the removal of acne scars.
Other benefits of the treatments mentioned above include smoother skin with increased elasticity, firmer skin, pore reduction, and improved acne condition. If you wish to go beyond acne scar removal, you may want to consider speaking with your doctor to include the penetration of salmon PDRN after doing Sylfirm or Venus Viva RF. This enhances healing, reduces downtime and side effects of skin dryness. Please read our article to find out how Sylfirm and Venus Viva RF can help your acne scars.
Another effective complement would be the add-on of LDM cellular therapy for enhanced cellular skin healing and elevated healthy proteins (HSP). For more information on these treatments, please check out the Eeva Acne Scar Removal Treatment Clinic.
How Many Sessions Do I Require?
The number of sessions required will depend on the severity and type of acne scars and your current skin condition. The treatments are typically performed once a month. Mild to moderately deep acne scars usually require around 4-6 sessions, while moderate to severe scars will require more than six sessions.
Deep scars typically need several sessions of subcision with Rejuran to elevate the wounds. Once the deep scars become superficial, you can consider doing a resurfacing procedure with Sylfirm or Venus Viva. Most patients have a combination of different types of imperfections. Therefore, a variety of treatments at various stages will yield the most optimal results.
How much improvement can I expect from the acne scar treatments?
This would depend on the severity, types of acne scars, and your pre-existing skin quality. With a consistent and regular treatment plan in place, you can expect around 50-80% improvement. Unfortunately, because acne scars are so hard to treat, there is no 100% cure or reversal.
If my skin is dry and sensitive due to oral isotretinoin, can I still proceed with acne scar removal treatments?
Isotretinoin is usually prescribed for severe acne, and a side effect includes having dry and sensitive skin after completing a course of isotretinoin. Our doctors recommend doing a subcision with Rejuran or skin boosters to overcome the dryness and restore skin hydration.
Meanwhile, if you are still on isotretinoin, avoid heat energy-based ablative treatment, which impairs healing, leading to more redness and irritated skin. Please read our article to find out what treatments are available while you are still on oral isotretinoin.
I have acne and acne scars, can I treat them in the same setting?
If the acne is predominantly active, it’s best to treat the acne first till the condition is under control, followed by acne scar removal treatments. If your acne is mild, then you can manage both acne and acne scars concurrently. For instance, you could do either laser treatment or medical-facial in conjunction with acne scar removal treatments.
What can I expect during my first consultation with the doctor?
Here is a list of steps that the doctor will guide you through:
- Detailed medical history taking
- The doctor may request to find out more about your past medication or treatments
- A thorough physical examination to assess the types and severity of acne scars, and the presence of acne
- Discuss a suitable acne treatment plan customized to remove your acne scars while meeting your budgets and expectations.
What is the treatment procedure like?
For acne scar removal, the doctor will first apply numbing cream for 40 minutes to minimize treatment discomfort before proceeding with the treatment. In the case of dark marks, removing them is a pretty comfortable procedure with no downtime.
Is there any downtime?
Most acne scar removal procedures are minimally invasive, with little downtime. There may be some swelling or redness after an injection, but these should heal relatively fast.
How do I care for my skin after an acne scar removal treatment?
It is important to protect your skin after treatment, as this will drastically reduce downtime. Applying targeted skincare to enhance collagen repair is very helpful. Avoid the sun as much as possible, and do not do any hot yoga or sauna for a week.
How often will I need to return for treatments?
This will depend on your doctor’s recommendation, but most doctors recommend maintenance therapy even after the acne scars are removed to ensure that your skin is fully healed.
Do over the counter (OTC) scar removal creams work?
If you have dark marks that are not severe, OTC creams containing lightening ingredients such as Vitamin C, Arbutin, and Kojic Acid may be helpful. However, it usually takes very long to see results.
If your scars are deep and depressed, no amount of creams will help. You will need to go for in-clinic minimally invasive treatments to activate collagen formation for structural skin improvement and lift depressed scars.
Consult our doctors now
Our doctors deeply care about the holistic wellbeing of our patients and delivering expectations. Emerge from our clinic with clear and radiant skin after undergoing our acne scar removal treatments. We look forward to hearing from you soon.
- “Acne Clinical Guideline.” American Academy of Dermatology, 2021, www.aad.org/member/clinical-quality/guidelines/acne.