Acne scars, just when you think you can put behind your past battle with those bright red protruding blemishes, they never fail to leave without permanent scarring to remind you of those times. There are many different types of Acne scar treatments available but let’s first find out why do acne scars form?
Why do acne scars form?
Acne lesions are inflamed blemishes due to skin pores blocked with excess sebum, dead skin cells, dirt and bacteria. This causes the pore to swell, breaking the follicle wall, causing a rupture. Shallow lesions heal more quickly, but deep lesions can discharge infected substances into the surrounding true dermis layer, causing much destruction into the nearby healthy skin tissues. In order to heal the damage, the skin forms new collagen fibers, which usually result in a rougher surface. As such, the greater the inflammation of the lesion, the higher the chances of acne scarring to occur.
Is it really an acne scar?
After a pimple has healed, sometimes what is left behind is a dark pigmented patch. This is known as post – inflammatory hyperpigmentation (PIH). The inflammation caused by the acne increases melanin production in that part of the skin. PIH usually will lighten on its own with time (weeks to months) or can improve with Q-Switch Laser. True acne scars on the other hand is a depressed scarring that develops and will not improve on its own.
What are the types of acne scars?
There are many types of acne scars, but typically, they are categorized into two types: 1) Atrophic acne scarring, which is depressed scarring, whereby acne scars develop due to loss of skin tissues. Examples are:
Ice Pick Acne Scars
which are deep, very narrow scars that extend into the dermis layer of the skin, making the skin look as if it is pricked by a sharp object.
Boxcar Acne Scars
which are wide dents with steeply angled sides, with the appearance of pits.
Rolling Acne Scars
which are wave-like depressions, looking like multiple hills on the skin.
2) Hypertrophic acne scarring, also known as raised scarring or keloidal scarring, whereby there is an overproduction of scar tissue, causing bumps on the skin.
What are the treatment methods for Acne Scars?
There are many different treatment methods for acne scars, each targeting a different kind of acne scar.
1) Q-switch ND Yag Laser ( pigment laser)
It targets melanin in the skin and breaks it down, lightening the pigmented area. Hence, this is typically used for PIH marks instead of acne scars.
2) Fractional CO2 Laser ( acne scar laser treatment)
It uses CO2 laser beam and pixellates it into little shafts of light, penetrating deep into the skin. The skin will then undergo acne scar remodelling to replace the damaged skin, using tissues from the surrounding healthy skin. At the same time, the body will regenerate collagen beneath the surface of the skin, to heal the ablated areas. This skin rejuvenation process will take over a duration of weeks to months, resulting in skin that appears to be smoother and tighter. Immediately after the treatment, mild redness and a slight tingling sensation might be felt. After 2 or 3 days, scabbing may occur, which will usually be peeled off in about 5 to 7 days for appearance of new skin, or as the chinese calls it “Fresh Skin Beneath The Shell”. This is usually used for most types of acne scars, especially boxcar acne scars.
The micro-needles of the machine are insulated, except at the end of the tips which emits RF energy, preventing damage of the surrounding skin while targetting directly into acne scars. These micro-wounds damages scar tissues and boost collagen production of the skin, allowing the skin to heal and fill up depressed acne scar areas, and gives an additional benefit of skin lifting. This treatment will result in mild redness of the skin within 2-3 days. As such, this acne scar treatment method is best used for rolling scars, which usually gives the appearance of sagging skin. This method of acne scar treatment is especially favoured in individuals who cannot afford the downtime of up to a week. Also known as the weekend treatment, patients usually come in on fridays after work for the acne scar treatment and find that the redness has mostly dissipated by the following monday. Do note that this varies between individuals. Some improvements in the acne scar can be seen immediately after the treatment, this is usually due to slight oedema ( or swelling) of the superficial skin surface. True results take 3 months to be seen, as the body requires that amount of time to create new collagen tissue for the treated acne scars.
4) TCA Chemical Peel (CROSS technique)
The CROSS (Chemical Reconstruction of Skin Scars) technique uses Trichloroacetic Acid (TCA) to conduct a medium to deep chemical peel, causing a local inflammatory reaction that promotes collagen synthesis to improve on acne scar. Slight redness and peeling of the skin can be expected a few days after the treatment. As TCA CROSS treatment is a specialised focal technique, it can be used to target individual deep acne scars by causing scar tissues remodelling. Therefore, this treatment is best used for icepick scars or deep boxcar scars.
This acne scar treatment is used to breakdown acne scar tissues that are tethered down within the skin layer with the use of a needle. This releases elastin fibres and stimulate collagen growth, giving depressed acne scars an improvement in appearance. Temporary bruising and needle marks can be resulted at the end of the treatment. This treatment is typically used for most depressed acne scars.
6) Acne Scar Filler
Hyaluronic Acid is usually used to fill up depressed acne scars for a quick-fix, to fill up the volume loss of the skin due to acne scars and blend them in with your normal skin. It is appropriate for all skin types and tones and has one of the shortest downtime and fastest results for depressed acne scar. Common brands and types of filler used for acne scars include Revanesse Pure, Restylane Vital light. This is injected directly into the acne scar. The injection method is similar to subcission and does give a slight subcission effect. Depending on the number and depth of acne scars present, one may typically need 1-2cc of fillers to improve the acne scars.
7) Steriod Injection
Acne may result in thickened, keloidal scars. This acne scar treatment is typically used for raised acne scars, to breakdown excess scar tissues, resulting in a smoother surface. One to four sessions may be required every three to four weeks.
What is the best acne scar treatment method for me?
The best acne scar treatment will be a combination of the above acne scar treatments, as each treatment targets a different type of acne scar. Consult a certified medical practitioner to obtain a targeted treatment best suited for your skin. Is one session of acne scar treatment sufficient? It is usually recommended to do at least 5-7 sessions of acne scar treatments to get better results and smoother skin.
What are the post care tips that I should take note of after having acne scar treatments?
As most acne scar treatments will damage the skin surface as part of the resurfacing process, it is very important for you to take good post care practice and reduce the risk of undesired complications. For the 1st week: 1) Use a gentle cleanser that is free from micro beads, salicylic or glycolic acid to prevent damaging the sensitive skin. 2) Apply a thin layer of prescribed antibiotic cream over the treated area to reduce risk of injection. 3) Apply the quick recovery cream to soothe the treated area and provide the required nutrients for skin repair. 4) Always finish with a layer of sunblock (SPF 50 and above) to protect the skin in the morning. It is very important for you to avoid prolonged sun exposure, to prevent permanent skin discolouration.
Will my skin ever be completely smooth?
Your skin condition will most definitely improve but will most likely leave a slightly noticeable appearance.
How do I achieve maximum results for acne scar treatments?
Typically for 1 acne scar treatment session, there will be about 5-10 percent improvement ( varies between individuals). As such, in order to achieve maximum results, on average 5-7 acne scar treatment sessions are expected. It is also important for you to use the appropriate acne scar treatment for different types of acne scars. Lastly, there will be gradual improvement of the skin appearance over a period of 2-3 months after each acne scar treatment, hence time also plays a great factor. Contact us at 68159922 (T) 88669922 ( M) or drop us an email at firstname.lastname@example.org for a consultation to find out more about your acne scars and how treatment can help to reduce these unsightly scars.