What are acne scars and how to treat them?
Stop doing just 1 treatment for your acne scars!
Acne scar treatments should be individualised and customised for each patient based on
1. Scar type
2. Skin type
3. Location of scarring
4. Ongoing acne
Ice pick scars are usually narrower as they are deep with sharp edges. They sometimes look like deep pores and can vary from superficial to deep (dermal levels). Treatments are designed to work at the base of the scar, gradually "filling it up"from the base
TCA cross (Chemical Reconstruction of Skin Scarring) - Using high concentration of acid applied to the base of the scar, the acid causes coagulation of the scar tissues and stimulates new collagen production.
With the same idea in mind, an ablative laser (c02 or ErYAG) using pin-point irradiation to the base of the scar can achieve the same effect while avoiding complications like PIH (post inflammatory hyperpigmentation) and prolonged redness. (reference 1)
Boxcar scars are depressed scars with steep vertical/ well-defined edges. When treating such scars, the aim is to reduce the depth of the scarring as well as treat the sharp edge of the scar.
Subcision helps to treat deep (dermal) scarring and the added polynucleotide (aka Rejuran) helps stimulate wound healing and collagen remodelling. This can be done in combination with an ablative laser to improve skin texture and to treat the scar edges. (reference 2)
Rolling scars are broad depressed scars with ill-defined/sloping edges and often undulating in appearance. Dr Mark recommends subcision to specifically treat this type of scarring.
Hypertrophic scar/ Papular scars are more common in the nose and chin area. They look like raised, flesh coloured bumps. They are often mistaken for and treated wrongly as acne. They respond well to ablative lasers and I often combine this with Polynucleotide injections in the same setting for a synergistic effect.
1. Mohammed G. Randomized clinical trial of CO2 laser pinpoint irradiation technique with/without needling for ice pick acne scars. J Cosmet Laser Ther. 2013 Jun;15(3):177-82. doi: 10.3109/14764172.2013.793584. Epub 2013 May 8. PMID: 23581798.
2.Kim JH, Jeong JJ, Lee YI, Lee WJ, Lee C, Chung WY, Nam KH, Lee JH. Preventive effect of polynucleotide on post-thyroidectomy scars: A randomized, double-blinded, controlled trial. Lasers Surg Med. 2018 Mar 25. doi: 10.1002/lsm.22812. Epub ahead of print. PMID: 29574803.