Acne Scar Treatment
What are Acne Scars?
Acne scarring - the frustrating scars that remain even after you have treated your acne. These can range from discoloured spots that will fade naturally, to permanent scars that leave depressions or raised spots. Acne scars are usually grouped into three categories:
- Acne marks
- Depressed scars
- Raised scars
Types of Acne Scars & Scar Treatment
Acne marks appear as red or brown discolourations on the skin. They are left behind after pimples have cleared. Red marks are caused by small blood vessels, also known as capillaries, forming under the surface of the skin due to healing and inflammation. Brown marks, otherwise known as post-inflammatory hyperpigmentation (PIH) are caused by an overproduction of melanin due to inflammation. Though these will fade on their own, they may take several months to do so depending on your age, skin colour, and genetics.
Treatment for Acne Marks
By boosting cellular turnover with our skincare products, the skin can heal and reduce acne marks at a faster rate. Our skincare ingredients promote healing, cell regeneration and suppress melanin production to ensure that acne marks fade at an accelerated rate.
Depending on your needs, our doctors may prescribe oral supplements to hasten healing while reducing oxidative damage from the environment. Glutathione supplements lighten discolouration by targeting the melanin formation pathway and prevent damage from free radicals and inflammation. Sunblock supplements containing colourless carotenoids will also help prevent excess melanin production and UV damage in scar tissue, which will in turn aid in reducing brown spots.
Vascular lasers like the Dual Yellow and Clarity II selectively shrink and destroy blood vessels while promoting collagen production. They are especially useful in reducing red marks, but help to lighten brown marks too, while also boosting the skin’s texture and tone.
Q-Switch and Pico Lasers
Q-switch and Pico lasers like the Spectra XT and PicoPlus work well in reducing brown marks by breaking down the pigments that cause discolouration. These pigments are then naturally cleared by our body. Such lasers also stimulate collagen production, which speeds up the clearance of red marks while minimising pores, resulting in a brighter skin tone.
Medical facials contain gentle, non-irritating exfoliants and active ingredients to help lighten and heal the skin. This promotes the reduction of acne marks, especially when combined with other treatment options. They are tailored specifically to suit your unique skin type and skin concerns, which will help to reduce acne marks faster than a one-size-fits-all approach.
Depressed or atrophic scars are found most commonly on the face and are a result of a permanent loss of collagen due to destruction from acne symptoms. They are named as such because they leave depressions that sit below the surface of the skin. Depressed scars are generally categorised into the following 3 types:
- Boxcar scars are wide, U-shaped scars with sharp edges that can be shallow or deep. The more shallow they are, the better they respond to treatment, but at our clinic, we are able to treat deep scars as well.
- Rolling scars are wide, with rounded or sloped edges and an irregular, rolling shape. Similarly, they can be shallow or deep, but tend to respond well to treatment compared to other types of depressed scars.
- Icepick scars are narrow, V-shaped scars that tend to be deep. They appear as small round or oval holes, and may be mistaken for enlarged pores sometimes. They tend to be the deepest of all the depressed scars, and can be challenging to treat. However, we have developed a unique combination approach to effectively treat such scars at Harmony Aesthetics Clinic.
Treatment for Depressed Scars
While scarring may seem simple to treat, not all scars will respond to the same treatment methods. For example, what may work for icepick scars will not work on rolling scars, and may in fact worsen their appearance. What makes scar treatment complex is that most people tend to have a mixture of scar types, hence careful and detailed analysis has to be done in order to achieve good outcomes. At our clinic, you are ensured a thorough evaluation before a custom skin treatment program that best suits your needs, lifestyle, and budget is prescribed, to give your skin the treatment it deserves.
For deep icepick and boxcar scars, the main priority is to first make them shallower so that they can respond to other forms of scar resurfacing treatments. Thus, trichloroacetic acid, also known as TCA acid, is used to chemically reconstruct the skin. When high concentration TCA acid is applied to the scar, it causes an inflammatory reaction at the application site, which boosts collagen production and brings up the depth of these scars.
This treatment method involves using a hypodermic needle inserted directly underneath the scar to loosen and break up the fibrotic bands connecting the scar to the underlying tissue. This helps to raise the scar as it is no longer tied to the tissue beneath. The wound healing process from the treatment also promotes collagen production, which helps to fill in the skin and lift up the scar. The treatment area will be numbed beforehand so that little to no pain will be felt during the procedure.
For shallow rolling and boxcar scars, the PicoPlus laser is a highly effective treatment. As it fires in picoseconds, which is incredibly fast, the PicoPlus laser is able to penetrate deeply without harming the top layer of the skin. It utilises Laser Induced Optical Breakdown (LIOB) technology to break down skin cells beneath the surface of the skin and create micro-injury zones. The process of healing in these micro-injury zones promotes collagen production, which helps to lift depressed scars and shrink pores concurrently. Skin texture is thus improved at the same time as scars are re-modeled.
Certain injectable products can help to reduce the appearance of depressed scars by introducing healing ingredients that aid in scar re-modeling, or by directly lifting scars up. At Harmony Aesthetics, we offer the following options:
Containing one of the market’s most powerful skin-healers, Rejuran helps to boost your skin’s healing and inflammation-reducing abilities. It increases collagen production to help lift depressed scars and improve their appearance while preventing scars from reforming. It is recommended to be used alongside other methods to provide an all-rounded, effective treatment plan.
Hailed as an “injectable moisturiser”, Profhilo has the highest concentration of hyaluronic acid (64mg / 2ml) when compared to other similar products in the market. It helps to boost elastin and collagen production for the lifting of depressed scars while offering deep-skin hydration.
Also containing hyaluronic acid, fillers give an almost instantaneous boost to depressed scars by giving them a direct lift. However, the result is temporary, as hyaluronic acid will be broken down naturally by the body in a few months (depending on the type of product). Fillers are best used in conjunction with other treatments to give a more long-term solution to depressed scars.
Raised scars are typically found on the jawline, chest, shoulders and back, and are caused by tissue damage resulting in an overgrowth of scar tissue. They can be grouped into hypertrophic and keloid scars. Hypertrophic scars do not grow beyond the size of the original wound but keloid scars spread into the surrounding normal skin. Keloid scars are usually difficult to treat as they can recur repeatedly if treatment is insufficient or poorly timed, and they are reactive to skin tension. Aggressive, well-timed early treatment, and scar prevention is needed for a good outcome. These are points our doctors take into consideration when formulating your individualised treatment plan.
Treatment for Raised Scars
Corticosteroid injections suppress inflammation and stop cells from further dividing to form new scar tissue. This flattens and softens the scar. However, steroid injections have to be used carefully as they can weaken the tissues around the scar. BTX injections help to reduce skin tension which in turn cuts down on the stimulus for scar overgrowth. Rejuran may be used to prevent keloids from forming in the early stages of wound healing. It achieves this by reducing inflammation and by promoting the regrowth of healthy skin tissue.
The Dual Yellow and Clarity II lasers selectively target and destroys abnormal blood vessels present in scars while keeping the skin surface intact. This cuts down on the inflammation and tissue overgrowth which causes raised scars. Such lasers are typically used in conjunction with injectable treatments to produce an overall better outcome.