[By Tania Hui]

Acne is perhaps one of the commonest skin condition known, affecting up to 80% of those from puberty to their early 20s and up to 5% of older adults. While it seldom impacts greatly on the general health of affected individuals, acne can have tremendous untoward bearings on the social and psychological well-being of many.  The majority tend to recover from acne without any permanent effects but a sizeable handful are left with disfiguring acne scars. Scarring is part of the natural healing process when our skin works to repair wounds.

Henceforth, if the acne is severe, the more chance we have of getting noticeable marks and scars.  There are some topical skin care products and medications that can improve mild scarring, but the truth is, most acne scars can only be treated effectively with skin resurfacing, at times combined with surgical procedures. If you happened to be one of the unfortunate souls plagued with acne scarring, read on for RSB’s list of the best 5 ways to treat acne scarring and help restore a pockmarked face.

1. Chemical Peels

After an acne lesion or a pimple healed, it can leave a dark or hyper-pigmented mark on the skin. Strictly speaking, this is not a real scar, but rather a post-inflammatory change known as Post Inflammatory Pigmentation or PIH. This hyperpigmentation is seen as the skin goes through its healing and remodelling process, which can take up to 6 months or more. If no more acne lesions develop in that area, the skin can heal normally and revert back to its original state and colour. Professional Chemical Peels are excellent not only for lightening these post inflammatory marks but help to reduce oiliness and control new acne outbreak at the same time. In addition, it tackles open pores, uneven skin tone and fine lines too!  A chemical peel is just as it sounds, different types of acids are used individually or in combination Glamour Peel to peel off dead skin cells from the surface so as to increase cellular turnover for new skin to regrow. It can be done at monthly interval by a qualified aesthetics physician to restore a blemish free complexion. It is important to take note of photosensitivity and observe strict sun protection both pre and post peel.

2. Laser Peel

A great option to chemical peeling to treat Post Inflammatory Hyperpigmentation and mild acne scarring is with a Laser Peel.This completely new approach to skin rejuvenation resurfaces and replenishes the skin at the same time with the use of gentle yet deep penetrating laser energy to exfoliate the rough and damaged outer layer of dead skin cells marked with mild acne scars. By shrinking down the sebaceous (oil) glands, laser peels will thus help to reduce surface grease, minimize pore size and refine skin texture. So if you are looking for a safe and effective way to slough off dead cells, deal with discolouration and shrink those pores without using harsh chemicals and with virtually no downtime; there are more than a few good reasons to schedule a laser peel today and get back your glowing complexion.

3. Non- ablative Fractional Laser Resurfacing

Acne scars are classified as icepick, rolling, and boxcar based on their appearance. Here’s a brief description to help you roughly identify yours but this is best done by a qualified practitioner or dermatologist.

  • Icepick scars are narrow and sharp, so called as they give the impression of the skin surface being punctured with an icepick. They are usually narrower than 2 mm and extend into the deep dermis. Icepick scars are notoriously difficult to treat as they are usually too deep to correct with skin resurfacing treatments.
  • Boxcar scars are round to oval depressions that have sharp vertical edges. Unlike icepick scars they do not taper to a point at the base. Shallow boxcar scars are 0.1-0.5 mm in depth and can be successfully corrected with laser resurfacing techniques while deeper ones might need to be further treated with subcision or other surgical forms of full thickness treatment.
  • Rolling scars occur as a result of tethering of otherwise normal-appearing skin to the subcutaneous tissue below. This process gives the skin a rolling or undulating appearance. They should be corrected by breaking up the subcutaneous fibrous bands with subcision and when combined with laser resurfacing, the results are often gratifying.

The non- ablative Fraxel Restore Laser system is the world’s pioneer fractional resurfacing laser that represents a new breakthrough as it offers patients the positive results of ablative resurfacing with the low-impact benefits of non-ablative therapies. Unlike old ablative lasers that remove the top layer of skin, this innovative system produces tiny, microscopic sites of thermal impact separated by areas of unaffected, healthy tissue when it’s applied to the skin. The spared healthy tissue between treatment zones contains viable cells that jump start and promote rapid healing of the outer skin layers and thus tackle moderate to severe deep acne scarring.

“Clinical studies suggest that 3 to 5 treatments spaced about 4 to 6 weeks apart is required to produce a gradual remodelling of dermal matrix components,” explains Dr. Chua Han Boon, medical consultant with The Sloane Clinic. “The skin repair procedure for treated skin and scarred tissue is accumulative and patients do continue to show improvement 1 to 3 months after a course of successive sessions.”

4. Ablative CO2 Laser Resurfacing

The most popular laser types used for resurfacing of acne scars are the carbon dioxide (CO2) and erbium:YAG (Er:YAG) lasers and they remain the gold standard for treating severe acne scarring. Lasers work by essentially burning the top layers of skin to a precise depth. The skin then heals, replacing the burned layers with newer appearing skin. However, the correct post-operative care of skin that has undergone laser resurfacing is a fairly long drawn process with significant downtime not acceptable to many. Things are changing with recent advances made in laser technology. Unlike traditional CO2 and other ablative laser resurfacing technology, Mixto MicroResurfacing laser combines advanced fractional CO2 technology with a high-speed computer scanner to deliver a precise matrix of microlaser pulses which erase skin imperfections and activate skin rejuvenation, while facilitating rapid skin healing with results that rival or are even superior to those achieved by traditional ablative options but without the much dreaded downtime. As a bonus to scar treatment, what patients notice and love is the immediate tightening of the skin! This is consequent to the immediate contraction of collagen fibres which reduces wrinkles and loose skin. In fact, skin laxity is noticeably improved even after a single session.

5. Minor Surgical Correction

There are two minor surgical procedures that can be employed to deal with scars that are known to respond poorly to laser resurfacing techniques.

  • Subcutaneous incision, also known as Subcision, is used to break up the fibrous bands that cause rolling scars. Subcision is performed under local anaesthesia by inserting a bevelled needle under the skin so that it is  parallel to the skin surface. Staying in the plane between the dermis and the subcutaneous tissue, the needle is gently advanced and retracted in a piston-like motion to cut or break the tethering bands. This procedure causes bruising which may take 5 to 7 days to fade away.
  • Punch excision is another method of surgically correcting acne scars especially for deep ones such as icepick and deep boxcar scars. This procedure uses a punch biopsy tool which is basically a round, sharp “cookie-cutter” instrument. The size of the tool is matched to the size of the scar to include the walls of the scar and under local anaesthesia, the scar is excised with the punch tool and the skin edges are sutured together. The newly produced scar eventually fades and may not be noticeable.

These surgical modalities usually give remarkable results when done in combination with laser resurfacing techniques.

 

* Selected as Editor’s Choice Jun 2013*

 

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5 thoughts on “Make Acne Scars disappear with these 5 acts”

  1. I have tried the Ablative CO2 Laser Resurfacing treatments. So this is my third laser in the last 2 yrs. going through the itchy stage as I type this. I know it’s absolutely horribly going through this but I do know what to expect and being prepared will help you through. Having lots of ice on hand and plenty of aquaphor will help. I also find that vitamin e should helps with the itching. This time they went very aggressive on my chin. I’m a bit concerned as it is almost purple in color and not looking like its going to peel anytime soon. When I had my first laser, I had realistic expectations in hoping I would see 25% improvement. You really have to be patient and understand you won’t see the full results until months after. Each time I’m more amazed with about 50% improvement. I suffer from cystic acne which has left scarring. After the two lasers, I haven’t had to wear foundation. I’m on my 4th day and I’m hoping for even more improvement.

  2. I have tried several treatments for my scars and I can tell you what works and what does not. Firtsly, if you expect acne scars to improve 100% then you are in for a disappointment. But if you have realistic expectations, it may be a fulfilling experience to embark on some treatments. I have tried chemical peels– it helps for superficial brown marks, nothing for the pitted scars. I have tried Fraxel Restore lasers– not bad, helps pited scars by about 30-40%. recently, I tried Mixtp laser at the Sloane Clinic and I am floored. The improvement was one of the best i have seen– about 40-50% after 3 sessions. The downtime is a little more than the rest but as I say, no pain no gain.

  3. Does creams help? I am now trying a hydroquinone cream on my pimple scars, and I am hoping to see some change. it has been 3 weeks but nothing so far…. 🙁

  4. Hello, I am 20 years old and ever since I was about 12-13 I have experienced horrid acne which eventually has led to the scars on my face today. On top of the reoccurring acne I am pale, and have an incredibly hard time tanning. So the acne is bright red on a white palette which makes it less than subtle. The embarrassment has led to me caking on makeup to hide the acne scars and the acne

    itself. i loathe putting on so much makeup, it feels heavy on my face and makes me feel somewhat like a clown. However, the random red marks on my face along with the scars and acne make it nearly impossible for me to go out in public without makeup on. While out and about I was complaining about my face and how it bothers me and my mom suggested a chemical peel. I had never thought about this solution so immediately I began looking at local doctors and spas that performed chemical peels and compared prices etc. The place that I will be going to usually charges $110 for a chemical peel but with a consultation they offer a $65 off a facial which I am using towards the peel.

  5. I am in the midst of a series of six chemical peels with microdermabrasion and have had fantastic results (the cost I posted is for all six combined, they are $125 each with no charge for the sixth).

    I originally went to take care of brown spots under my eyes caused by the sun and tanning in tanning beds. I did not see a big difference after the first session. That session was pain free, I felt some tingling. Because I did well with the first session, we stepped up the percentage of the peel in my second session (went from 40% to 70%). In my second session, there was a lot of burning. Nothing terrible, but I could definitely feel it. My face was very red when I left and I had scabs the next day that lasted for several days. I was a bit nervous to return but I am so glad I did.

    My third and fourth sessions, the 40 and 70% were mixed and she didn’t leave it on for long. In my third session, I lost at least 7 years off my forehead. It was a couple days after the peel and microdermabrasion that I noticed how fantastic my forehead looked. I also noticed my skin color started to really even out, as I have always had red patches on my cheeks. After my fourth session, I noticed the brown spots are hardly visible anymore.

    I’m having my fifth treatment in a few days and I cannot wait. My 20 year high school reunion is in two weeks and I feel great!

    I went to get rid of the sun spots and have gotten much more than I thought I was paying for. My skin is smoother and prettier and younger. She told me that after my series of six, I can come in once or twice a year to maintain my skin. I am very happy with my results! 😀

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