Acne Scarring Part I…


Acne scarring is perhaps one of the most distressing skin conditions to have because as its’ name suggests, it leaves a scar and once scarred, the affected skin will never go back to its’ once flawless state.

However, with a greater understanding and knowledge of acne scarring as well as advances in technology, we now have a wide array of tools and options available to improve acne scars and return scarred skin as much as possible to its’ original state.


So what exactly causes acne scarring in the first place?

The short answer to that is inflammation and trauma to the skin resulting in a fibrous process of healing.  The trigger of which is ACNE in this case.

Up to 30% of those afflicted with moderate acne (or worse) can be expected to have scarring.


Acne scarring is often ATROPHIC in nature:  aka Depressed scars.

They can be:

  1. Rolling scars:  Wide depressions with rolled edges

rolling scars

2)  Boxcar Scars:  Wide depressions with sharp edges

box car scars

3)  Ice pick Scars:  Narrow, sharp and deep depressions

ice pick scars

For depressed scars, strong fibrous bands of tissue pull and tethers the skin downwards and as such, treatment is aimed at breaking up these strong bands and releasing this pull of tissue and skin.


Besides being depressed, acne scars can be RAISED and THICKENED as well, although these types of scars are less common.

The 2 main forms of acne scars that are thickened are:

  1. Hypertrophic scars:  Scars that are thickened and generally confined to the area of the acne / injury
  2. Keloids:  Thickened scars that grow beyond the boundaries of the acne/ injury



The treatment of THICKENED scars are usually via injection to flatten these scars.


With this understanding of how acne scars form, we can now proceed to unravel the different methods available for the treatment of  DEPRESSED acne scarring.

  1. Treat your acne !!

We now know that the trigger of scars is acne itself!  Treat your acne early so as to control the inflammation and damage that is being caused to your skin.

Do not wait till the inflammation from acne causes irreparable damage and scarring to your skin!


2)  Do not squeeze your acne / pimples !!

The force from the squeezing of acne can cause increased inflammation which in turn causes more deep tissue damage and thereby increases the risk of scarring.


3)  Subscision

This is a manual method of releasing scars by using a needle to divide the scar tissue beneath the skin.



4)  Venus Viva Radiofrequency Skin Resurfacing


This is perhaps the LATEST technology in machine-driven therapy to treat depressed scars.

Radiofrequency energy is delivered to break up the scars and stimulate collagen regeneration thereby releasing the scars and making them less depressed.

As compared to the traditional CO2 (carbon dioxide) and Erbium lasers, the down time associated with this machine is HALVED that of the traditional lasers.

It is Effective, Quick and has Minimal downtime!

I will discuss more about the Venus Viva in my next post.


5)  MicroNeedle Radiofrequency Skin Resurfacing

For more severe scars, a MicroNeedle Radiofrequency machine can be used to tackle scars that are deeper.

Radiofrequency energy is emitted from the microneedles to break up the scar tissue and stimulate collagen regeneration.

microneedle rf

6)  TCA CROSS Technique

This is a technique where by TCA acid is carefully applied to indiviual acne scars to “fill” up the depression and make the scar less depressed.

This technique is especially useful in Ice-pick scars and some Box-car scars.

The number of sessions required will depend on the severity of the scar.

Video Link Here:  TCA CROSS Technique



7)  Fillers

In certain cases, fillers can be used to fill up depressed scars to smoothen out the skin surface.

Anaesthetic is first administered to the entry point of the area that is to be filled, and then the filler is administered via the entry point to raise the depressed scar.

The advantages of fillers are that effects are seen immediately, and MINIMAL to NO downtime is required.


With these available technologies, acne scarring can now be treated more effectively and with less down time!

Sometimes, a combination of different methods can be utilised effectively to achieve the best results!

Stay tuned for more updates on acne scarring!


















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