Acne Scarring Treatments That Your Doctor May Recommend


Woman with Acne Scars on Her Face

By Dr Lai Wen Shen

Acne scars, the lingering aftermath of severe acne episodes, can profoundly impact not just the skin but also a person’s self-esteem. Acne scars come in different forms and severity, and they are known to be notoriously difficult to completely eradicate. So what are some of the available acne scarring treatments in the market and what should you know about them? 

In this article, we delve more into four common treatment options – radiofrequency (RF) microneedling, laser resurfacing, skin boosters and chemical peels. 

Understanding acne scarring

Acne scars are not to be confused with acne marks, which are dark marks left behind after inflammation, or post-inflammatory hyperpigmentation (PIH). Acne scars manifest as enduring depressions on the skin that occur after acne inflammation damages the surrounding skin and tissue.

There are different types of acne scars, from rolling scars to ice pick and boxcar scars. In treating these scars, we have to identify the types of scars and which treatments would be most suitable.

Illustration of Fibrotic Scarring vs Volume Loss

4 common acne scar treatments and how they work

1. Radiofrequency Microneedling

RF microneedling combines traditional microneedling with the use of RF energy.

Microneedling,  which involves ultrafine needles to create micro-injuries, stimulates the skin’s healing process to generate collagen and elastin. Collagen provides structural support to the skin, while elastin allows the skin to stretch and recoil.

RF energy delivered to the deeper layers of the skin through the microneedles enhances this process by introducing controlled thermal injury. This heat energy fosters tissue contraction to tighten the skin, and stimulates collagen remodeling. 

Illustration of how radiofrequency microneedling works on the skin

The combination of microneedling and RF energy allows for targeted treatment of the skin’s surface and deeper layers. This makes RF microneedling a great option to address not only acne scars but various skin concerns such as fine lines,  wrinkles, and skin laxity. It is a highly versatile treatment option that is customisable based on the person’s needs and skin condition.

2. Laser resurfacing

Laser resurfacing eCO2, or fractional CO2 laser, is another commonly used treatment option for acne scars.

High-intensity laser energy is emitted by the CO2 laser machine in short pulses. This laser energy is absorbed by the water content in skin cells, vaporising targeted cells and initiating an exfoliation and tissue remodelling process. Controlled injury from the laser stimulates the production of collagen.

As the skin heals from the laser treatment, the new collagen fibres help to remodel and rebuild the skin’s structure. This process results in smoother and more even-looking skin.

Fractional lasers use a fractional pattern of laser beams, which means only a fraction of the skin’s surface is exposed to the laser energy. This creates microscopic columns of thermal injury, known as microthermal zones (MTZs) in the skin. These zones are surrounded by untouched, healthy skin tissue. As only a fraction of the skin tissue is damaged by the laser energy, this fractional approach allows for faster healing, as well as a lower risk of complications, as compared to traditional ablative lasers that damage the entire skin surface.

3. Skin boosters

Doctor performing Skin Booster Injection on Woman's Face for Skin's Natural Grow with Radiance Revival

Most skin boosters contain hyaluronic acid, a molecule known for its water-attracting properties. By enhancing hydration within the skin, these treatments improve skin texture, plumpness, and elasticity of the skin. Akin to how a dehydrated orange peel can appear more wrinkly when dehydrated, the acne scars on our skin can appear more obvious when our skin is dry.

Apart from improving hydration, skin boosters can also stimulate fibroblasts, the cells responsible for producing collagen and elastin. By promoting collagen synthesis, skin boosters encourage the skin to rebuild and repair itself. Boosting this remodelling process helps to replenish the loss of volume in some of these damaged skin,  leading to a smoother and more even skin surface in the long run. 

There are also skin boosters that contain polynucleotides (PN), a content that helps support DNA repair and cellular functions. They promote skin cell growth by inducing fibroblast and collagen production while healing the skin structure. Its high viscosity makes it suitable for treating depressed scars, improving the physical appearance of sunken acne scars.

4. Chemical peels

Chemical peels induce controlled injury to the outermost layers of the skin by applying a specialised chemical solution to the skin. These chemical solutions include alpha hydroxy acids (AHAs), beta hydroxy acids (BHAs), trichloroacetic acid (TCA), and phenol. There are different concentrations and preparations for each of these solutions, and they each have their own degrees of penetration and exfoliating properties.

Controlled exfoliation leads to the removal of the outermost layers of skin, leading to skin rejuvenation, improved texture, and a reduction in various skin imperfections. This process triggers the body’s natural healing response, leading to increased cell turnover and the production of collagen and elastin fibres. This helps to improve skin texture, firmness, and elasticity.

Which acne scar treatment is the best?

Effective acne scar treatment hinges on individual factors, such as scar type, severity, skin type, medical history, and desired outcomes. The choice of treatment varies based on each person’s unique circumstances. Multiple sessions are often recommended to achieve the best results. In cases of severe acne scarring, a combination of treatments may be needed. 

For a tailored approach to addressing your acne scarring, it’s advisable to seek guidance from a skilled and informed medical professional who is well-versed in the array of treatment choices. This personalised consultation ensures that your treatment plan aligns precisely with your unique requirements, paving the way for the achievement of your aspirations for a rejuvenated and more vibrant complexion.

Dr Lai Wen Shen is an Aesthetic Doctor at Mizu Aesthetic Clinic.

Dr Lai’s experiences span a comprehensive range from General Surgery, Orthopaedics Surgery, Obstetrics, Gynaecology, Internal Medicine, Paediatric Medicine, to both Adult’s and Children’s Emergency.

Through his practice across various disciplines, he developed a keen interest in aesthetic and primary care medicine. His pursuit of aesthetic medicine stems from a profound sense of fulfilment when he applies his skills and knowledge to help his patients achieve a sense of confidence and wellness.

Medical aesthetics became a natural progression and he decided to join Dr YZ Tan and his team at Mizu to further a shared vision of helping patients attain their goals with minimally invasive procedures to achieve maximal results.

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