How to treat acne scars in Singapore: Types of scarring, best healing methods, and everything else you need to know according to a dermatologist

How to treat acne scars in Singapore: Types of scarring, best healing methods, and everything else you need to know according to a dermatologist


Text: Emily Heng

Image: Instagram | @retouchingacademy

If a breakout is the equivalent of an unwanted party guest, then acne scarring is its oblivious brother who lingers long after the festivities have wrapped. Often attributed to a bad case of restless fingers that won't stop popping or picking at a zit, it appears that its formation is actually a lot more complex than previously presumed.

"Long-lasting acne scars are actually the result of recurring cystic acne," Dr Liew Hui Min, founder and accredited dermatologist of HM Liew Skin & Laser Clinic, sets the record straight. "Contrary to popular belief, surface blackheads, whiteheads and pimples can be removed without scarring." She is, however, quick to point out that “self-inflicted picking and popping, does worsen and affect how deep the scar will be."

And while that answers the biggest question we have, it barely scratches the surface as to what acne scarring truly is. We get Dr Liew to delve deep into the matter below, uncovering the differences between the numerous types of scarring, to the best methods of removal — if even possible. Fingers crossed.

How do acne scars form?

Inflammatory acne — i.e. angry, red bumps and cystic types — are commonly responsible for scarring. See, what happens is that inflamed acne is caused by skin pores that become engorged with excess oil, dead skin cells and bacteria. The superficial layer of the skin then becomes damaged due to the severity of the inflammation, usually worsened by self-inflicted picking of the bumps. This, thus, leads to impaired and poor healing of the skin that results in scarring.

What are the different types of scarring that can occur from inflammed acne?

There are three: ice-pick scars, rolling scars, and boxscars. Ice-pick scars are the deepest of the lot, and come with a narrow opening. Its depth is often caused by constant self-inflicted picking, making them the trickiest to handle. Rolling scars have broad depressions and sloping edges — they cause the skin texture to appear uneven. Boxscars, which have broad depressions and defined edges, occur due to chronic inflammation in the same area.

Does the severity of the scarring affect its natural healing rate?

Most definitely. The more severe an acne is is, the longer it takes to heal. Note that active acne has to heal first before scarring treatment can be applied. Otherwise, it can slow the healing process.

Is it possible to get rid of acne scarring entirely?

Entirely? Nope. There are, however, methods one can employ to help reduce the appearance of acne scarring drastically. Dr Liew recommends a different course of action for each type of scarring. Those with ice-pick scars should ask for a punch excision with a high concentration of trichloroacetic acid, done under local anesthesia. Boxcar scars on the other hand, will fade with chemical peels, a fractional CO2 laser, RF microneedling or even dermal fillers. Individuals with rolling scars will benefit from subcision procedures and/or RF microneedling. Basically, the general idea behind them is to create localised damage to the skin with either a laser or chemical — they encourage the skin to heal and scars to shrink through the formation of collagen.

Can at-home remedies or over-the-counter products help shrink acne scars?

Not really, unless the scars are superficial scars as opposed to deep scars. The ever-popular topical retinoid present in acne creams will only work on very mild scarring.

Can other types of scarring — sustained through falls or hot oil, for example — fade with time and treatment as well?

Yes, it is possible to reduce the appearance of such scars. First degree burns, for example, tend to heal with time as long as there is no skin infection. This is why it is important to seek medical help immediately after experiencing a burn so as to treat any infection actively. Scars and dark patches of this caliber can also be lightened with a variety of treatment procedures, though it is recommended a dermatologist is consulted first as this is best handled on a case-by-case basis.