Conditions We Treat

Acne Scars

At Livingstone Dermatology, we understand that your skin is a reflection of your health and well-being. We are committed to the latest advancements in dermatological science, and dedicated to providing you with quality care.

What is Acne?

Acne is a common skin condition characterized by the development of pimples, blackheads, whiteheads, and, in more severe cases, cysts and nodules. It primarily affects areas with a high concentration of oil glands, such as the face, chest, and back.

What are acne scars?

Acne scars are the aftermath of inflammation caused by acne blemishes. They form when acne damages the skin tissue, especially during deep breakouts or picking at our skin. As the inflammation subsides, your skin will heal itself, acne scars may be left behind in their place.

Depending on your body’s wound healing capabilities, the look of the scars may vary. The most observed acne scars are atrophic scars, which are formed due to loss of tissue in the area of scarring [2, 3].

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Types of acne scars

Depending on the wound healing mechanisms of your body, you may end up with atrophic scars, hypertrophic scars, or keloidal scars.

Atrophic scars — caused by loss of collagen, which forms the familiar indented or depressed scars. They can be further divided into scars based on appearance:
- Ice pick scars — Ice pick scars have a deep, sharp V-shaped well, as if an ice pick was plunged into the skin.
- Rolling scars — Rolling scars have an indented look, making the skin look wavy and uneven.
- Boxcar scars — Boxcar scars are typically wider and have an indented look with sharper edges.
Hypertrophic scars — caused by excessive healing response of the skin, resulting in raised scars [2].
Keloidal scars – Keloids also have a raised appearance, however unlike hypertrophic scars, keloids continue to grow beyond the wound borders.

How are acne scars treated?

There are a variety of treatment options to improve the look of acne scars, ranging from simple topical treatments to dermatological procedures.

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Topical treatments for acne scars

Vitamin A — vitamin A derivatives such as retinoids and retinol are known to improve atrophic acne scars by promoting proliferation of epidermal cells, improve skin protective function, and reduce collagen loss [4]. Retinol is also a popular ingredient for anti-ageing.
Vitamin C — vitamin C promotes wound healing through collagen metabolism, it also reduces hyperpigmentation in scars [2].
Glycolic acid — Glycolic acid peels treat acne scarring by removing the top layer of skin cells, repeated treatments of low-strength glycolic can improve skin texture over time [2].
Epidermal growth factor (EGF) — EGF serums are able to stimulate cell growth and proliferation to improve the appearance of atrophic acne scars [5, 6].

Dermatological procedures for acne scars

Chemical peels — Chemical peels work by removing the top layer of skin cells, revealing the smoother skin underneath with less visible scars.
Dermabrasion and microdermabrasion — These treatments abrade the top layer of the skin, reducing visible scars.
Laser treatments — This treatment precisely delivers heat to the deeper layers of the skin, which stimulates new collagen production.
Microneedling – Microneedles are used to make tiny pricks on the skin, stimulating wound healing process and collagen production for smoother skin.
Steroid injections — Steroid injections can be used to treat raised scars or keloids by reducing inflammation and flattening the raised scar.
Subcision — Subcision involves the dermatologist using needles to break the fibrous bands that “pull down” the scar to elevate the indented scars
Excision — The dermatologist surgically removes the scars and closes the wounds with stitches.

What can I do to reduce acne scars?

Treatment of stubborn acne scars can be challenging and, sometimes, over-the-counter products do not suffice. Ways that may minimise the appearance of acne scars include:

Treating acne early — Treating acne as soon as possible reduces the chances of new scars to form.
Avoid further inflammation — Picking or squeezing a blemish can irritate the skin further and worsen scarring.
Wear sun protection — Applying sunscreen regularly can reduce sun damage to your skin, thereby preventing hyperpigmentation of scars, which makes them more noticeable.
See a dermatologist — When over-the-counter acne scar products do not suffice, getting professional treatment may help.

Achieving clearer skin is possible with the right treatments. Here at Livingstone Dermatology, we are committed to providing holistic, medical-grade solutions for your skin needs. Schedule a consultation with us for a comprehensive skin analysis and personalised treatment plan.

Frequently Asked Questions

Are all acne scars permanent?

Most acne scars naturally fade over time, however some can be permanent.

Can acne scars be treated at home?

Some over-the-counter products or home remedy treatments can lighten the scars and improve their appearance. However, some can also cause more harm than good, worsening scars or causing more breakouts, especially if you have sensitive skin.

Consulting a dermatologist can ensure that you’re getting the right acne scar treatment for your specific skin type and concerns.

How long does it take to see results from acne scar treatments?

Depending on the treatment, results may be visible within a week to several months. Procedures such as chemical peels, microneedling, or laser treatments rely on the body’s healing process, which means your skin will gradually improve over time as your skin heals and regenerates.

Do acne scars get worse with age?

Untreated scars may get worse with age. Natural loss of collagen occurs as we age, hence the appearance of atrophic acne scars may worsen over time. Furthermore, sun exposure may also lead to hyperpigmentation of these scars.

Are steroid injections effective for all acne scars?

Steroid injections are typically used for hypertrophic or keloid scars. It works by breaking the collagen strands that give these scars their raised appearance. Steroids can also be used to treat cystic acne.

How much do acne scar treatments cost?

The cost will depend on the type of treatment and how many sessions you require. In Singapore, laser treatments and chemical peels can start from SGD 200, microneedling procedures can start from SGD 300. Injectables vary from type of injectables and how many injections are required.

Our dermatologist will work with you to determine what treatment suits your needs and budget.

References

Knutsen-Larson S, Dawson AL, Dunnick CA, Dellavalle RP. Acne vulgaris: pathogenesis, treatment, and needs assessment. Dermatol Clin. 2012 Jan;30(1):99-106, viii-ix. doi: 10.1016/j.det.2011.09.001. Epub 2011 Oct 21. PMID: 22117871.
Bikash C, Sarkar R. Topical management of acne scars: The uncharted terrain. J Cosmet Dermatol. 2023 Apr;22(4):1191-1196. doi: 10.1111/jocd.15584. Epub 2023 Jan 6. PMID: 36606377.
Clark AK, Saric S, Sivamani RK. Acne Scars: How Do We Grade Them? Am J Clin Dermatol. 2018 Apr;19(2):139-144. doi: 10.1007/s40257-017-0321-x. PMID: 28891036.
Zasada M, Budzisz E. Retinoids: active molecules influencing skin structure formation in cosmetic and dermatological treatments. Postepy Dermatol Alergol. 2019 Aug;36(4):392-397. doi: 10.5114/ada.2019.87443. Epub 2019 Aug 30. PMID: 31616211; PMCID: PMC6791161.
Seidel R, Moy RL. Improvement in Atrophic Acne Scars Using Topical Synthetic Epidermal Growth Factor (EGF) Serum: A Pilot Study. J Drugs Dermatol. 2015 Sep;14(9):1005-10. PMID: 26355620.
Stoddard MA, Herrmann J, Moy L, Moy R. Improvement of Atrophic Acne Scars in Skin of Color Using Topical Synthetic Epidermal Growth Factor (EGF) Serum: A Pilot Study. J Drugs Dermatol. 2017 Apr 1;16(4):322-326. PMID: 28403265.
Wollina U, Goldman A. Fillers for the improvement in acne scars. Clin Cosmet Investig Dermatol. 2015 Sep 29;8:493-9. doi: 10.2147/CCID.S86478. PMID: 26491364; PMCID: PMC4598204.

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