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290 Orchard Rd, #13-07 The Paragon, Singapore 238859

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Acne Scars

Acne is prevalent amongst 80% of youths1 in Singapore and approximately 12% of adults, so chances are that acne scarring is something you are quite familiar with.

What are Acne Scars?

Acne often feels like a double-edged sword, first causing painful and unsightly whiteheads, blackheads, pimples, and cysts, and then acne scarring after you have recovered from active acne. Acne scars are what gets left behind after your acne has healed.
There are two types of acne scars, depending on how much collagen was made during repair. If too little collagen was produced, the scar will be depressed or atrophic. If too much collagen was produced, the scar will be raised or hypertrophic (also known as, keloids).

Depressed or atrophic scarring consists of three common acne scars which are3:

• Icepick

V-shaped and narrow like an ice pick. It goes deep into the skin and is the most difficult to treat. It is most commonly formed on the forehead and the upper cheeks where the skin tends to be thinner.

• Rolling

Rounded and irregular. It gives your skin a wavy and uneven appearance. Typically found on the lower cheeks and jaws where the skin tends to be thicker.

• Boxcar

U-shaped scars with sharp edges. It can either be shallow or deep. It is usually found on the lower cheeks and jaws.

• Hypertrophic scars or keloids

These are raised scars due to an over-production of collagen during healing. Hypertrophic scars can be tender to the touch, painful, or itchy. They occur most commonly on the back and chest.

What are the common causes of Acne Scars in Singapore?

Your skin is made up of three layers: the epidermis, the dermis, and the hyperdermis. If someone has moderately severe to severe acne, they are more likely to have numerous inflamed pimples, nodules, and cysts which could penetrate the layers of the skin deeply. Basically, the deeper the penetration, the deeper and more obvious the scar. This is because our bodies will always try to heal our wounds; it does so using collagen. If too little or too much collagen is produced during the healing process, a scar is formed.

Who is at risk?

Depressed or atrophic scarring consists of three common acne scars which are3:

• Icepick

V-shaped and narrow like an ice pick. It goes deep into the skin and is the most difficult to treat. It is most commonly formed on the forehead and the upper cheeks where the skin tends to be thinner.

• Rolling

Rounded and irregular. It gives your skin a wavy and uneven appearance. Typically found on the lower cheeks and jaws where the skin tends to be thicker.

How are Acne Scars diagnosed?

Acne scars are first diagnosed visually in Singapore, where your dermatologist will examine the area and determine a diagnosis. Next, he/she will determine the severity of your acne scarring.

4 grades of acne scarring based on severity5

Grade 1Macular: red and flat scar
Grade 2Mild: scar that is easily covered by makeup or hair
Grade 3Moderate: not easily covered by makeup or hair, visually obvious at less than 50 centimetres
Grade 4Severe: unlikely that makeup or hair can cover up, visually obvious at more than 50 centimetres

What are the treatment options for Acne Scars in Singapore?

The treatment for acne scarring is multi-fold and dependent on the grade of your scars. 

Grade 1 and 2 scars:

• Alpha hydroxy acids: mild acid that removes old skin to reveal the new skin underneath. 

• Retinoids: also known as retinol commercially, helps block inflammation, improves cell regeneration, and reduces acne lesions.

• Salicylic acids: helps reduce swelling and redness which may help improve appearance of acne scarring.

• Lactic acids: works as a peel that removes dead skin cells, which may help improve the appearance of acne scarring.

• Silicone dressings: helps reduce the appearance and size of acne scars.

Grade 3 and 4 scars:

• Chemical peels: helps reduce the size and appearance of acne scars.

• Injections: corticosteroid injections can help soften and flatten hypertrophic acne scars.

• Dermal filler: soft tissue fillers that are particularly helpful with rolling and boxcar scars.

• Micro-needling: encourages the production of collagen which can help smoothen the skin and improve the appearance of acne scars.

• Laser treatment: uppermost layer of skin is removed to reveal the new skin beneath. It helps reduce the texture and appearance of acne scars.

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