Acne scarring refers to either the depressions or elevations in the skin caused by abnormal collagen breakdown and formation as a result of inflammatory acne. Acne scarring can come in various forms ranging from ice-pick scars (deep and narrow), boxcar scars (wider at their base, either deep or shallow), rolling scars (shallow, wider, bumpy appearance) or hypertrophic and keloid scars (raised from the skin). Of all of these, hypertrophic and keloid scars tend to be the hardest to treat. However, the success rate with multi-modality treatment can be quite good for depressed scars.

The options available at Face Doctors Clinic include:

• Subcision: aims to break down tethered collagen that is holding the scar down to the underlying fatty tissue like an anchor. We use a needle with the bevel up to go inside the scar tissue and cut down the tethers.
• Dermal fillers: can be injected into the space beneath a depressed scar to elevate the skin and produce a more even appearance. It works well when combined with subcision with the dermal fillers being injected into the empty space created when the collagen tethers are released.
• Clearskin laser: this laser treatment with no downtime is specifically made for acne and acne scarring. It works by using heat to stimulate specialised cells called fibroblasts to produce more collagen.
• Ablative lasers: can be used to strip of the superficial layer of the scar. Can work well combined with the Clearskin laser, however, the Clearskin laser is a more appropriate first choice.
• Microneedling: a very effective treatment in stimulating the body’s own collagen production. Tiny, virtually painless needles create a controlled trauma that tells fibroblasts to produce more collagen. Note that the needles need to go deeper than home roller needling options to effectively stimulate collagen production.

Sometimes, instead of scarring, the body may also undergo darkening and discolouration in response to the irritation and inflammation caused by acne. The discolouration occurs because the body produces too much melanin. This remains even when the acne wound has healed completely. This generally requires a different treatment protocol to acne scarring. Post-inflammatory hyperpigmentation and acne scarring may occur together and need a combination of treatments to achieve the best outcome. Topical skin lightening creams such as hydroquinone with or without skin peels, LED therapy, tretinoin and q-switch lasers are some options for hyperpigmentation.