Courtesy of THIS Quarterly magazine
Deep impact

The turbulence of the teenage years may carry on into adulthood, in the form of acne scars. But fret not, there's help.

By Dr Cheong Lai Leng, Dermatologist

Acne is the collective term used to describe cases of congested pores, whiteheads, blackheads, pimples, pustules and cysts (or deep pimples). While it is part and parcel of teenage years for many, the scars they leave behind through to adulthood can cause frustration and distress.

There are different types of acne scars:

  • Ice-pick scars are pitted scars

  • Atrophic scars are flat, thin or depressed scars

  • Hypertrophic or keloid scars are thick lumpy scars

While there is no quick fix, there are treatments that can reduce the visibility and depth of acne soars. These procedures aim to stimulate collagen rejuvenation with or without the removal of a layer of damaged skin to encourage new and smoother skin to grow in the affected area. Many of these methods have shown good results.

The procedures commonly employed include laser resurfacing (ablative and non-ablative), chemical peeling, filler injections, scar excision, subcision and dermabrasion.

Laser therapies

One treatment that is gaining popularity is the use of special lasers to direct laser energy at affected skin. This encourages the regeneration of collagen and promotes new epidermal growth. Intense Pulsed Light (IPL) therapy can produce a similar effect. It usually takes a few sessions to see a reduction in scarring. Laser energy is harnessed to produce a precisely controlled destruction of the skin. Like a phoenix arising from the ashes, new collagen formation occurs in the wake of such planned tissue destruction. This collagen regrowth improves both the texture and contour of the skin surface. The latest form of this genre is fractional cO2 laser skin resurfacing. The Singapore dermatologist is specially trained to adjust the level of intensity of the laser energy to be delivered based on the nature and severity of the scarred area. It works by penetrating the deeper layers of skin (the dermis) to stimulate new collagen formation. Apart from reducing the appearance of acne scars, skin also tightens and firms.

Other therapies

Other ways to resurface the skin include chemical peeling and dermabrasion. These work by removing the top layers of skin. For depressed scars, the injection of fillers, which involves using special biologic materials or fat to plump out the depressions, may be helpful. While most filler substances have a limited lifespan and disappear at the end of it, subcision results in the permanent correction of depressed scars. The latter is a minor surgical procedure where a fine needle targets the tissue under the depressed scar causing targeted injury and consequent collagen regeneration exactly where it is needed. This newly formed collagen bolsters and elevates the base of the depressed scar. Tightening treatments such as radiofrequency may also be helpful over time. As the skin tightens, acne scars become less noticeable.

Holistic management

The treatment of acne scars must be coupled with comprehensive skin management to treat and reduce current and future inflammatory skin conditions, thus preventing further scarring. An optimal skincare regimen for acne—prone , people should include topical therapy for the management of acne and scars, Glycolic acid and tretinoin are valuable components of such a regime and a good sunblock is essential.

Dr Cheong Lai Leng
Consultant Dermatologist

MBBS (Singapore), M.Med (Internal Medicine),
MRCP (UK), FAMS (Dermatology).
Corr. Fellow, American Society for Dermatologic Surgery

3 Mount Elizabeth
#09-09 Mount Elizabeth Medical Centre
Singapore 228510
Tel : (65) 6836 1480
Fax : (65) 6836 1481
Email :
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