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Scars and Marks

What are Acne Scars?

They are permanent “indentations” or textural changes on the skin as a result of severe Acne.

How do you get Acne Scars?

In severe acne, large pus-filled spaces called acne nodules / cysts are formed. 

The inflammatory process destroys skin tissue and collagen which are inadequately replaced during the healing process. 

This deficit is noticeable as an indentation (or scar) on the face.

Types of Acne Scars and Marks

Boxcar scars - Relatively shallow scars with well defined edges

Icepick scars - Deep and narrow scars

Rolling, atrophic scars - Appear as depressions and undulations on the skin with ill defined borders

Hypertrophic or keloid scars - Raised and lumpy scars that remain after acne has healed

Post inflammatory erythema - Red persistent flat marks

Post inflammatory hyperpigmentation - Brown/grey marks that remain after acne has resolved

Treatment Aim

In acne scarring, Dr Edwin's aim is to restore the deficit in collagen by stimulating collagen production. The various methods to achieve this will be described below.

Treatment Options

CO2 Fractional Laser

Dr Edwin's first method of treating acne scars is the eCO2 Acne Scar Resurfacing Laser fractional laser which has long being viewed as the gold standard in acne scar treatment.

It uses Controlled Chaos Technology (CCT™), an advanced system which increases safety, reduces discomfort and accelerates healing time.

During the treatment, precise, micro-ablative Columns (MACs) are created. This tiny areas of "controlled damage" stimulates the body's healing process and increases production of new collagen and renewal of skin.

Rejuran S for Scar Treatment

For best results, Dr Edwin recommends combining CO2 Fractional Laser and Rejuran S . 

Rejuran S is made of Polynucleotides (PN), which are DNA fragments that help repair damaged cells and stimulate collagen. 

It is injected directly into the base of the scar to boost skin healing and remodel collagen, making it an ideal treatment for acne scars.

Subcision with Fillers

In certain cases of ice pick and rolling acne scars, Dr Edwin will recommend Subcision before embarking on a series of CO2 fractional laser sessions or Rejuran injections.

It involves using a sharp needle inserted beneath the scar to release fibrous scar tissue (tethers) that are "tugging downwards" on the depressed acne scars.

After releasing these tethers, Dr Edwin recommends injecting either Fillers or Rejuran to add volume and stimulate collagen production whilst preventing the re-formation of tethers.

This method produces quicker results as compared to just doing Fractional Laser treatments alone. 

2 to 4 sessions done monthly are needed for optimal results.

Post Inflammatory Erythema (PIE)

The Pro-Yellow laser is Dr Edwin's vascular laser of choice in reducing post acne red marks (Post Inflammatory Erythema).

These red marks are formed due to damaged and dilated blood vessels near the surface of the skin after inflammation from moderate to severe acne. In some cases, these marks may persist long even after the active acne heals.

The laser works by safely penetrating skin to break down and disperse these damaged blood vessels, thereby reducing the appearance of PIE. 

Post Inflammatory Hyperpigmentation (PIH)

PIH is commonly seen in the acne healing phase whereby red marks slowly fade to leave brown / grey marks. These marks can be stubborn and last for many months!

As its name implies, PIH occurs following inflammation and damage to the skin. The inflammatory process triggered during acne stimulates melanocytes (pigment producing cells) to increase melanin (pigment) synthesis. These melanin are deposited in the skin and remains even during the recovery phase, appearing as the all too familiar brown marks of acne.

Dr Edwin treats these PIH marks by using specially formulated medical grade topical creams as well as the Spectra Pigmentation Laser.

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