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Acne Scars

What is Botox?

Botox, or botulinum toxin, is an injectable treatment that is primarily targeted to treat wrinkles, fine lines and creases on the face. It can also be used as a non-permanent facial contouring treatment to slim down your profile. Botox is more widely known as an effective anti-aging product for improving the appearance of your skin. Botox is able to treat signs of advanced aging as it promotes collagen production and skin elasticity. In Singapore, Botox is used to temporarily give patients a younger and tighter look.

What are Acne Scars?

Acne scars are what gets left behind after active acne has healed. It is important to note, however, that not everyone with acne will develop scars.

In response to the damage caused by acne, the skin will repair itself by producing collagen. Acne scars form if:

  • Too little collagen was produced; resulting in a depressed or atrophic scar
  • Too much collagen was produced; resulting in a raised or hypertrophic scar

Whether someone develops acne scars depends on how well their body responds to injury.

Types of Atrophic or Depressed Acne Scars

Atrophic scars are the most common type of acne scars in Singapore.

  • Ice pick: a common scar which is v-shaped with a wide opening and a narrow base. It is difficult to treat and can be found on areas where the skin is thinner such as the forehead and upper cheeks.
  • Boxcar: indented, deep scars with sharper edges which can be found on the lower cheeks and jaws.
  • Rolling: scars with sloping edges which make your skin look bumpy and wavy. There scars can be found on areas where the skin is thicker such as the lower cheeks and jaws.

Types of Hypertrophic or Raised Acne Scars:

When the skin produces too much collagen, a raised acne scar is formed. Keloids or hypertrophic scars are examples of raised acne scars. They usually occur on the chest, back, shoulders, and jaw line.

Who is at risk of Acne Scars in Singapore?

A Singaporean study conducted in 2021 showed that individuals who developed severe acne scarring displayed the following risk factors:

  • Family history: genetics and family history play a huge role in acne scarring.
  • Gender: males are more likely to develop acne scarring.
  • Acne severity: the more severe your acne, the more likely you are to develop acne scars.
  • Treatment: the longer you delay treatment the more likely you are to develop acne scars.
  • Recurring acne: if your acne keeps recurring, your skin will most likely develop acne scars when healing.

How are they diagnosed?

Acne scars can be diagnosed during a physical examination. There are several stages of acne scarring based on their severity, these stages are:

Grade 1MacularRed and flat
Grade 2MildScars that can be covered by makeup or hair
Grade 3ModerateScars are still visible after makeup, visually obvious at less than 50cm.
Grade 4SevereScars that cannot be covered by makeup or hair and are visually obvious at more than 50cm

What are the treatment options for Acne Scars in Singapore?

Different treatments are used for the different types of acne scars, the treatment options include:

  • Soft tissue fillers: injecting hyaluronic acid, fat, or other substances can help raise indented scars thereby making the scars less visible. Typically, filler injections will need to be repeated.
  • Steroid injections: some types of raised scars can be improved by steroid injections.
  • Dermabrasion: typically used for more severe scarring. However, some individuals may experience some rare side effects such as scarring and pigment changes.
  • Needling: also known as microneedling, works by activating the production of collagen, thereby improving the appearance of acne scars.
  • Botox: works best with raised acne scars. Injecting botox can improve the appearance of an acne scar. Repeat treatments are necessary.
  • Chemical peel: removes the top layer of skin which helps improve the appearance of deep scars by making them appear less deep.
  • Laser resurfacing: one of the most popular approaches which aims to flatten raised scars and also to stimulate collagen in the cavity of deeper acne scars.
  • Energy-based devices: pulsed light sources and radiofrequency devices also aim to help make scars less noticeable.

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