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  • Dr. Henry Ngai

What is new in the “scar” war?

If one is good, two is better- seeking the right combination treatment strategy for acne scars.

True acne scar is permanent

Acne scarring is a major sequelae of acne. Most acne scar is preventable provided acne is aggressively treated to start with. Unfortunately most patients and even their parents or loved ones believe that acne is a benign disease. To them, acne is a just a phase of life and it is natural or inevitable. Although acne might only appear during a certain part of life, its scar lasts forever. Another misconception is only serious acne leads to scarring. While it might be true in many cases, we now know that even mild acne can potentially leave noticeable scars.

Types of scar left by acne

Once acne scar is present, treatment becomes more challenging. There are two main types of acne scars, hypertrophic scar and atrophic scars. Some also consider discoloration is a form of scarring but technically it is not so as it does not affect the deeper structure of the skin.

Treatment options- different strokes for different folks

The only home used topical method that can minimize the appearance of scar is topical vitamin A or its derivatives. It helps shallow scar, improves dyspigmentation and reduces pore size.

Chemical peels can also be very helpful in treating acne scars. However, one needs to use a stronger peeling regimen to get noticeable results. It becomes problematic in darker skinned individuals and people with sensitive skin. I would not recommend chemical peel as the first choice for acne scars in patients with darker skin tone. Nowadays, there are much better strategies in this group of patients.

New energy based technologies and surgical techniques have developed over the years to treat acne scarring safely, effectively and with less recovery time. More importantly, many of these technologies prove to be appropriate across all skin types.

Combination treatments

We have found that combination techniques work better than anyone technique working alone. We can safely perform 2-3 different treatment modalities in one single session. For example, we can combine subcision of scar with laser resurfacing with or with platelet rich plasma. We have not seen an increase in side effect for combination treatments which are offered at our clinic. On the contrary, we have seen better treatment outcome and better patient’s satisfaction. Recently, we have also discovered dermal filler play an important role in scar revision.

Working as a team in scar treatment

We truly believe that we have to work as a team with the patient. We always discuss the expectation, cost, recovery time, side effects, and most importantly patient’s preference of treatment. Some patients prefer one form of treatment than others because of various reasons. We try to dispel some misunderstanding and address all questions a patient might have over some treatment modalities. We also learn from the patients their concerns and reservation over any treatment.

Acne scar treatment is complex process. They are many nuances and algorithms when it comes to treating acne scars. It is also one of the most gratifying experiences we have as staff at Reviva, to see the good successful outcome of acne scar treatment.


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