Scars

Scars occur as a result of skin injury. “Injury” to the skin can occur in the form of physical injury, surgery, burns, or inflammation of the skin as a result of skin disease such as acne.

Some scars may be unsightly, and can also be itchy and painful.

There are a variety of treatments that can improve the appearance of scars, as well as reduce the itchy and painful symptoms that are associated with scars.

Acne scars
There are different forms of acne scars. They can be divided into:

1. Post inflammatory hyperpigmentation
2. Atrophic scars
3. Hypertrophic scars

1. Post inflammatory hyperpigmentation
Acne often leaves behind brown spots on the skin. These brown spots are a result of hyperpigmentation secondary to the inflammation from acne. The brown discoloration tends to be worse in Asians and in people who repeatedly squeeze and manipulate their skin. This form of scarring is usually temporary. However, they can take many months or even years to fade away. It is important to avoid excessive sun exposure as this can aggravate the brown discoloration. Certain medicated creams ( eg topical retinoids and alpha-hydroxy acids) and chemical peels can also be effective in speeding up the lightening of these scars.

2. Atrophic acne scars
Atrophic acne scars refer to depressed or “sunken-in” scars. These occur as a result of collagen damage from inflammatory acne. Unfortunately, this form of acne scarring tends to be permanent.

Atrophic acne scarring can be improved with procedural treatments such as resurfacing lasers, subcision and filler injection. Sometimes, a combination of different treatments is required.

3. Hypertrophic scars... see section on Other scars below

Other scars

Hypertrophic scars and keloids
Hypertrophic scars and keloids are thick, bumpy scars that stick out above normal skin. They most commonly occur over the upper arms, back, chest and jawline. They can also occur on the ears after ear piercing. Asians and Afro-caribbeans are more prone to developing these unsightly scars. Hypertrophic scars and keloids may develop after surgery, burns, injections, tattoos, or even after acne.

These scars can be improved with intralesional steroid injections, medicated gels and silicon plasters. Certain lasers can also be useful as an additional treatment, as they help to reduce the redness and bulkiness of these scars.