Conditions · Texture & Scarring

Acne Scars

Not one condition. Icepick, boxcar and rolling scars have different architecture and respond to different things — which is why a single device rarely resolves a mixed face.

Mechanism

What is actually happening

Icepick scars are narrow and deep, extending to the dermis or beyond. Boxcar scars are wider with sharply defined vertical walls. Rolling scars are shallow undulations tethered from below by fibrous bands.

The distinction

How it is told apart

Tethering is the distinction that changes the plan. A rolling scar is held down by a band; resurfacing the surface above it does very little. Release addresses the band; resurfacing addresses texture. They are not substitutes.

Assessment

What is established first

Scar type distribution across the face, depth, tethering, active acne, Fitzpatrick type and prior treatment history.

Approach

What is typically done

Mixed presentations generally need combined approaches sequenced over time — release for tethering, resurfacing for texture, and pigment work where post-inflammatory marks are the main visible issue.

When treatment waits

When it is deferred

Active inflammatory acne is controlled before scar work begins. Treating scars while new lesions are forming produces new scars.

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Frequently asked

What is acne scars?

Not one condition. Icepick, boxcar and rolling scars have different architecture and respond to different things — which is why a single device rarely resolves a mixed face.

How is acne scars told apart from similar conditions?

Tethering is the distinction that changes the plan. A rolling scar is held down by a band; resurfacing the surface above it does very little. Release addresses the band; resurfacing addresses texture. They are not substitutes.

What is assessed before treating acne scars?

Scar type distribution across the face, depth, tethering, active acne, Fitzpatrick type and prior treatment history.

When is treatment deferred?

Active inflammatory acne is controlled before scar work begins. Treating scars while new lesions are forming produces new scars.

Have this assessed

Every assessment is carried out personally by Dr Sin Yong, Medical Director. 9 Scotts Road, #12-01 Pacific Plaza.

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