If you have acne-prone skin, then you’ll know that breakouts aren’t the only problem you can encounter on the road to a clear complexion. Scarring can be just as difficult to deal with, if not more. And deep acne scars can seem virtually impossible to get rid of. Luckily, there are a lot of skincare and derma clinics that offer different treatments to help diminish the look of deep acne scars. We asked PDS board-certified dermatologist Dr. Riza Milante everything you need to know about deep acne scars, what causes them, and the treatments you can try to get rid of them.
What are the different types of acne scars?
According to Dr. Milante, there are four types of acne scars:
- Post-Inflammatory Erythema - These are red scars that “represent incomplete healing of acne. What we see is redness of the face and can indicate underlying inflammation.”
- Post-Inflammatory Pigmentary Alteration - Acne scars that alter the pigment. “It can be darker or lighter scars depending on the skin tone, but there are no changes in texture”
- Atrophic Scars - Scars that leave a deep depression in the skin. “These are the more commonly known as deep acne scars: boxcar, rolling, and icepick scars.”
- Hypertrophic Scars - These are raised scars that “become localized and increase skin thickness.”
Which types are considered “deep acne scars?"
It’s clear that not all acne scars are made the same, and some—particularly deep acne scars—are harder to get rid of than other types. “When we talk about deep acne scars these are the ‘atrophic scars,’” says Dr. Milante. “They are subdivided into the boxscar, rolling, and icepick scars.”
Ice pick scars are deep, narrow scars that, as its name suggests, resemble an ice pick puncture. Boxcar scars have a “sharp, demarcated U-shaped appearance.” They usually have a well-defined structure and they may be shallow or deep. Rolling scars are “are large, poorly demarcated depressions” on the skin. They’re usually superficial but they still have depth to them.
What causes deep acne scars?
Even if you’re careful with your skin and don’t pick at it when you have acne, you might just be predisposed to scarring. “Deep acne scars are caused by a combination of factors, including genetics, inflammation, acne relapses, and time to effective treatment. We encourage patients who have a family history of scarring plus acne to seek treatment as soon as possible to prevent the formation of scars,” Dr. Milante explains.
Can I get rid of deep acne scars using skincare products alone?
Theoretically, yes, but it would be a really slow process with minimal results. Products like retinoids and other collagen-stimulating agents may help boost collagen production and sunscreen can help prevent further collagen degradation. “But rarely does it ever go back to the ‘original’ skin. The progress would be very slow and most of the time only minimal improvement can be seen. People who have deep acne scars need procedural intervention in order to truly make a significant impact in the appearance of scars,” Dr. Milante clarifies.
What treatments can I try to get rid of deep acne scars?
According to Dr. Milante, there are two very important approaches to getting rid of acne scars: prevention and treatment.
To prevent scars from forming or worsening, it’s important to consistently use sunscreen to minimize collagen degradation. Using anti-aging products like retinoids and vitamin C can also help stimulate collagen production in conjunction with the procedural scar treatment.
When it comes to treatment, it’s important to remember that most people have a different combination of scars on their faces, so a mixed procedure approach is usually better than just doing one type of procedure. “For Filipino skin or skin of color, there's an increased risk for post-inflammatory hyper or hypopigmentation for all procedures. That’s why most dermatologists would prefer using lower strength but repeated treatment sessions in order to be safe and not cause too much damage and risk the side effects.”
Just some treatments that can help minimize the appearance of acne scars include:
- Laser resurfacing - This “makes controlled wounds in the skin to stimulate collagen production deep in the dermis.”
- Pulsed Light Treatments - These stimulate collagen production deep in the dermis.
- Fillers - Substances like hyaluronic acid or biomodulators are injected into the skin over the scars to plump up their appearance.
- Botulinum Toxin Injections: - These help limit stress on scar tissue and minimize their visibility.
- Chemical Peels - These “ remove the top layer of the skin and facilitate collagen production underneath.”
- Microneedling - “The doctor uses different depths of a needle studded device to roll over the scars for collagen induction.”
- Surgery - “The doctor can cut out individual acne scars and repair the wound with stitches or skin tape in a process called punch excision.”
The Most Popular Treatments That Can Get Rid Of Acne Scars
If you’d like to get rid of deep acne scars, we rounded up popular treatments and where to get them below!
Acne Scar Revision Treatment
This is a customized treatment plan that adopts a combination approach to deep acne scars with the use of soft tissue fillers, punch excision, microneedling, subcision, TCA cross, and medium-depth chemical peels.
Price: Starts at P3,000+
Where to get: Legazpi Eye Center, Legazpi City
This laser treatment helps gently remove lesions at the epidermis and dermis level to help skin look smoother. It also helps skin resurface to lessen the look of deep acne scars.
Price: Starts at P8,000
Where to get: Luminisce Clinics in BGC and Alabang
Fractional CO2 Laser
This is a non-invasive laser resurfacing treatment that lessens the look of deep acne scars by acting on the deep dermis to smoothen skin. It helps the body’s natural healing process to sweep away damaged tissue and rebuild the skin with collagen.
Price: Starts at P5,000
Where to get: Cauayan City, Isabela
Acne Scar Treatment
The Smart Skin by Sayo Family Care Clinic
This is a treatment plan using TCA cross, subcision, and fractional CO2 laser resurfacing to lessen the appearance of deep acne scars and smoothen the skin.
Price: Starts at P2,500
Where to get: Malolos City, Bulacan
Pixel Laser Resurfacing
Try this treatment if you want to not only lift deep scars, but also brighten pigmentation. The laser presses on your skin in a grid-like pattern to help boost skin-healing and collagen production. You can also choose to spot laser an area or get a full-face treatment, depending on your skin concerns.
Price: Starts at P2,500
Where to get: Simply Skin Clinics in Quezon City, Pasig City, Muntinlupa City, Mandaluyong City, and BGC
Time Capsule + Air Dissector
The secret to your fave K-drama star’s ~flawless~ skin could be this treatment. The popular Korean procedure frees up the bottom of acne scars using air-infused under the skin, allowing deep scars to lift and become more and more shallow with each session.
Price: Starts at P13,500
Where to get: Belo Clinics in Metro Manila