ACNE SCAR Review Singapore 2020 | Ask Dr Daniel Chang



Let me share with you a personal encounter. Years ago, I remember meeting a wide-eyed and cheerful air steward who was bothered by his acne scarring. He was working with a low cost carrier, but always dreamt of flying with SQ. It was his goal, his aspiration, his desire to don the SQ uniform and fly the national flag high. He missed the cut previously, failing in his interview where he was informed he had to fix his acne scarring. He visited me for a consultation, and together, we worked on a 6 month acne scar programme for him. I am pleased to say his dream came true. He is now flying high with our national carrier. Being able to help my patients look and feel their very best is an endearing feeling that keeps me going.

In my practice, acne scars is one of the top 3 concerns my patients want addressed. Gone are the days where acne scar treatment involves 1-2 weeks of skin scabbing and peeling. Over the years, treatments for acne scarring has become more evidence based, safer and faster. This only means one thing. Now you can look and feel your very best!

So what is the cause of ACNE SCARS?

Acne scars form due to the repeated breakdown of collagen and elastin in your dermis. This can be aggravated by sun damage, persistent bursting of pimples and poor skincare. Acne scars frequently occur at sites which were acne prone in the past, namely your temples, cheeks, chin etc.

How common is acne scarring in Singapore?

In my experience, 1 in 10 of my female patients and 1 in 5 of my male patients suffer from acne scarring. Unfortunately, scars dont heal magically on their own. In fact, with ageing, scars can and often get worse.

ACNE SCARS Singapore



How is acne scarring treated?


Treatment: There is no one size fits all approach. I believe in a Customised Individualised Treatment that is dynamic and continuous. This is based on your skin type, scar type, and lifestyle.

What are the different types of scars?

Scars can be divided into atrophic and hypertrophic and keloidal scars.

Hypertrophic and keloidal scars can respond to intralesional steroids. Atrophic scars is more complex, so I shall divide them into their common variants.


Atrophic scars

Tethered scars: These are scars that are attached to your underlying tissue, eg muscles. So for example, when you smile, the scars become more pronouced. I recommend subcision for majority of these cases.

Tethered scar Treatment: Subcision + Rejuran

Rolling scars: These are uneven scars with a curved surface. They can improve visibly but will take time. I recommend

Rolling scar Treatment: Subcision + Dermal Fillers + Rejuran + Fractional Laser

Ice Pick Acne Scars : These are traditionally very tough to treat. Especially those over your nose. In my experience, careful use of

Ice pick scar Treatment: Rejuran + TCA cross + Fractional Laser

Box Acne Scar: These type of scars respond very well to treatment. One can expect pretty nice results. In my experience a combination approach works best.

Box scar Treatment: Fractional Laser + Rejuran


Your Take Home message

  1. Scars are 3 dimensional and 2D photos will not do justice to your scars. Hence yours scars need to be examined in a face to face consult with your doctor.
  2. Males tend to have worse acne scarring due to a lack of pre and post care. 
  3. Treatment results appear as early as the 2nd month, but it is advisable to complete a programme for optimal results


To learn more about

  1. Dark eye circles
  2. Threadlifts, pls click here Facelift, V-Lift.
  3. Dermal fillers, pls click here ABCs to Dermal Fillers. 




  1. Dreno, B., A. Khammari, N. Orain, C. Noray, C. Merial-Kieny, S. Méry, and T. Nocera. “ECCA grading scale: an original validated acne scar grading scale for clinical practice in dermatology.” Dermatology 214, no. 1 (2007): 46-51.
  2. , Fractional resurfacing in the Asian patient: Current state of the artLasers in Surgery and Medicine49, 1(45-59)(2016).
  3. , Acne scarring: A review of available therapeutic lasersLasers in Surgery and Medicine48, 2(95-115)(2015).
  4. , Comparison of non‐ablative and ablative fractional laser treatments in a postoperative scar studyLasers in Surgery and Medicine46, 10(741-749)(2014).


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