Why Topical Treatments Fall Short in Treating Acne Scars

Treatments Fall Short in Treating Acne Scars

While some acne scars fade over time with good skincare, others barely show any improvement.

In this article, we discuss why you may not see the results you want with topical acne scar products and what treatments in Singapore we would recommend for your acne scars.

Why Topical Treatments are Ineffective Against Deep Acne Scars

Topical treatments, such as creams and ointments, primarily focus on the skin’s surface. While they can work for mild cases and superficial concerns, they may fall short when dealing with deeper scars that extend beyond the epidermis.

For example, retinol and alpha hydroxy acids are effective for skin texture and discolouration issues as they promote cell turnover and collagen production. However, they cannot address structural issues present in deep acne scars.

Deeper scars like boxcar, ice pick, and rolling scars demand a more targeted approach to reach the dermal layers effectively.

Types of Acne Scars

Types of Acne Scars
Credit: wangmando

Post-Inflammatory Hyperpigmentation (PIH)

PIH is a common aftermath of acne, resulting in darkened spots on the skin. While these aren’t technically scars, they can linger for an extended period, causing distress and impacting your complexion. PIH can fade over time with topical treatment and a good skincare routine.

Rolling Scars

A smooth, undulating appearance characterizes rolling scars. They often occur due to collagen damage beneath the skin, creating a wave-like texture that can be challenging to address with topical solutions alone.

Rolling scars often develop due to inflammatory acne, extending deep into the skin layers. When inflammatory acne lesions heal, irregularities in collagen production can lead to the creation of scar tissue that tethers the skin, causing it to appear uneven.

Boxcar scars

Boxcar scars present as angular depressions in the skin. These scars result from tissue loss, leaving behind indented, box-like shapes that topical treatments may struggle to reach effectively.

Boxcar scars often develop due to inflammatory acne lesions, such as nodules or cysts. The irregularities in the healing process contribute to the characteristic shape of boxcar scars. As the skin attempts to repair itself, the tissue loss creates a broad, flat depression with well-defined edges.

Ice Pick Scars

Ice pick scars resemble the marks of an ice pick or a needle. These scars are deep and narrow as they penetrate the skin, making it difficult for superficial treatments to reach the root of the problem.

Ice pick scars often develop due to severe acne. These are inflammatory acne lesions that penetrate deep into the skin. Ice pick scars are typically small but can be quite noticeable and are often considered one of the more challenging types of acne scars to treat.

Professional Treatment for Acne Scars

Treatment for Acne Scars
Source: Treatment for Acne Scars

If you have deep acne scars, turning to professional treatments becomes a logical next step. These interventions go beyond the limitations of topical solutions, offering more targeted methods to tackle the various types of scars.

Fractional CO2 Saser

Fractional CO2 laser treatments stimulate collagen formation and create new, healthier skin cells by emitting concentrated beams of light that penetrate the skin.

How it Works

The CO2 laser emits wavelengths of light as it penetrates the dermis. This process generates heat, leading to controlled skin layer damage, reaching the collagen-producing cells.

As the skin heals, new skin cells replace the damaged ones, resulting in a smoother and more even skin surface. For deep acne scars, the collagen remodeling induced by the laser helps fill in the indentations and improve the skin’s overall texture.

Microneedling RF

Microneedling with radiofrequency (RF) is performed using tiny needles that penetrate the skin while applying radiofrequency energy. This dual-action treatment stimulates collagen and elastin production, making it beneficial for addressing rolling scars and improving overall skin firmness.

How it Works

Radiofrequency energy is introduced into the skin’s deeper layers through the tiny punctures made by the needles. The RF energy heats the targeted tissues, prompting the body to produce new collagen and elastin fibers.

The newly formed collagen helps improve the skin’s texture and resilience as the skin heals. This process contributes to filling in the deep acne scars and smoothing the overall skin surface.


Subcision is a technique used to treat rolling scars and boxcar scars. It involves breaking the fibrous bands under the scar to lift the depression and improve its appearance.

How it Works

A specialized needle is inserted just beneath the skin’s surface, targeting the fibrous bands that are causing the depression in the scar. The needle moves through the scar tissue to sever the fibrous bands, pulling the skin downward. This release allows the depressed area of the scar to lift and become more level with the surrounding skin.

The trauma caused by the needle also stimulates the body’s natural healing response, prompting collagen production in the treated area and improving the skin’s texture and appearance.

TCA Cross

Trichloroacetic acid (TCA) cross is designed explicitly for treating ice pick scars. This method is a targeted solution for deep, narrow scars that may not respond well to surface-level treatments.

How it Works

High-strength TCA is applied directly to the deep acne scars using a fine-tipped applicator, such as a toothpick or a needle. The chemical solution coagulates and denatures proteins in the skin, leading to controlled peeling and creating a small wound within the scar.

The controlled injury induced by TCA triggers the body’s natural wound-healing response, producing collagen that will fill the deep acne scars and improve the skin’s overall texture.

Treating Acne Scars According to Its Type

While topical treatments have their place in skincare and can improve PIH, they may not be the answer for deeper scars that demand more targeted interventions, especially when seeking effective acne scar treatment in Singapore. If you have deep acne scars, addressing them requires a tailored approach that considers the type and depth of the scars.

Understanding the specific characteristics of your acne scars and consulting with an aesthetic doctor in Singapore can guide you toward the most effective professional acne scar treatments to achieve your desired skin.

Leave a Reply

Your email address will not be published. Required fields are marked *


Doctor holding in hand Personalized Medicine

Relieving Chronic Back Pain: A Holistic Approach to Arachnoiditis through Physical Therapy

Prostate Health Breakthroughs in Screening, Detection, and Treatment of Prostate Diseases

Prostate Health: Breakthroughs in Screening & Treatment of Prostate Diseases