My face is like the moon’s surface

The good news is the pimple that spouted on your nose for the past few days has finally disappeared. The bad news is the breakout can leave a mark in the form of a scar, much like the moon's surface.

The good news is the pimple that spouted on your nose for the past few days has finally disappeared. The bad news is the breakout can leave a mark in the form of a scar, much like the moon's surface.

The good news is that the pimple that sprouted on your nose for the past few days has finally disappeared. However, the bad news is that the breakout can eventually leave a mark in the form of a scar.

Acne is a common woe in teenagers and young adults. However, for some people, acne can continue to bug them even much later in life.

Even without picking, acne spots, particularly cystic ones, will lead to scarring because of the intense, collagen-damaging skin inflammation with which they are associated with.

Acne scars develop in areas where former cystic acne lesions been present.

They can show up in three varieties:

- Atrophic, which are mostly shallow

- Box-shaped

- Ice pick-shaped, which are narrow and deeper

Scars comprise mainly of collagen (a protein fibre found in the skin layer) and are the body’s way of repairing itself.

Acne scars are usually indented due to collagen loss from intense inflammation. Picking on the active acne lesions results in more inflammation. This adds to the skin’s discolouration and scarring.

Squeezing a pimple causes bacteria to get deeper into the skin, resulting in more infection and collagen damage.

Individuals may also experience darkening of the scar, called post-inflammatory hyperpigmentation.

Exposing scars to the sun can lead to darkening and slow down the healing process. To reduce the chances of darkening, slather on some broad-spectrum sunscreen with an SPF of 30 or higher, especially when you’re going outdoors.

There are several ingredients to look for that help lighten hyperpigmentation. Kojic acid (a natural skin lightener derived from a mushroom extract), arbutin (bearberry essence), and even vitamin C are helpful topical agents that can lighten dark acne blemishes.

The bad news is, there is no over-the-counter treatment that can fill the indentations of atrophic acne scars.

If your acne marks don’t go away on their own, it might be time to consider scheduling an appointment with your skin doctor.

Your aesthetic doctor or dermatologist may recommend laser skin resurfacing utilising Fractional Carbon Dioxide (CO2)or Erbium Yag lasers. These can improve the acne scars by stimulating the formation of collagen, thus levelling the scar and reducing the indentations.

Fractional CO2 laser is one of the newer advances in non-surgical acne scar and skin rejuvenation treatment. With the appropriate settings, it can be used safely even in those with darker skin tones, as opposed to certain types of lasers that can cause more complications if one has darker skin colour.

Besides acne scars, Fractionated CO2 lasers are also great at reducing wrinkles and textural changes due to ageing, sun damage, and surgical or accident scars. With adjusted settings, it can be used on the more delicate eyelid area, and also, around the mouth.

Hyaluronic acid dermal filler injections can be used to fill up the indentations of acne scars. The filler disintegrates over time as it is absorbed by the body, so the procedure would have to be repeated after six to 12 months, depending on the molecular structure of the filler used.

Dermal fillers give immediate results to help fill up acne scars and is a safe option without any downtime.

Another option is to use the patient’s own fat, which is taken using a liposuction cannula. The fat transplantation procedure involves injecting the fat into the skin defect. Results last three to six months.

Ice-pick acne scars have irregular borders. The depth of the scar tends to be irregular too.

By surgically excising the scar and closing it with sutures, the dermatologist or plastic surgeon can bring together the dermis in a uniform, fine line without its ragged margins. This leaves a tiny linear scar, which is not as conspicuous as the original acne scar. Over time, the scar will start to fade away bit by bit.

Subcision is a procedure whereby the doctor undermines the acne scar with a needle or small scalpel.

This helps to break down the fibrous tissues of the scar. The procedure helps to stimulate collagen formation, which helps to fill up the scar.

Dermabrasion is a procedure whereby the skin is anaesthetised and a rapidly rotating blade sheers away the top layers of damaged tissue. It’s something like using a sandpaper to abrade away the top layers of the skin.

There is quite an amount of recovery time needed for this more aggressive procedure, and ithas fallen out of popularity as there are newer procedures that can produce good results without as much downtime.

Chemical peels, also called skin peels, are performed by applying a layer of special acid onto the skin. The stronger the acid, the deeper the penetration into the skin, and the better the results.

However, stronger peels also cause more redness, inflammation and discomfort, and come with a longer downtime.

Dr Chen Tai Ho is an experienced aesthetic doctor who chills by the pool sipping espresso latte when he’s not attending to his beloved patients. For further information, e-mail

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