1. How does the dermatologist choose the right treatment for acne scar?
Ans: The most important thing is to determine the type of acne scar, because each type of scar is treated in different ways.
2. What are subtypes of acne scar?
Ans: Acne scar has 4 types according to the figure.
3. What are the main choices of acne scar treatment?
- Adjust the red color of acne scar > by vascular laser such as pulse dye laser.
- Stimulate collagen production > by topical retinoid, polynucleotide, hyaluronic acid, platelet rich plasmas and fractional laser.
- Change the morphology of scar into small linear scar > by punch excision of acne scar.
- Lift the scar > by punch elevation or filler augmentation.
- Cut dermal tethering > by subcision.
4. Which type of acne scar has good respond to laser?
Ans: Rolling scar, Shallow box scar and Hypertrophic scar
5. Which type of acne scar has excellent result to acne scar surgery?
Ans: Deep box scar and Deep rolling scar
6. Which type of scar responds well to subcision?
Ans: Deep rolling scar
7. How can the dermatologist treat the difficult refractory icepick scar?
Ans: They use trichloroacetic acid for chemical reconstruction of skin scars (TCA-CROSS) which is a minimally invasive, safe, and cost-effective technique for resistant ice pick scar.
8. Can hyaluronic acid (Filler) improve the scar appearance?
Ans: Hyaluronic acid fillers are effective in harmonizing acne scars due to their filling effect.
9. What are treatment modalities in Bangkok Hospital Phuket?
Ans: We have many options to solve all type of acne scars on your face & body, described here;
- Laser: Fractional CO2 laser, Pulse dye laser (Vbeam)
- Injectable: Polynucleotide for acne scar, Platelet rich plasma, Hyaluronic acid-based filler.
- Acne surgery: Punch excision, Punch elevation, Subcision, Hypertrophic scar injection (triamcinolone acetonide, 5-fluorouracil, bleomycin), Keloid excision
- Trichloroacetic acid for chemical reconstruction of skin scars (TCA-CROSS)
Reference
- Am J Clin Dermatol 19, 459–477 (2018). https://doi.org/10.1007/s40257-018-0358-5
- Dermatol Surg. 2023;49(6):581-586. doi:10.1097/DSS.0000000000003789
