Acne Scars on Ageing Skin: What to Know

As we age, our skin undergoes changes that affect its ability to heal and regenerate. Having mature skin means that acne scars, which may have faded more quickly in younger years, often take longer to improve. This situation can be frustrating for older men and women, as scars become more noticeable over time due to age-related changes.

In this article, we discuss how exactly ageing skin impacts the healing of acne scars and available treatments.

How Ageing Affects Acne Scars

As skin ages, it undergoes several physiological changes that can worsen the look of acne scars. Key factors include:

1. Loss of Volume and Sagging: Ageing leads to fat and collagen loss, causing the skin to sag. Atrophic scars, which already have volume loss, become more pronounced and tethered as the surrounding skin loses support.
2. Less Collagen and Elastin: Collagen and elastin maintain the skin's structure and elasticity. With age, their production diminishes, causing the skin to thin and scars to appear more pronounced.
3. Decreased Skin Regeneration: Younger skin regenerates quickly, which aids in healing scars. Ageing skin has a slower turnover rate, making it harder for scars to fade naturally over time.
4. Changes in Skin Texture and Tone: As skin loses firmness and hydration, scars may appear more uneven. Additionally, hyperpigmentation associated with scars can become more noticeable against duller, ageing skin.
5. Reduced Sebum Production: While reduced oil production can mean fewer acne breakouts, it also leads to drier skin, making scars more visible.
6. Increased Risk of New Scars: Reduced skin resilience and slower healing can make new scars more likely to form after breakouts or skin injuries.

Unique Challenges of Treating Acne Scars on Ageing Skin

Treating acne scars on ageing skin presents specific challenges due to the skin's changing nature:

1. Reduced Healing Response: Many scar treatments rely on stimulating collagen production, but ageing skin heals more slowly and may respond less effectively to these therapies.
2. Sensitivity to Treatments: Ageing skin tends to be thinner and more sensitive, limiting aggressive treatments like deep chemical peels and certain lasers.
3. Longer Recovery Times: Healing takes longer in mature skin, requiring patients to be more patient and diligent with aftercare.
4. Risk of Further Damage: Overly aggressive treatments can cause additional damage to ageing skin, such as pigmentation issues or prolonged redness.
5. Complex Scar Profiles: Ageing skin often exhibits a mix of rolling, boxcar, and ice-pick scars, each requiring a tailored approach.
6. Increased Risk of PIH: Ageing skin is more prone to post-inflammatory hyperpigmentation (PIH), making discoloration a concern after treatments.

Treatment Options

Fortunately, we have treatments that can address acne scars on ageing skin. These include:

1. Fractional Laser Therapy: Fractional CO2 lasers create tiny, controlled areas of damage within the skin. These areas are surrounded by healthy tissue, which speeds up the healing process. The heat from the laser stimulates fibroblasts to produce new collagen, improving skin elasticity and reducing the appearance of acne scars.
2. Fractional Microneedle RF: Fractional Microneedle Radiofrequency (RF) combines microneedling capabilities with radiofrequency energy to stimulate collagen production within the skin. Its double-action helps improve skin texture, tighten loose skin, and diminish acne scars without damaging the surface of ageing skin.
3. Dermal Fillers: Dermal fillers involve injecting a gel-like substance beneath the skin to fill in indented areas caused by acne scars. They restore volume and smooth out uneven areas on the skin.
4. Collagen-Stimulating Fillers: These fillers not only restore volume to indented acne scars but also stimulate collagen production for skin remodelling. As mentioned above, though, they may not always clear acne scars well enough on ageing skin and you’ll need the advice of an experienced doctor to see if your skin profile fits.  
5. Subcision: Subcision treats depressed acne scars, such as rolling or boxcar scars. A surgical tool gently breaks the fibrous bands that pull the skin down, releasing the tension and allowing the skin to rise to a smoother, more even level.

At 1Aesthetics, we emphasise a combination approach to treat acne scars effectively. By addressing different types of scars with multiple modalities, better results can be achieved.

The Role of Skincare in Supporting Treatment

Proper skincare is crucial in supporting acne scar treatment outcomes and maintaining skin health. We recommend:

1. Hydration: Moisturisers help maintain the skin's barrier function, keeping it supple and less prone to irritation.
2. Sunscreen: UV rays can worsen hyperpigmentation and slow down healing. Daily application of broad-spectrum sunscreen is essential.
3. Active Ingredients: Retinoids, vitamin C, and peptides can support collagen production and improve skin texture over time.
4. Gentle Cleansing: Using mild cleansers prevents stripping the skin of natural oils, which is particularly important for ageing skin.

Preventing Further Damage

To minimise future skin damage and prevent the exacerbation of acne scars, consider the following:

1. Avoid Picking: Picking at scars or acne can worsen the condition and result in infection or further scarring.
2. Adopt a Healthy Lifestyle: Proper nutrition, adequate hydration, and regular exercise support overall skin health.
3. Stress Management: Stress can exacerbate acne and slow down the healing process, so practices like meditation and yoga may help.

When to Seek Professional Help

Mature skin's reduced ability to regenerate means scars may persist longer without targeted treatment. If consistent skincare use hasn't produced noticeable improvements, it may be time to explore professional acne scar removal treatments like laser therapy.

Consultation for Acne Scar Removal in Singapore

Acne scars on ageing skin require a thoughtful approach to achieve optimal results. For those seeking professional help in Singapore, 1Aesthetics offers expert care and customised solutions for acne scar removal.

The complex nature of acne scars means there isn't a one-size-fits-all treatment. An effective treatment protocol can be designed only through a detailed examination of a patient's condition and with a multimodal approach.
Book a consultation with us to find out how we can help with your acne scars.