Acne may come and go, but acne scars last forever and can surface as young as your teenage years. They aren’t straightforward to treat as well; to date, atrophic scars are the most complicated to treat. In Singapore, recent treatments for acne scars include laser therapy, dermabrasion, subcision, chemical peels, radiofrequency and lots more. Lately, there’s been talk surrounding threadlifts and acne scars. Is there a chance this skin tightening treatment can help with acne scar removal? Let’s find out more. 

Types of atrophic scars

Atrophic acne scars are often the result of severe acne. They form when the skin is unable to regenerate tissue and leaves behind imbalanced scarring as a result. There are three types of atrophic scars:

Icepick scars

  • Small and narrow,  less than 2mm 
  • Resembles deep pores
  • Sharply delineated and tapered into the subcutis and deep dermis

Rolling scars

  • Relatively broad, wider than 4-5mm 
  • Does not have distinct edges, appears in a M-shape 
  • Superficial, depth corresponds to epidermal thickness 

Boxcar scars

  • Round, oval-shaped resembling chickenpox scars 
  • Broad, flat base with a U-shape

However, these three types of scars are not easily distinguishable and would require a combination of treatments for removal. I will briefly touch on the treatment options for atrophic scars and move onto threadlifts.

Types of treatment methods for atrophic scars

Lasers

Fractional lasers are your laser of choice as they damage only small columns of skin with a faster recovery rate and fewer side effects. However, multiple sessions are required as only a bit at a time can be treated each session. While fractional ablative lasers work better on icepick and boxcar scars and fractional non-ablative lasers work better on rolling scars, combining both might actually yield better results. 

If you have active acne and wish to treat your acne scars at the same time, my laser of choice is the Erbium Glass Laser. With a wavelength of 1540nm, this non-ablative laser can target the inflammation of acne and stimulate collagen in deeper layers of the skin at the same time.

Excision

Excision involves using an ablative laser to cut out the scar tissue followed by careful repair of the wound. This procedure is reserved for stubborn icepick and boxcar scars and needs to be done very carefully to reduce the risk of leaving a new scar.

Chemical peels

With chemical peels, you remove acne scars by applying chemicals to your skin’s surface, destroying the damaged layer of skin. While different chemical levels are used depending on the severity of your atrophic scarring, in Singapore deeper peels are rarely used as they require sedation, except focally as in TCA CROSS.

Subcision

During subcision, a needle is inserted under the skin and moved in a fanning motion. The aim is to break apart tough scar fibres and create a new wound that can heal correctly into a normal layer of skin. While subcision is effective by itself, I personally like to combine it with other treatments like fillers and chemical peels.

Fractional Microneedling Radiofrequency

Microneedling involves using microneedles to bypass the skin surface and deliver radiofrequency energy directly to the deep part of the skin where the scarring is. This triggers your skin to remodel and produce collagen, which regenerates the skin.

Threadlifts for acne scars?

Threadlifts are often used as a non-surgical alternative to lift the nose, face, neck and other parts of the body. Apart from their amazing lifting effects, threadlifts are also known for their ability to stimulate collagen production and rejuvenate our skin’s elasticity. This is due to the effects of PDO lifting threads as they dissolve in your body. 

Atrophic scars form when your body doesn’t produce enough collagen during the healing process to repair the damage done. So, it’s self-explanatory that the introduction of collagen into your skin can help heal acne scars, as seen with some treatments. Does this mean that threadlifts may help with acne scars too? For sure — but I wouldn’t rely on it as the main treatment method if acne is your priority. 

If you have areas of sagging skin you would like to lift and want to treat your wrinkles and acne scars as well, you’ll definitely see desirable results, but I don’t reckon threadlifts will provide the same results as acne-focused treatments. Any of the treatments I listed above might be better, especially if you have moderate to severe acne scarring.

Takeaway

Acne scars are not easy to treat. To assess if a treatment works for you, the best way is to look at clinical studies, analyse the technology used and of course engage a doctor who knows what he’s doing.

References

  1. Mujahid, N., Shareef, F., Maymone, M., & Vashi, N. A. (2020). Microneedling as a Treatment for Acne Scarring: A Systematic Review. Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.], 46(1), 86–92. https://doi.org/10.1097/DSS.0000000000002020
  2. Bhargava, S., Cunha, P. R., Lee, J., & Kroumpouzos, G. (2018). Acne Scarring Management: Systematic Review and Evaluation of the Evidence. American journal of clinical dermatology, 19(4), 459–477. https://doi.org/10.1007/s40257-018-0358-5