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2025.07.10
Acne scars come in different types! Treatment varies depending on whether they're redness or crater-like scars.
As an Assistant Professor, Associate Ward Director, and Chief of Dermatopathology at the university hospital dermatology department, I deepened my expertise through academic presentations and paper publications both domestically and internationally. I have handled a wide range of treatments, from birthmark therapy in children to adult pigmentation concerns, utilizing various lasers and injection therapies, while also contributing to community healthcare. Through encountering numerous cases, I strongly felt the potential and necessity of aesthetic medicine, resolving to pursue further expertise. Building upon my solid dermatological knowledge and meticulous diagnostic skills, I value treatments that gently support each individual's skin while bringing out its inherent beauty.
Good evening! As someone from a generation that had limited insurance coverage for acne treatment, I regret the acne scars—especially the permanent ones—that remained. But now we live in an era where significant improvement is possible through out-of-pocket treatment.
I am Dr. Aya Hayama, a board-certified dermatologist.
While both are referred to as acne scars, treatment differs depending on whether it's just redness (post-inflammatory erythema) or indented crater-like scars (acne scars).
Redness from acne scars (the following 3 types)
Red & Pigmented Spot, as shown in the lower right,Post-inflammatory erythemaIf this is the case, it means either lymphocytes remain in the dermis after inflammation, or vasodilation occurs due to the wound healing effect. Even if the inflammation appears to have subsided and the area has flattened with antibiotics, it takes 3-6 months for natural healing to complete.
On the contrary, continuing to apply antibiotics won't make it go away any faster; it only increases resistant bacteria, so stop using them.
While stopping new acne breakouts is the priority, many people also want to treat acne scars after healing or even while treating active breakouts.
For self-funded treatments, we recommend tranexamic acid to calm inflammation for initial redness, and vitamin C to suppress vasodilation for persistent redness.Cosmetics, including doctor-developed cosmeticsWell,Mesona JWe recommend incorporating items such as these. Additionally, boosting skin metabolismpeelingThis treatment is also excellent for preventing new acne breakouts.
Personally,Bio PeelIt seems effective for hyperpigmentation and post-inflammatory erythema, so I highly recommend it!!
※Bio Peel (Milan Peel)
https://biancaclinic.jp/treatment_category/skin-care/skin/biorepeel/
Next, the keloid in the center-bottom (Keloid）
When acne forms on the lower jaw, the affected area is mobile, causing the acne scar to enlarge beyond its original size and develop into a pale pink nodule known as a keloid. This involvesLocal steroid injection(Kenacort) andSteroid tapePlease consult us as it is effective.
In cases where the scar is large, surgical excision followed by careful suturing may result in a clean appearance. However, depending on the individual's constitution, keloids may recur.
Lower left HypertrophicHypertrophic scar）
The area corresponding to the wound thickens with a reddish hue during the temporary wound healing process. While it may improve naturally if left alone, it can also progress to a keloid. Therefore, steroid tape or topical steroid application,Tranist Oral Solutionand can also help prevent and improve conditions more quickly.
Acne scar crater scars (top 3 types)
The most troublesome aspect of acne is the pitted scars that remain. When inflammation from acne becomes chronic, it leads to fibrosis—a hardening of the underlying tissue—causing the skin to become thick and rigid. When this fibrosis occurs intensely in localized areas, creating noticeable unevenness, it's called acne scarring. During the healing process, the dermis becomes fibrotic and gets pulled, creating depressions or craters. In such cases, treatment requires both an external approach from the surface and an internal approach from within the dermis.
The ice pick in the upper rightIce pick type）
It is a small but deep scar.
This involves applying a highly concentrated peeling agent to utilize skin regeneration and reduce the depth of the indentation.TCA CrossUsing needles or cannulas, we shear the hardened, fibrotic tissue beneath the skin caused by acne scars, lifting the sunken crater-like areas upward.SubdivisionSimilarly, using a CO₂ laserTri-filTreatment using [method] is effective.
Tri-Fill also allows simultaneous injection of skin-nurturing agents, making it a highly promising treatment for scar therapy.
Boxscar in the center-rightBoxcar type）
Both the bottom of the depression and the surrounding area are scarred.
This also has the aforementionedTCA CrossやSubdivision、Tri-filis effective, and furthermore, as a surface approach, it smooths the edges and promotes wound healing.DermapenWell, it's become less common lately, but...Fractional LaserTreatment is also effective. Recently,DermapenFine needles are inserted, emitting high-frequency RF waves that activate collagen production from the tips.potenzais popular.
Combining these treatments can also be effective.
Rolling (top left)Rolling type）
Those with strong scar tissue pulling down the bottom portion.
Similarly to boxcars,TCA Cross, Subcision, Tri-Fill, Dermapen, Fractional Laser, Potenzais valid.
We also recommend combining treatments!!
Here's a personal musing from me, a dermatologist...
Starting tomorrow, I hope to be able to explain each individual treatment.
As an insurance-covered treatment, I've treated tens of thousands of people for acne. I've also held numerous acne discussion groups and lectures under insurance coverage, and have been actively involved in educational outreach.
While I myself don't suffer from severe acne, I am prone to breakouts due to stress and have experienced scarring. This is an area where I focus my efforts, both in terms of insurance coverage and out-of-pocket treatments.
To celebrate BIANCA's opening, we're offering a discount campaign so you can receive plenty of the acne scar treatments you've been wanting most! Please take this opportunity to consult with us!!
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