Acne Scar Surgery

Acne Scar Surgery is frequently performed as it gives a big reward for avoiding a terrible scar on the face.

Acne Scar Surgery 

Acne Scar Surgery may sound intimidating but it is not the case. Most of the procedure is very tiny and leaves no scar.

Surgery? Operation? The thought of this is scary for most client. Why should acne and acne scar require such a big procedure?

Surgery is never the first line treatment for the acne scar issues. This is the last line of treatment left for the stubborn acne scar. However, these procedures are mostly mini operation, requiring no more than a simple local anaesthesia.

The common surgery performed includes blemish excision, laser surgery and chemical surgery.



Acne Scar Surgery

Acne Scar Surgery is needed for Boxer Scar & Ice-picked Scar.


Acne Scar Surgery: Blemish excision (blemish incision and drainage)

Acne Scar Surgery is mostly about draining the burst or un-burst pustule letting out the pus.

Acne blemish is caused by the deep-seated follicular unit whereby the sebaceous gland whose sebum secretion is blocked by the abnormal dead cell sloughing along the sebaceous duct. The distending duct rupture at the very deep portion of the follicular unit into the surrounding sub-cutaneous tissue thereby releasing the bacteria as well. This brings about inflammatory response to wall-off the damage. Pus and debris collection occurs here causing discoloration called blemish. Simple course of antibiotic may sometime is all that is required to clear this blemish. Occasionally, it refuses to clear off. In such an even, a small incision using a needle is sufficient to release and drain off the pus and debris and hence clear away the blemish.

Blemish excision (I&D) Laser surgery Chemical surgery Intra lesion injection
·         Is incision and drainage of inflamed & infected pus of cystic acne

·         Always done by aesthetician

·         May leave a small imperceptible scar

Non-invasive laser

·         Help reduce inflammation, and bacteria activity

·         Help remodeling & rejuvenation

·         For less severe scar

·         Rolling scar

·         Pulsed dye laser- decrease acne redness


Superficial, lunchtime peel—AHA, BHA peel

For acne prevention, rejuvenation, rolling scar

Deep peel—Jessner’s peel followed by Retinoic acid peel

Phenol peel

For ice pick scar, Boxcar scar, rolling scar


·         Is squeezing of non-inflammatory blemishes eg black head, white head/milia

·         Done by beauty saloon

Invasive laser

·         CO2 & erbium YAG- for Boxcar scar, ice pick scar

·         Rolling scar

Treat cystic acne before it scar Treat acne &acne scar Treat acne & acne scar Treat cystic acne before scaring

Keloid acne scar on body

Less expensive Most expensive Less expensive

Acne Scar Surgery: Laser surgery

In Acne Scar Surgery one of the common method is to use laser instrument.

There are many different types of laser. Some are non-invasive while others are invasive. The choice will depend on the severity of breakout, types of acne scar, skin types and the aspiration of the patient. A summary is given in the table.

Invasive laser is more appropriately called as surgical procedure. While the non-invasive laser procedure is not exactly a surgery.

Acne Scar Surgery: Chemical surgery

In Acne Scar Surgery, where chemical, mostly mild peel may be used to clear away very shallow blemishes.

By this is mean the use of chemical peel. Various properties of different peel is summarized below. Surface peel usually provoke and initiate dermal remodeling and thus bring about rejuvenation. The effect is similar to laser treatment. Thus is good news for institution to do chemical peel without investing excessively in laser to achieve similar result.

AHA BHA Jessner’s Phenol
Eg glycolic acid

Lactic acid

Malic acid

Citric acid

Tartaric acid

Salicylic acid 3 formulae

Salicylic acid

Lactic acid


14% each

Use Croton oil


Not possible to over peel
Superficial Superficial Superficial Deepest peel

Reach dermis

Mild mild mild Intense

Restore dermal architecture

Followed by Retinoic acid

Apply & go home

Peel on 3rd day

Go deeper but stop at predetermined depth


Acne Scar Surgery: Intra-lessional injection

n Acne Scar Surgery where steroid injection can be used to address the acute phase acne eruption just before it enter a stage of heavy inflammatory reaction causing havoc response and resultant scar. 

Here, usually use corticosteroid, such as cortisone injection, directly delivered inside the acne lesion, usually huge cystic acne. Well, this is just an injection, it is not a surgery.

This is considered an acne emergency injection to prevent severe scaring in a huge eruption like the cystic acne. The result is dramatic. Within couple of days the blemish disappear completely, the redness gone and the swollen acne completely flattened. It is as if no sign eruption taken place! It is very rewarding to do this procedure for acne vulgaris.