Medically reviewed by Dr Sin Yong · Last reviewed · 33 min read · Doctor-performed, never delegated · Jump to questions
See also: ice pick scars treatment.
Dr Sin Yong · MBBS (NUS) · MRCS (Edin) · MSc Aesthetic Medicine with Distinction (Queen Mary, London) · MSc Practical Dermatology (Cardiff) · Global KOL
Acne scars are not all the same — boxcar, rolling, ice-pick and pigmented marks each respond to different treatments. Dr Sin Yong matches the method to the scar, combining subcision, resurfacing lasers, RF microneedling and collagen stimulation to smooth and refine acne-scarred skin.
Acne scar removal in Singapore is not one procedure but a sequence chosen per scar. Acne scar treatment starts with identifying the scar type: ice-pick, boxcar, rolling and tethered scars form differently and respond to different tools. Dr Sin Yong matches subcision, TCA CROSS, fractional CO2 resurfacing, RF microneedling and collagen stimulation to each scar on the same face rather than applying one method to all of them. Dr Sin Yong assesses and treats this personally at his clinic on Orchard Road, Singapore.
Also called: pitted scars, pockmarks, 痘疤, 痘坑, ニキビ跡
Acne scar treatment in Singapore is a sequence, not a single machine: the scar is graded by type and depth, tethers are released, pits are treated at their floor, and the surface is resurfaced last. Dr Sin Yong performs each step himself on Orchard Road, and the plan is written down with its fee factors before anything is booked. The sections below cover who treats acne scars in Singapore, how each modality compares, how skin type changes the plan, and what the first visit involves.
Acne scars in Singapore are treated by three kinds of doctor. An aesthetic physician such as Dr Sin Yong is a registered medical doctor practising aesthetic medicine; he performs the subcision, TCA CROSS and laser passes himself. A dermatologist is a specialist in skin disease who may also perform scar procedures. A plastic surgery specialist is the right referral for excision and grafting of large or deep scars. Which one suits you depends on the scar, not the title; the acne scar specialist Singapore page explains what each does and what to check before booking anywhere.
| Modality | What it changes | Scar types | Recovery | Skin-type caution |
|---|---|---|---|---|
| Subcision | Releases the fibrous tether under a depressed scar | Rolling, tethered | Bruising and swelling for days | Low; no surface injury |
| TCA CROSS | Collapses the walls of a narrow pit from its floor | Ice-pick, small deep boxcar | Crusts for about a week | Spot PIH possible; test spots first on darker skin |
| FSX Laser | Surface-directed remodelling of texture and shallow scars | Superficial boxcar, textural scarring | Shorter recovery than S3 | Settings chosen for Fitzpatrick III–V |
| S3 Resurfacing Lift | Multi-depth fractional CO₂ columns to the scar floor | Deep boxcar, ice-pick texture, mixed | Longest of the four; staged | Highest PIH risk; pre- and post-care planned |
| Secret DUO RF microneedling | Dermal remodelling with insulated needles, surface spared | Rolling, textural, post-subcision | Redness and pinpoint marks for days | Low; the preferred energy device on darker skin |
| Filler support | Holds a released scar up while collagen forms | Rolling after subcision | Minimal | Low |
Most faces treated on Orchard Road are Fitzpatrick III to V, and that changes the plan more than any device choice. Ablative energy on darker skin carries a higher risk of post-inflammatory hyperpigmentation, so settings are lowered, passes are staged, and the skin is prepared and protected before and after. It is also why superficial scars are given the FSX Laser, which has a shorter recovery than S3, and why Secret DUO, which spares the surface, is favoured for texture. Deep ice-pick and boxcar scars still need the S3 Resurfacing Lift; the difference on darker skin is the density of the passes and the spacing between sessions, not whether the laser is used.
Acne scar removal in Singapore is marketed as if one machine does it. In practice a scar is removed, softened or only camouflaged depending on what it is made of: a fibrous tether, a missing column of dermis, a sharp pit, or a raised over-growth. Dr Sin Yong grades each scar at the consultation and assigns it a tool. The table is the logic he uses; the fee follows the plan, not the device.
| Scar type | How it looks | What Dr Sin Yong uses | Why |
|---|---|---|---|
| Ice-pick | Narrow, deep, sharp-edged pits | TCA CROSS first; S3 Resurfacing Lift for the surrounding texture | Depth: a pit deeper than it is wide is treated at its base, not sanded from the top |
| Boxcar (shallow) | Flat-bottomed, defined edges, shallow | FSX Laser or S3 at a light setting | Superficial scars get the shorter-recovery option |
| Boxcar (deep) | Flat-bottomed, steep walls, deep | S3 Resurfacing Lift (fractional CO₂, multi-depth) | Deep scars need an ablative column that reaches the scar floor |
| Rolling | Wave-like, soft edges, worse under angled light | Subcision first, then Secret DUO or S3 | Tethers under the skin must be released before any resurfacing can lift the surface |
| Tethered / bound-down | Dimples that deepen when the face moves | Subcision, sometimes with a filler support | A fibrous band is the problem; energy alone does not cut it |
| Hypertrophic / keloid | Raised, firm, sometimes itchy | Intralesional injection and vascular laser | Raised scars are over-healed, so resurfacing is the wrong direction |
| Mixed, extensive, or previously treated | Several scar types on one face, or scars that did not respond | 4D Scar Reconstruction (layered programme) | Sequencing across layers, not a single device, is what changes |
Depth decides between the two lasers: FSX Laser for superficial scars, where its shorter recovery than S3 matters, and S3 Resurfacing Lift for deep ice-pick and boxcar scars. Tethered rolling scars are released by subcision before either laser is used. Anything described as permanent acne scar removal should be read as scar remodelling: the goal is a smoother surface under normal light, judged by you at the review, not a promise of invisible skin.

Not sure which scar type you have? Try the four-question checker →
No single treatment corrects every acne scar. Dr Sin Yong draws on a full toolkit, layering methods to address mixed scar types.

A multi-dimensional protocol that addresses acne scars at different depths in one coordinated plan — combining resurfacing, remodelling and collagen stimulation for complex, mixed scarring.

A precision resurfacing laser that refines the skin surface, softening shallow boxcar and rolling scars and improving overall texture and tone.

A technique that releases the fibrous bands tethering rolling scars to deeper tissue, allowing the depressed skin to lift and the surface to smooth.

A focal chemical application applied precisely into deep, narrow ice-pick scars to stimulate remodelling and gradually raise the scar base.

Radiofrequency energy delivered at controlled depth to remodel scar tissue and stimulate new collagen — well suited to rolling and boxcar scars with minimal surface disruption.

A collagen-stimulating injectable used to restore lost volume beneath atrophic scars, supporting the skin from below for a smoother surface over time.
“A rolling scar is tethered from below. Resurfacing the surface of a tethered scar treats the wrong structure.”
Dr Sin YongOn matching method to scar type
Acne scar treatment in Singapore starts by separating true scars from marks. A scar is a change in contour: a pit, a dip or a raised bump you can feel. A mark is a change in colour on smooth skin: red, brown or pale. The two often sit side by side, and they answer to different treatments. Treating a mark as a scar, or a scar as a mark, is a common reason a course disappoints.

| Concern | What it is | What is usually used | Not for |
|---|---|---|---|
| Red marks (post-inflammatory erythema) | Dilated small vessels left after a pimple; they blanch under pressure | Acne control, then vascular-directed light or laser | Brightening serums or resurfacing |
| Brown marks (post-inflammatory hyperpigmentation) | Extra pigment left after inflammation | Sun protection, topical care and pigment-directed laser | Aggressive heat, which can deepen it |
| Pale marks (hypopigmentation) | Loss of pigment after inflammation or earlier treatment | Assessment of the cause; sun protection to limit contrast | Repeated aggressive energy |
| Depressed scars (ice-pick, boxcar, rolling) | Loss or tethering of the dermis | Subcision, TCA CROSS, FSX Laser or S3 Resurfacing Lift, chosen by scar type | Brightening products or pigment laser alone |
| Raised scars (hypertrophic, keloid) | Over-healed scar tissue above the skin | Intralesional injection and vascular laser | Resurfacing, which can worsen a raised scar |
Dr Sin Yong grades every scar and mark himself, in person, under angled light. He uses a pressing-glass test: if a red mark empties under pressure, it is blood in vessels, not pigment and not a scar; see red acne marks (PIE). A stretch test shows which depressed scars are tethered. Tethered scars are released by subcision first. Narrow ice-pick tracts are treated with TCA CROSS. Superficial scars suit FSX Laser, which has a shorter recovery. Deep ice-pick and boxcar scars are resurfaced with his S3 Resurfacing Lift on the DEKA SmartXide Tetra CO2. Brown marks are planned alongside, with PIH care built around sun protection, so colour and contour are treated in a set order.
Acne scars form when inflammation from acne damages the skin's collagen. The type of scar left behind depends on how that damage healed. Pitted, depressed scars — the atrophic scars most people mean by acne scarring — divide into ice-pick scars, boxcar scars and rolling scars, each with a different shape and depth. Flat brown or red pimple marks left after a breakout are pigment rather than true scars, and raised keloid or hypertrophic scars are a separate category again.
This is why there is no single right acne scar treatment. A fractional CO2 laser that refines the surface of a boxcar scar does little for a deep ice-pick scar; subcision that releases a tethered rolling scar does nothing for pigmentation. Dr Sin Yong assesses your exact mix of scar types first, then plans acne scar removal around them — so that each scar type is matched to a method suited to it.
Most people who seek acne scar treatment in Singapore have more than one type of scar at once, along with some pigmentation and enlarged pores. A combination plan addresses each of these on its own terms.
Dr Sin Yong’s toolkit is matched to the structure of each scar: subcision for tethers, TCA CROSS for narrow ice-pick tracts, fractional CO2 resurfacing for edges and texture, RF microneedling for boxcar and rolling scars, and collagen-stimulating injectables where volume beneath is lost. Methods are layered and planned as a series because collagen remodels gradually. The sequence he uses is set out on the Scar Repair Programme.
Different scar shapes form differently, so ice-pick, boxcar and tethered rolling scars each need a method suited to them.
Flat marks are pigment or redness rather than true scars and are treated with different, pigment-focused approaches.
“You can resurface a tethered scar indefinitely. The tether keeps pulling it down.”
Dr Sin YongOn why release comes before resurfacing
Most acne scars can be improved rather than erased: realistic aims are smoother texture, shallower scars and a more even surface, built over a course. Downtime depends on the method, from redness and peeling after resurfacing to bruising after subcision, and active acne is settled first. Method-by-method detail is on acne scar treatment downtime, and the order of acne control, marks and texture on the acne-to-scar pathway.
The same principles apply to other scars. Stretch marks are dermal scars and respond to the collagen-remodelling lasers, subcision and microneedling used for acne scars; surgical and injury scars are assessed on the same basis, and raised keloid or hypertrophic scars are a separate category. Cellulite is not scarring but is often asked about at the same visit. See stretch mark treatment, scar reconstruction and keloid treatment.
Acne scars fall into distinct types, each with its own shape and its own most suitable treatment. Tap a scar type to see how it looks and how Dr Sin Yong approaches it.
Acne scar treatment in Singapore starts with matching the method to the scar. Dr Sin Yong treats pitted acne scars including ice-pick, boxcar and rolling scars, as well as flat pigmented acne marks, drawing on subcision, RF microneedling, fractional CO2 laser resurfacing, TCA CROSS and collagen stimulation. Because most people have a mix of scar types, acne scar removal is planned as a combination rather than a single laser, targeting each scar at the right depth for smoother, more even skin over a series of sessions.
Permanent acne scar removal is one of the most-searched phrases in this area, and it overstates what any device can do. A scar is a structural change in the dermis. Resurfacing, subcision and energy-based work remodel that structure; they do not return the skin to a state where a scar was never formed. What is realistic is a change in depth, edge definition and light behaviour, which is what makes a scar read as less visible.
“You can resurface a tethered scar indefinitely. The tether keeps pulling it down.”
Dr Sin YongOn scar assessment
Pitted scar treatment is decided by which pit is present. Boxcar, rolling and ice-pick scars share an appearance to the patient and behave differently under every modality — a rolling scar is tethered from beneath and is a subcision problem before it is a laser problem, while an ice-pick scar is narrow and deep and often answers better to TCA CROSS than to resurfacing. Laser pimple scar removal, as it is commonly searched, is really this sorting exercise followed by the matching tool.
Fotona acne scar work sits alongside the CO2 platforms here rather than replacing them; Dr Sin Yong is an international key opinion leader for Fotona as well as DEKA, and the platform is selected for the scar type rather than for the badge on the machine. Cost follows the plan and is set out at consultation; see what determines the fee.

Acne scars are not one thing: narrow, wide and tethered scars need different tools. A short video from Dr Sin Yong’s Instagram, with captions.
Acne scar removal in Singapore is searched for as if a scar could be taken off the skin. It cannot. A scar is a change in the structure of the dermis, and what treatment does is reduce its depth and its visibility under ordinary light, not erase it. "Removal" therefore means something different for each scar type, because each is built differently: a narrow tract, a wide depression with walls, a soft wave held down by a band, or an over-growth above the surface. The table sets out which of four actions, release, resurface, fill or flatten, applies to each, and links to the page for that scar.
| Scar type | What "removal" means here | Release | Resurface | Fill | Flatten | Page |
|---|---|---|---|---|---|---|
| Ice-pick | Rebuilding a narrow, deep tract from its floor so it reads as shallower | Not needed; there is no tether | Point-shot CO2 into the pit, then fractional passes for the surrounding texture | No; filler spreads around a narrow tract | TCA CROSS applied into each tract | Ice-pick scars |
| Boxcar | Softening the vertical walls and raising the floor of a wide depression | Only where the stretch test shows a tether as well | FSX Laser for shallow boxcar scars; S3 Resurfacing Lift for deep ones | Occasionally, under a released floor with a volume deficit | TCA CROSS for narrow, deeper boxcar scars | Boxcar scars |
| Rolling | Letting a tethered wave rise once the band beneath it is cut | Subcision first, before anything else | Afterwards, for surface texture | Radiesse into the released space where tissue beneath has thinned | Not applicable | Rolling scars |
| Hypertrophic or keloid | Bringing a raised, over-healed scar down towards the surface | No | No; resurfacing can worsen a raised scar | No | Intralesional injection and vascular laser | Keloids and hypertrophic scars |
Two rules follow from the table. A rolling scar is a subcision problem before it is a laser problem, because resurfacing fixes skin in whatever position it finds it and a tether keeps pulling it down. A raised scar is the one type for which resurfacing is the wrong direction altogether. Across all four, "removal" is a reduction in depth and visibility judged by you at review under ordinary light; it is not erasure, and no method returns the skin to a state where the scar never formed. How the four actions are sequenced on a face that carries several scar types is on 4D Scar Reconstruction, and what each method's recovery involves is on acne scar treatment downtime.
TCA CROSS places high-strength trichloroacetic acid into the base of each ice-pick scar with a fine applicator, prompting the tract to rebuild from within over several sessions; a small crust forms on each scar and sheds. It suits depth rather than width, so ice-pick and narrow, deep boxcar scars, and is not used across whole areas. The technique is on TCA CROSS for acne scars, and the scar itself on ice-pick scar treatment.
Surgery is occasionally right for a few individual scars, not a whole face: punch excision, elevation and grafting exchange a deep pit for a flat line or small graft, and the surrounding texture still needs laser or RF work. Dr Sin Yong refers these to a plastic surgery or dermatology specialist and plans resurfacing around them. When surgery is and is not needed is on scar removal surgery vs non-surgical options.
Acne scar laser treatment usually means fractional resurfacing: ablative fractional CO2, such as the DEKA platform behind the S3 Resurfacing Lift, vaporises fine columns and remodels the dermis; non-ablative lasers heat without removing the surface; fractional pico suits shallow texture in pigment-prone skin. No laser releases a tether or reaches an ice-pick floor. Compare them on subcision vs laser, Fraxel vs CO2 vs Tetra, pico laser for acne scars and RF microneedling for acne scars.

| Option | What it does | What it cannot do | Typical recovery | Who it tends to suit |
|---|---|---|---|---|
| Subcision | Releases the fibrous bands that tether a rolling scar to deeper tissue, so the depressed skin can lift from below | Does not resurface texture, soften scar edges or reach narrow ice-pick tracts | Bruising and swelling over the treated area that settle on their own | Rolling scars and boxcar scars with a tethered component |
| S3 Resurfacing Laser (fractional CO2) | Ablative fractional resurfacing that softens scar edges and refines surface texture while the dermis remodels | Does not release tethering, and is not the primary tool for deep, narrow ice-pick scars | Redness, fine crusting and peeling while the surface renews; strict sun protection afterwards | Shallow boxcar scars and mixed texture where edge definition is the problem |
| RF microneedling | Delivers radiofrequency at a controlled depth to remodel scar tissue with limited surface disruption | Does not lift a tethered scar on its own and does not treat flat pigmented marks | Short-lived redness and pinpoint marks | Boxcar and rolling scars, and pigment-prone skin where surface injury is kept low |
| TCA CROSS | Places high-strength trichloroacetic acid into the base of each narrow scar to prompt collagen remodelling from within | Not suited to wide rolling scars or to treating a whole area; carries a pigment risk in darker skin | A small crust on each treated scar that sheds as the skin heals | Ice-pick scars and narrow, deep boxcar scars |
| Radiesse collagen stimulation | An injectable that supports atrophic areas from beneath and stimulates collagen where volume has been lost | Does not change scar edges or surface texture | Possible swelling or bruising at injection points | Scars with an underlying volume deficit, usually alongside release and resurfacing |
| Surgical scar revision (referred on) | Punch excision, punch elevation or punch grafting removes or raises an individual deep scar surgically | Does not improve surrounding texture, and exchanges a pit for a fine surgical mark | Sutures and wound care set by the operating specialist | Isolated scars too deep or wide for TCA CROSS or resurfacing; Dr Sin Yong refers these patients to a plastic surgery or dermatology specialist |
Dr Sin Yong begins by sorting each scar by type, including a stretch test to separate tethered scars from surface ones, because the type decides the tool. His acne scar work follows his 4D Scar Reconstruction protocol, which addresses surface texture, dermal depth, subcutaneous tethering and volume deficit in sequence: subcision first to release tethered scars, Radiesse placed into the released space where a volume deficit exists, TCA CROSS for narrow ice-pick tracts, and resurfacing for the scar walls and surface.
The resurfacing step is his S3 Resurfacing Lift on the DEKA Tetra Pro fractional CO2 platform. Rather than a uniform pass across the area, he places precision point-shot ablations into individual scar pits first and then applies fractional passes across the surrounding skin, so the pits are treated at depth before the skin around them is resurfaced. Local anaesthetic is applied beforehand, and parameters are adjusted to the individual skin type, with the risk of post-inflammatory pigmentation in Fitzpatrick III to V skin planned for. Isolated scars that need punch techniques are referred to a plastic surgery or dermatology specialist, and resurfacing is planned around that.
An acne scar course at this practice is planned from an examination, not from a device list, and the plan is written before anything is booked. The method is his 4D Scar Reconstruction protocol, set out in full on 4D Scar Reconstruction; what follows is how a course is built from it, step by step.

Each scar is examined under angled (oblique) light, which throws the edges of boxcar scars and the dips of rolling scars into shadow so that contour can be read rather than guessed. The skin is then stretched: a scar that flattens when the surrounding skin is pulled is tethered by a fibrous band beneath it, whatever its shape, and that finding changes the first step. A pressing-glass test separates red marks, which empty under pressure, from pigment and from true scars. Photographs are taken under standardised lighting for the record. Fitzpatrick skin type, acne activity, any isotretinoin use, keloid history and earlier treatments are noted at the same visit, because each changes settings or timing.
The result is a map, zone by zone, of which scars are ice-pick, boxcar, rolling, tethered, raised, or marks rather than scars, with the Goodman and Baron grade recorded as a description of how visible the scarring is. Most faces carry more than one type, and the map is what lets each scar be assigned its own tool rather than one laser being run over everything.
The course runs in a set order. Release comes first: wide-zone subcision divides the bands that hold tethered and rolling scars down. Support comes second: Radiesse is placed into the released space where a volume deficit exists, and TCA CROSS is applied into narrow ice-pick tracts to rebuild them from the floor. Resurface comes last: the S3 Resurfacing Lift on the DEKA SmartXide Tetra CO2 places point-shot ablations into individual pits before fractional passes cross the surrounding skin, so pits are treated at depth before the skin around them is resurfaced. Depth decides the laser: FSX Laser for superficial scars, S3 for deep. Active acne is controlled before any of this begins, and on Fitzpatrick III to V skin the passes are lighter and staged, with pigment care built around sun protection.
Each stage is reviewed against the standardised photographs before the next is timed. Review looks at which scars have changed and which have not, whether a tether has re-formed, how the skin has healed, whether pigment has darkened, and whether residual superficial scarring now suits the FSX Laser rather than a further S3 pass. The interval between stages follows healing, because each treatment starts a wound-healing response that must complete before the next begins. The number of stages is not fixed at the outset; it is set from what the review shows. Isolated scars too deep or wide for these methods are referred to a plastic surgery or dermatology specialist, and the course is planned around that.
Filler helps a rolling scar only where the tissue beneath it has thinned, and does nothing for the tether, so in the 4D Scar Reconstruction sequence subcision comes first and Radiesse is placed into the released space second. No filler changes scar edges, texture or an ice-pick tract. Why the two are paired, which goes first and who should not combine them is on subcision with filler.
Subcision divides the fibrous bands that hold a rolling or tethered scar down so the floor can rise, using a needle or blunt cannula beneath an intact surface under local anaesthetic; bruising and swelling follow and settle. It comes first because resurfacing fixes skin where it finds it, and it does not refine texture or reach ice-pick tracts. The technique is on subcision for acne scars, and its limits on subcision vs laser.
Some people are better served by waiting: active, inflamed acne, recent isotretinoin, a current infection or cold sore, a fresh tan or pregnancy each defer scar work, and an expectation that scars will vanish is addressed before anything begins. Isolated scars too deep for TCA CROSS or resurfacing are referred for punch techniques. How acne control, marks and texture are sequenced is on the acne-to-scar pathway.
People hoping for completely smooth skin, or who still have active inflamed acne, tend to respond poorly, because treatment improves scars rather than erasing them.
Expected effects depend on the method: redness, swelling and pinpoint scabbing after resurfacing, and bruising where subcision has been done. These settle as the skin heals. Less often, treatment can cause prolonged redness, darkening of the skin (more likely in deeper skin tones and with sun exposure), infection, or a scar that looks different from before. Injectables carry their own risks, including lumps, which are discussed before they are used. How the skin responds varies between people, and outcomes are never fixed in advance.
Aftercare in brief: keep the skin clean, let scabs fall away on their own, avoid heat, heavy exercise and active skincare until advised, stay out of the sun and restart retinoids only when the clinic says. What each method’s recovery looks like is on acne scar treatment downtime, and the resurfacing checklist on CO2 laser aftercare.
The fee depends on the area treated, which methods the scar pattern calls for, the consumables or injectables used, the number of zones and whether methods are combined in one plan. A written quote follows examination, which also decides whether treatment is advised at all or acne should be controlled first. How quotes are set at this practice is on how we quote.
Scars on one face often belong to more than one type, so the useful question is which type each scar is, not which laser to book. The table below is a reading aid, not a prescription: it lists how each type tends to look, the approach usually chosen first, what is commonly added and what tends not to work. A tethered scar is one that flattens when the skin around it is stretched, whatever its shape. Dr Sin Yong sorts scars by this kind of examination, including the stretch test, before any method is proposed, and the plan is reviewed as the skin responds.
| Scar type | How it looks | First-line | Adjunct | What does not work |
|---|---|---|---|---|
| Ice-pick | Narrow, deep tract, wider at the surface | TCA CROSS into each scar | Point-shot fractional CO2 | Filler; surface resurfacing alone |
| Boxcar | Broad depression with defined vertical edges | Fractional CO2 or RF microneedling | TCA CROSS for narrow, deeper scars | Subcision, unless also tethered |
| Rolling | Wide, soft-edged undulation that flattens on stretch | Subcision to release the tether | Radiesse in the released space; resurfacing for texture | Resurfacing on its own |
| Tethered (any shape) | Flattens when the surrounding skin is stretched | Subcision before anything else | Volume support, then resurfacing | Laser or filler over an intact tether |
| Hypertrophic or keloid | Firm, raised scar above the skin | Intralesional injection | Energy-based devices, assessed individually | Resurfacing, which can worsen raised scars |
| PIH or PIE marks | Flat brown or red marks, no change in texture | Pigment-focused laser with topical care | Daily sun protection throughout | Resurfacing, which can deepen pigment |
Clinicians need a shared way to describe how visible acne scarring is, and the qualitative scale published by Goodman and Baron in 2006 is among the most widely used. It has four grades, based on appearance at a social distance and on whether the scarring can be flattened by manually stretching the skin. It is a description of how scarring looks, not a treatment chooser: two people with the same grade can need entirely different methods, because the grade does not say whether a scar is ice-pick, boxcar or rolling. It is useful for recording how scars are assessed at consultation and for reviewing change later, and it sits alongside the scar-type examination rather than replacing it.
| Grade | Published descriptor | What it means for planning |
|---|---|---|
| 1 | Macular: flat red, brown or pale marks, a colour rather than a contour issue | Pigment- or redness-focused care; resurfacing is not the aim |
| 2 | Mild atrophic or hypertrophic scars, not obvious at social distance, can be covered by make-up | Often managed with resurfacing or RF microneedling, chosen by scar type |
| 3 | Moderate scars, obvious at social distance, but flattened by stretching the skin | The stretch result suggests tethering, so release is considered first |
| 4 | Severe scars, obvious at social distance, not flattened by stretching | A layered plan; isolated deep scars may be referred for punch techniques |
Acne scar work goes in a deliberate order, and the order is a large part of why it is planned rather than sold as a single laser. In Dr Sin Yong's 4D Scar Reconstruction, the first step is release: subcision divides the tethers that hold scars down (see 4d scar reconstruction). The second is support: Radiesse is placed into the released space where a volume deficit exists, and TCA CROSS is used to rebuild narrow ice-pick tracts from within. The third is resurface: the S3 Resurfacing Lift on the DEKA Tetra Pro refines the scar walls and the surrounding skin once the structures beneath are addressed.
Reversing the order tends to treat the wrong structure. Resurfacing remodels skin in whatever position it finds it, so lasering a tethered scar leaves the tether pulling it down, and filler placed under an intact band tends to spread around it rather than lift the scar. Sequencing also protects the skin: active acne is settled first, each step is allowed to heal before the next, and pigment risk in Fitzpatrick III to V skin is planned for throughout. The plan is reviewed between steps and adjusted to how your skin responds, which is why no fixed course is promised at the start.
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Every treatment is performed by Dr Sin Yong personally. Singapore Medical Council registered · invited to share his clinical expertise internationally as a Key Opinion Leader for CLASSYS, DEKA, HIRONIC, FOTONA, ALMA, LUTRONIC and ILOODA · HSA-registered devices · ultrasound-guided correction
Dr Sin Yong's aesthetic clinic in Singapore is on Orchard Road, a short walk from Orchard MRT. More about the aesthetic doctor in Singapore who performs every treatment.
WhatsApp Dr Sin Yong →or use the enquiry formNo. Flat red or pink marks after a pimple are post-inflammatory erythema: small vessels that stay dilated after the inflammation ends. The skin surface is smooth, and the mark blanches when a glass is pressed on it. They answer to acne control and vascular-directed treatment, not to the resurfacing used for pitted scars. A face can carry both, so each is assessed separately.
Depressed scars are a change in contour, so they show through shadow. Overhead or side lighting catches the edges of boxcar scars and the dips of rolling scars, while direct, even light flattens them. That is why scars are graded under angled light at assessment, and why progress is reviewed in the same lighting each time.
The most useful step is treating active acne early, because deep, inflamed spots are the ones most likely to scar. Not picking or squeezing spots, and using daily sun protection, also lowers the chance of lasting marks. Once a scar has formed, skincare cannot reverse the change in contour, but controlling acne stops new scars adding to it.
Skincare can help marks and overall texture, and retinoids are often part of a plan, but no cream lifts a tethered scar or fills a pit. Make-up hides colour better than contour, because a depression still casts a shadow. Products can support treatment and protect results; the structural change in a scar is addressed with subcision, TCA CROSS or resurfacing.
Deep and stubborn scars are anchored in the deeper dermal layers, which more superficial treatments may not fully reach. Dr Sin Yong combines subcision with S3 laser resurfacing — a concentrated laser powered by DEKA technology that works at deeper dermal levels — and his 4D Scar Reconstruction approach, matching the method to each scar type, including ice pick, boxcar and rolling scars, and scars that have not fully responded to previous CO2 laser or RF microneedling.
Raised keloid and hypertrophic scars differ from the pitted scars most people mean by 'acne scars' — they sit above the skin and are managed differently, often with intralesional injections and energy-based devices rather than resurfacing. At consultation Dr Sin Yong distinguishes raised scars from pitted ones and plans accordingly, since treating them the same way can worsen a raised scar.
Asian and darker skin tones carry a higher risk of post-inflammatory pigmentation, so device choice and settings matter. Dr Sin Yong holds an MSc in Practical Dermatology (Cardiff) and calibrates conservatively for pigment-prone skin, often favouring subcision and radiofrequency microneedling, which treat the scar with lower surface risk. Sun protection between sessions is part of the plan.
Acne scar treatment can be suitable for teenagers, but timing matters. Active acne is usually brought under control first, and younger skin is assessed individually. Dr Sin Yong reviews each case at consultation and, for younger patients, discusses the plan with a parent or guardian present.
Scar change is structural, but skin quality benefits from ongoing care — sun protection, a suitable routine, and keeping any active acne controlled so new scarring is less likely. Dr Sin Yong advises on maintenance at review.
Acne scar correction depends on accurate diagnosis of the scar type — boxcar, rolling, ice-pick or a mix — because each responds to different techniques. Dr Sin Yong is an aesthetic physician who holds an MSc in Practical Dermatology (University of Cardiff) and combines subcision, fractional laser and radiofrequency microneedling, matching the method to each scar type rather than applying a single treatment. Scars are assessed individually at consultation on Orchard Road, Singapore.
Yes. Stretch marks are a form of dermal scarring — the deeper skin tears as it stretches during pregnancy, growth or weight change and heals as fine streaks. They respond to the same collagen-remodelling lasers, subcision and microneedling used for acne scars, refining their texture over a course of sessions. Newer marks tend to improve more readily than older, silvery ones.
Yes. Surgical scars, injury scars and post-inflammatory marks can be improved using the same resurfacing, subcision and collagen-stimulation principles, matched to the scar’s depth and texture. Cellulite, a related textural concern rather than a scar, can also be discussed at the same consultation. Dr Sin Yong will assess which approach suits each mark.
There is no single right treatment — the right choice depends on your scar type. Ice-pick scars, boxcar scars, rolling scars and pigmented marks each respond to different methods. Dr Sin Yong assesses your scar pattern first, then matches and combines treatments accordingly.
Most acne scars can be improved rather than erased entirely. Realistic goals are smoother texture and a more even surface. Dr Sin Yong discusses expected improvement honestly, since results depend on scar depth, type and skin response.
Scar treatment is usually a series rather than a single visit, because collagen remodelling happens gradually. The number depends on scar severity and the methods used, and is set out in a personalised plan after assessment.
Downtime after acne scar treatment varies by method. Resurfacing lasers and some microneedling involve a short recovery with redness, while subcision and injectable treatments involve less surface disruption. Dr Sin Yong explains what to expect for your specific plan.
Generally yes. Active, inflamed acne is usually settled before scar treatment begins, so that new scarring does not form. Dr Sin Yong will advise on timing at consultation.
Yes — mixed scarring is often addressed by combining methods, for example subcision to release rolling scars alongside resurfacing for texture. This is planned around your individual scar pattern.
The cost of acne scar treatment and removal depends on your scar types, how severe they are, and how many sessions and methods are needed. Because plans are personalised to your scar pattern rather than sold as a fixed package, Dr Sin Yong gives a clear quote after assessing your skin at consultation.
There is no single right treatment for pitted or depressed acne scars — it depends whether they are ice-pick, boxcar or rolling scars. Deep ice-pick scars often need TCA CROSS, boxcar scars respond to resurfacing and RF microneedling, and rolling scars usually need subcision. Most people benefit from a combination.
Each has a role, for different scars. RF microneedling remodels scar tissue at depth with minimal surface disruption, while fractional CO2 laser resurfaces and refines the surface. Dr Sin Yong may use either or both depending on your scar type and skin, rather than relying on one device for everything.
Yes. Flat brown or red marks left after acne are pigmentation rather than true scars, and they are addressed with pigment-focused and toning lasers rather than resurfacing. These are often treated alongside a scar plan so pigment and texture are planned together.
They can. Atrophic acne scars sit in skin that gradually loses collagen, fat and elasticity, so a scar that looked shallow in your twenties may cast a deeper shadow later as the support around it thins. This is one reason a scar plan sometimes includes collagen stimulation or volume support alongside release and resurfacing. Dr Sin Yong assesses both the scars and the surrounding skin quality at consultation.
It can be used in Fitzpatrick III to V skin, but the main risk is post-inflammatory pigmentation around each treated scar, so acid strength, technique and sun protection are planned with that in mind. Because only the scar itself is treated, the skin between scars is left alone. Whether TCA CROSS suits your scars and skin type is decided at assessment.
Bring a list of earlier scar treatments, your current skincare and medicines, including any isotretinoin, and mention a history of cold sores or keloid scarring. Avoid a fresh tan in the weeks beforehand, because tanned skin is more prone to pigment change after resurfacing. Retinoids and exfoliating acids are usually paused before resurfacing, and active acne should be under control. Specific instructions follow the method chosen at assessment.
Most methods are carried out under local or topical anaesthetic. Subcision is usually described as pressure and movement rather than pain, resurfacing as heat during the laser, and TCA CROSS as a brief sting on each scar. Tenderness, bruising or a warm, tight feeling afterwards depends on the method and settles as the skin heals. Comfort measures are discussed before treatment, since tolerance varies.
There is no single interval that applies to everyone. Older advice was to wait several months after stopping isotretinoin before resurfacing or subcision; more recent reviews suggest some procedures may be reasonable sooner, but the evidence is limited. Timing is weighed case by case, taking into account the method, the depth of treatment, your skin and whether the acne is controlled, and is agreed at assessment.
Treated scars do not usually return, because the change in the dermis is structural. Two things can make scarring look worse later: new acne forming new scars, which is why acne control continues, and ageing, as the collagen and fat around a scar thin and its shadow deepens. Sun protection and a maintenance routine help preserve the surface, and a later review can address either.
Sculptra, which is poly-L-lactic acid, and Ellansé, which is polycaprolactone, are collagen biostimulators like Radiesse, but they work through different materials on different timelines. Radiesse is the biostimulator placed into the released space in Dr Sin Yong's 4D Scar Reconstruction sequence; whether another material suits a particular scar is decided at assessment. None of them can be dissolved with hyaluronidase, and none raises a narrow ice-pick scar or changes scar edges.
It is worth considering for depressed scars that bother you, once acne is controlled and expectations are realistic: many scars can be made shallower and smoother, though not all disappear. It is a poorer fit for flat brown or red marks, which need pigment-focused care, or for anyone expecting every scar to vanish.
No duration can be promised. Collagen change is gradual, and longevity depends on scar type and depth, skin ageing, sun exposure, new breakouts and how the skin heals. Scars rebuilt from within tend to be more stable than those only smoothed at the surface. Review timing and any maintenance are set at consultation.
Treatment usually needs a planned course, not one visit. Resurfacing involves scabbing and redness while the skin heals, subcision can bruise, and injectables can cause lumps. Some scars improve less than others, particularly deep or tethered ones, and darker skin needs extra care to avoid pigmentation. Active acne must be controlled first.
It is set by scar type. Tethered rolling scars are released by subcision first. S3 Resurfacing Lift (multi-depth CO₂ on DEKA Tetra Pro) is the protocol Dr Sin Yong uses most for ice pick, boxcar and rolling scars. Secret RF is added for shallow rolling scars and overall skin quality. Most faces are mapped and planned with a combination.
Yes. Acne scars are one of the six concerns he treats day in, day out, and S3 Resurfacing Lift is his own protocol for them.
Yes, for superficial scars: shallow boxcar scars, fine textural scarring and post-acne marks. Its advantage is a shorter recovery than S3 Resurfacing Lift. Deeper ice-pick and boxcar scars need S3, which resurfaces at multiple depths; Dr Sin Yong grades the scars at assessment and says which applies.
At Dr Sin Yong’s clinic on Orchard Road, the assessment, subcision, TCA CROSS and every laser pass are performed by Dr Sin Yong himself. There is no hand-off to a therapist for the treatment itself; the scar grading at the first visit is what sets the plan.
Reduction is the accurate word for most atrophic scars: subcision, resurfacing and RF microneedling remodel the scar so it is shallower and less visible under normal light. TCA CROSS is directed at the floor of a sharp ice-pick pit so its walls can contract inward; a wide rolling scar is softened rather than erased. Dr Sin Yong says which is realistic for each scar at the consultation.
Depth decides. Superficial scars, shallow boxcars and textural marks suit FSX Laser, which has a shorter recovery than S3. Deep ice-pick and boxcar scars need the S3 Resurfacing Lift, a multi-depth fractional CO₂ protocol that reaches the scar floor. Many faces need both, on different scars.
The fee follows the plan: how many scar types are present, whether subcision or TCA CROSS is needed before resurfacing, the area treated, and the number of sessions the depth calls for. Dr Sin Yong writes the plan and its fee factors down after the assessment; see how fees are set.
Two, chosen by depth. FSX Laser for superficial scars, with a shorter recovery than S3, and the S3 Resurfacing Lift (multi-depth fractional CO₂ on the DEKA Tetra Pro) for deep ice-pick and boxcar scars. A picosecond pass is added for the brown marks, not the scar itself. See acne scar laser treatment Singapore.
There is no registered specialty called acne scars. Aesthetic physicians, dermatologists and plastic surgery specialists all treat them; what matters is who performs the procedure, which scar types they treat with which tools, and whether the plan is written down. Dr Sin Yong performs every step himself. See who treats acne scars.
Grading each scar under angled light, the stretch test for tethers, a check of skin type, earlier treatment and active acne, and a written plan with fee factors. No treatment is done on the first visit unless it was planned beforehand. See the acne scar removal clinic visit.
Rarely. Punch excision, punch elevation and grafting are surgical and are referred to a plastic surgery or dermatology specialist for large or deep scars. Subcision is a minor procedure Dr Sin Yong performs in clinic; lasers, RF microneedling and TCA CROSS are not surgery. See acne scar surgery in Singapore.
Resurfacing means remodelling the surface layer of a scar: fractional CO₂ (S3) for deep scars, surface-directed FSX Laser for superficial ones. It does not release a tether, which is why rolling scars are subcised first. See acne scar resurfacing.
Reduction is the honest word for most atrophic scars: the aim is a shallower, less visible scar under normal light, judged by you at review. Sharp pits respond most completely to TCA CROSS; wide rolling scars are softened rather than erased.
The tools are the same; the settings, staging and preparation are not. Fitzpatrick III–V skin carries a higher risk of post-inflammatory hyperpigmentation after ablative energy, so passes are lighter and spaced further apart, and surface-sparing options are favoured where the scar allows.
The word has no clinical meaning. What changes the fee is the plan: how many scar types are present, whether subcision or TCA CROSS is needed before resurfacing, the area, and the number of sessions depth calls for. See acne scar treatment cost: the fee factors.
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“If someone offers you one treatment for your acne scars, they haven't looked closely enough.”Dr Sin Yong
Why One Machine Can't Fix All Your Acne Scars
The 30-Second Home Test For Your Acne Scars
Medically reviewed by Dr Sin Yong, MBBS (NUS), MRCS (Edinburgh) · Last updated 7 October 2026 · Editorial policy
Patient guide (PDF): Acne scar types and options — a printable summary of this page, medically reviewed by Dr Sin Yong. General information, not a substitute for assessment.
Book an acne scar assessment with Dr Sin Yong at his aesthetic practice on Orchard Road, within reach of Somerset, City Hall and the Central town area.
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