Published 31 October 2026 · Reviewed by Dr Sin Yong
You are likely to be suitable for acne scar treatment when you have depressed scars you can feel, such as ice-pick, boxcar or rolling scars, on skin where acne is now controlled. Active acne, recent isotretinoin, a fresh tan or pregnancy mean waiting. Flat red or brown marks and raised scars take a different path. Dr Sin Yong grades each scar himself before anything is planned.
Short answerSuitability for acne scar treatment depends on three things: what kind of scar it is, whether acne is still making new ones, and how your skin heals and pigments. The method is then chosen scar by scar. This page sits under acne scar treatment in Singapore.
Acne scar treatment suits depressed, or atrophic, scars: places where collagen has been lost from the dermis and the surface has sunk. They come in recognisable shapes, and most scarred faces carry more than one.
Illustrative image — not a patient.
Ice-pick: narrow, deep tracts, deeper than they are wide.
Boxcar: wider depressions with defined walls and a flat floor, shallow or deep.
Rolling: wave-like dips caused by fibrous bands tethering the skin from below.
Tethered, of any shape: a scar that flattens when the surrounding skin is stretched.
You are a candidate when you have scars like these, acne has been brought under control, and the aim is realistic: shallower, less visible scars under ordinary light rather than skin in which the scar never formed. A face with several scar types is not a harder candidate; it is planned as one sequence, in which tethers are released first, pits are treated at their floor, and the surface is resurfaced last. If you are unsure what you have, the acne scar type checker sorts the common patterns at home.
The grading itself has a long history. Goodman and Baron described their qualitative global scarring grading system in 2006, assigning four grades by scar shape and by whether the scarring can be disguised at social distance. Dr Sin Yong records that grade at the first visit, alongside the scar types, so that later reviews compare like with like.
Depressed scars, marks or raised scars: which path are you on?
Several different things are called acne scars, and resurfacing and release suit one of them.
What you see
What it is
Scar treatment now?
What usually happens
Pits, boxes or rolling dips you can feel
Depressed scars: lost collagen, sometimes tethered
Yes, once acne is quiet
A written sequence: subcision, TCA CROSS, then FSX Laser, the S3 Resurfacing Lift or RF microneedling by depth
Flat red or pink marks that blanch when pressed
Post-inflammatory erythema: dilated small vessels
No
Acne control and treatment aimed at the small vessels
Flat brown marks on smooth skin
Post-inflammatory hyperpigmentation
No; resurfacing can darken them
Sun protection, topical care and pigment-directed laser
Referral for punch excision or revision, with resurfacing planned around it
Most faces carry a mix, so a pressing-glass test at the assessment separates red marks from pigment and from true scars, and each is planned for what it is.
“A tethered scar is pulled down from below. If I resurface it without releasing the band, I am treating the wrong structure.”
Dr Sin YongOn deciding which scars suit which method
Who should wait, and what is weighed first
Reasons to wait
Active, inflamed acne. Scars are still being made while acne is inflamed, so acne is controlled first through acne treatment.
Recent isotretinoin. The interval before procedures is discussed rather than assumed, because advice varies; see isotretinoin and treatment timing.
A current infection or cold sore in the area.
A fresh tan, which raises the risk of darkening after resurfacing.
Pregnancy or breastfeeding.
Weighed before a method is chosen
A tendency to keloid or hypertrophic scarring, which rules some methods out.
Blood thinners or a bleeding tendency, relevant to subcision and injections. Declare them; never stop a prescribed medicine on your own.
Allergy to an anaesthetic or to an injectable.
Asian and darker skin
Medium to brown skin, Fitzpatrick III to V, is not excluded. It carries a higher risk of post-inflammatory darkening, so passes are lighter and staged, sun protection runs through the plan, and methods that spare the surface, such as subcision and RF microneedling, are often favoured. Resurfacing over brown marks can make them darker, which is another reason marks and scars are separated first.
What is graded at the first visit
The first visit is a medical consultation, and it commits you to nothing. Dr Sin Yong does the whole examination himself and grades six things before any plan is written.
Scar type by zone, under angled light, charting ice-pick, boxcar, rolling and raised scars across each area of the face.
Tethering, by stretching the skin: a scar that flattens is tethered, and release comes first.
The Goodman and Baron grade, by visibility at social distance and response to stretch.
Skin type and pigment risk, including any marks that darkened after earlier injury.
Acne activity and medicines, new inflamed spots and acne tablets past or present.
Keloid tendency and healing, raised scars elsewhere, earlier procedures and bleeding tendency.
Standardised photographs are taken for your medical record and are not published. You leave with a written plan that names which scar gets which method and in what order, lists the fee factors and keeps the option of no treatment. The visit and the course are walked through on what to expect at acne scar treatment.
If you are not suitable yet: what happens instead
Not being suitable today usually means a different first step rather than no plan.
Acne that is still active: acne is treated first, and scar work is timed once it is quiet.
Marks rather than scars: red marks get vessel-directed care and brown marks pigment care; neither needs resurfacing.
Raised scars: an injection-based path rather than release or resurfacing.
A scar beyond non-surgical methods: referral to a plastic surgery or dermatology specialist for punch excision, elevation, grafting or revision, which Dr Sin Yong does not perform.
Hoping a facial will do it: facials, peels and skin boosters work at or near the surface and have a supporting role at most; they cannot release a tether or rebuild a scar floor.
Evidence supports matching the method to the scar. A 2017 systematic review of 36 studies of non-energy methods reported improvement after subcision and after TCA CROSS for ice-pick scars, with mostly mild and short-lived side effects, while noting that results varied widely and larger trials are needed. No method has been shown to erase scars, which is why suitability is about a realistic aim as much as the skin.
Your next step
1. MessageWhatsApp +65 8023 7170 with what is bothering you. A reply comes from the clinic, not a bot.
2. AssessmentDr Sin Yong examines you himself on Orchard Road, with ultrasound where earlier filler is involved.
3. A plan in writingWhat he would do, what he would not, the fee factors, and the option of no treatment.
Every treatment is performed by Dr Sin Yong personally. Singapore Medical Council registered · invited to share his clinical expertise internationally for CLASSYS, DEKA, Fotona, Hironic and Ilooda.
Book an assessment with Dr Sin Yong on Orchard Road; each scar is graded before any method is chosen. How consultations work.
Ice-pick scars are planned separately; see TCA CROSS.
Frequently Asked Questions
Usually not yet. Active, inflamed acne is settled first, because new scars are still forming while it is inflamed, and resurfacing inflamed skin adds marks to old ones. Mild, controlled acne with occasional spots may not delay the plan. Dr Sin Yong checks acne activity and medicines at the first visit and sets the timing so that scar work starts on quiet skin.
Recent isotretinoin is a reason to discuss timing rather than proceed straight away, because advice on the interval before procedures varies between methods and sources. Dr Sin Yong asks about the course, when it finished and how the skin is healing, and agrees the timing at consultation. Do not stop or change a prescribed medicine on your own to bring treatment forward.
Yes, with planning. Fitzpatrick III to V skin carries a higher risk of post-inflammatory darkening after resurfacing, so passes are lighter and staged, a fresh tan means waiting, and sun protection runs through the plan. Methods that spare the surface, such as subcision and RF microneedling, are often favoured. Skin type and pigment history are graded at the first visit.
No, because they are not scars. Flat red marks are dilated small vessels that blanch when pressed and respond to acne control and vessel-directed treatment. Flat brown marks are pigment and respond to sun protection, topical care and pigment-directed laser; resurfacing can darken them. A face can carry marks and scars together, so each is assessed separately.
Anyone with active inflamed acne, a current infection or cold sore, a fresh tan, or who is pregnant or breastfeeding should wait. A keloid tendency, blood thinners or an anaesthetic allergy are weighed first and can rule methods out. Raised scars take an injection-based path, and an isolated scar too deep or wide for non-surgical methods is referred to a specialist.
References
Postacne scarring: a qualitative global scarring grading system. Dermatologic Surgery 32(12), 2006. source
A systematic review of treatments for acne scarring. Part 1: Non-energy-based techniques. Scars, Burns & Healing 3, 2017. source
About this page: written and medically reviewed by Dr Sin Yong, MBBS (NUS), MRCS (Edinburgh) · Last reviewed 31 October 2026 · Illustrative images only, not patients · Editorial policy
