Chemical Peels for Acne Scars: Should You Try Them?

One frustrating part about having acne is the reminder it leaves after your blemishes have healed. Acne scarring, compared to dark spots or hyperpigmentation, is very challenging to treat and doesn’t usually respond to over-the-counter products. And even with treatment, there is no guarantee that the scars will be completely gone.

There are, of course, several treatments that can improve or significantly reduce the appearance of scarring. Chemical peels are one of them and involve using a chemical solution to remove the skin’s old outer layer. This is then replaced with new skin that is less scarred and looks smoother.

Acne scars are not acne marks

First, it is important to keep in mind that acne scars are completely different from acne marks or dark spots. Acne marks are temporary discoloration in the skin that occurs as a part of the body’s healing process. Acne scars, on the other hand, occur due to a deep trauma to the skin and take in different forms including:

• Atrophic scars – shallow depressions that are commonly caused by severe cystic acne. There are three types of atrophic scars:
  • Ice pick scars – deep pitted scars that commonly appear on the cheeks.
  • Boxcar scars – broad skin depressions with defined edges that are common on the lower face and jaw.
  • Rolling scars – have sloping edges with varying depths that can make the skin look uneven.
• Hypertrophic scars – elevated or raised scars that are common on the jawline, back, shoulders, and chest.

Further reading: 5 Common Questions About Acne Scars Answered

How do chemical peels for acne scars work?

When undergoing a chemical peel for acne scars, a trained/licensed therapist or skin/aesthetic doctor uses an acid solution that is applied to the skin. This then triggers a controlled injury that causes the outermost layer to peel off. Once the peeling process is over, you’ll see healthier and smoother skin underneath.

What chemical peels do is unclog pores, speed up skin cell turnover, and stimulate the production of collagen. The main goal of chemical peels is to rejuvenate your skin or restore your complexion. There are, however, different types of acids applied with the strength of the peel varying from superficial to deep.

In general, chemical peels are more suited to treat atrophic scars than hypertrophic ones. A medium depth peel is usually recommended, as superficial ones may have minimal effect on atrophic acne scars. Light chemical peels are more effective at treating dark spots or hyperpigmentation.

Some of the peels used for acne scarring include:

• Salicylic and glycolic acid
• Modified Jessner
• Certain types of VI Peel
• TCA Cross (using trichloroacetic acid)
• Phenol – the deepest peel; only reserved for deep scars and other deep dermal conditions

How can Cutis help?

Here at Cutis, we have different types of chemical peels that can lighten or fade dark spots, as well as improve the appearance of scarring. We have:

• VI Peel – a medical-grade peel that offers a deep peeling effect without the pain and longer downtime associated with other types of peels. It can:
  • Clear acne skin conditions
  • Reduce or eliminate age spots and hyperpigmentation
  • Soften lines and wrinkles
  • Reduce or eliminate acne scars
• Modified Jessner Peel – provides anti-bacterial and anti-inflammatory effects that clear out pores and reduce acne. It can also smooth out uneven skin texture and help patients dealing with shallow scarring, pigmentation, and photodamaged skin.

A 2015 study involving a combination of Jessner’s peel and 20% TCA noted a marked improvement of acne scarring in 60% of cases, moderate improvement in 32% of cases, and mild improvement in 8% of cases.

• TCA CROSS – refers to the Chemical reconstruction of skin scars (CROSS) using trichloroacetic acid (TCA). This involves applying a pure solution of 70% trichloroacetic acid (sometimes higher) only as a spot treatment for atrophic acne scars.

This safely triggers an acid injury to the skin, as well as induces inflammation, and stimulates new collagen to fill in the scar. Multiple treatments lead to an improvement in both scar depth and diameter. Over a period of six months, patients may see a one- to two-grade improvement in their acne scars.

Risks and recovery with chemical peels

Higher-strength peels have a higher risk of pigmentation and further scarring, especially when done improperly. Lighter peels, of course, have extremely low risks. Deeper peels also have longer recovery like 7 to 10 days for TCA Cross, whereas a superficial one may have minimal to no downtime at all.

This only makes it important to go to a medical aesthetic clinic with doctors and trained aestheticians. You also need to follow the aftercare instructions which will vary depending on the type of peel chosen. The use of gentle products, including a thick or creamy moisturizer and sunscreen is of utmost importance.

Are there alternatives to chemical peels?

Since not everyone wants or qualifies to undergo deep chemical peels, other non-surgical treatments can be considered. These include:

Professional microneedling – involves the use of an automated skin-needling device that pierces the skin, resulting in micro-trauma. This accelerates the healing process and stimulates collagen creation.

The microneedling device we use at Cutis has a dedicated scar setting and protocols for the revision of deep and atrophic scars. It can help treat post-acne, burn, surgical, and striae (stretch marks) scars. Professional microneedling can also improve other skin issues such as enlarged pores, fine lines, and pigmentation.

Skin resurfacing – uses pulses of light in a pre-selected pattern directed to the skin’s top layer to break up scar tissues. It resurfaces the damaged layer and heats the dermis to generate collagen production, as well as the formation of new and healthy skin.

With skin resurfacing, the skin will form a natural protective dressing that will peel off after 3 to 5 days. This then reveals a clearer, healthier, and glowing complexion. It can treat or improve:

• Acne marks and scars
• Age spots
• Fine lines and wrinkles
• Hyperpigmentation
• Sun-damaged skin
• Uneven skin texture

A number of things, which include quality skincare and aesthetic procedures (including chemical peels), can help improve the appearance of acne scars and other skin blemishes. Contact Cutis Medical Laser Clinics in Singapore today and schedule a consultation with our aesthetic doctor to learn more about acne scar treatments and find out which one is right for you.