Acne Scar Types & Which Treatment Wins
Ice Pick Scars
TCA Cross + Fractional LaserDeep, narrow V-shaped holes. Hardest to treat. Require TCA cross technique (phenol/TCA application) + fractional laser + subcision.
Boxcar Scars
Fractional CO2 + SubcisionWide U-shaped depressions with defined edges. Respond to fractional ablative laser, subcision, filler. Improve significantly with 4–6 sessions.
Rolling Scars
Subcision + FractionalWave-like undulations from tethered fibrous bands beneath the skin. Require subcision (manual release) + fractional laser.
Post-Inflammatory Hyperpigmentation (PIH)
Pico Laser + PeelsDark flat spots — not true scars but very common in Filipino skin after acne. Respond well to pico laser, brightening peels, topical tranexamic acid.
Hypertrophic / Keloid Scars
Intralesional Steroids + PDLRaised, red thickened scars. More common in darker skin tones. Require intralesional steroids, pulsed dye laser, and silicone sheets.
Pico Laser vs Fractional Laser for Acne Scars in BGC
Pico Laser
Ultra-short picosecond pulses. Minimal downtime (1–3 days). Best for PIH and mild surface texture. Multiple brands: Picosure, Picoway, Discovery Pico.
Pros
Cons
Fractional Ablative Laser
Ablative resurfacing (CO2 or Erbium:YAG). Creates micro-channels to stimulate collagen remodeling. 5–10 days downtime. Most effective for structural scars.
Pros
Cons
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