Scars, Pores, And Milia: A Singaporean Doctor Answers Readers’ Skin Questions

Portrait of Dr Cheng Yu Chua
Dr Cheng Yu Chua

May 6th, 2019· 5 min read

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The skin is often seen as an indication of health when it comes to appearance and complexion. As it is our largest organ, problems with skin can be visually apparent, which is why people may seek help quickly when it comes to skin issues.

Dr Chua Cheng Yu is an aesthetic doctor at Veritas Medical Aesthetics. He recently responded to Human reader questions regarding various skin concerns. In no particular order, here are a few key takeaways.

What are ice pick scars?

ice pick scars on skin

Ice pick scars are a type of acne scar condition that gets its name from the deep and narrow impressions they leave on the face or body (like small stab wounds caused by ice picks). They are considered difficult to treat because of their sharp and deep indentations. [1]

Treatment of scars is determined by their shape, size, and location

a woman looking in the mirror

The method of scar treatment is determined by the shape, size, and exact location of the scars. For example, punch excisions cannot be performed on scars that are too wide, while an elliptical incision might generate better outcomes for such scars. [1]

Consult your doctor for a better picture of your condition.

A combination of lasers could treat multiple kinds of scars

a handheld scar treatment device

In some instances, patients report having a mix of ice pick scars and boxcar scars. In such cases, Dr Chua recommends using a combination of lasers including some ablative lasers.

Deeper scars might benefit from punch excisions and microsurgery for more effective results. [2]

Micro-needling radiofrequency may not work very well for acne scars

medical illustration of skin undergoing collagen induction therapy

If you are suffering from acne scars, micro-needling radiofrequency treatments should be avoided. They do not work on all kinds of scar patterns.

How can you treat dark scars on legs and arms from bug bites?

a woman applying cream to bug bites on her legs

If bug bites (such as those from sand flies) form dark scars, they may be post-inflammatory hyperpigmentation marks and can fade with time. For faster removal of stubborn post-bite marks, topical skincare and certain pigmentation lasers can work. For people with post-inflammatory hyperpigmentation, avoiding the sun and applying sunblock is crucial. [3]

Resurfacing lasers can help tighten pores

a woman receiving medical laser treatment

If you're looking for an effective way to tighten your pores, resurfacing lasers can work well (both ablative options such as fractional CO2 and non-ablative options such as Thulium). [2]

The frequency of resurfacing lasers depends on your condition

a woman having pigmentation removed from her cheek

The combination and frequency of laser treatments are determined by your individual condition.

Non-ablative options can be repeated more frequently, but it also depends on:

  • individual skin type,
  • skin condition,
  • and necessity.

Whiteheads and clogged pores are common in women

a woman washing her face in her bathroom

It is common for ladies to have clogged pores in the lower face which lead to whiteheads, especially near that time of the month. Regular exfoliation and oil control regimes can treat the issue gradually. BHA is a useful ingredient to look out for in OTC skincare, whilst retinoids are commonly used in higher concentration in medical skincare. [4]

Be sure to get a proper diagnosis from your doctor

a female doctor speaking to a patient

Sometimes, you might be diagnosing your own condition inaccurately. See a doctor for proper evaluation because other facial growths could mimic stubborn whiteheads.

There are retinoids that can help treat milia

a hand with skin cream on a finger

In Singapore, there are two retinoids that are available over the counter to deal with milia; Differin and Epiduo.

Differin can prevent milia but it will not treat milia. Electrocautery or CO2 laser ablation and a treatment regime may be needed. Consult your doctor. [5]

Milia can be treated permanently with energy-based devices such as ablative lasers or microneedling RF

a man receiving laser treatment on his face

The success rate for the removal of milia seeds with ablative lasers is quite high, with costs being around a few hundred dollars (depending on your condition).

Experienced beauticians may also be able to help with the extraction of milia, but they recur easily. Energy devices could treat milia in a more efficient and safe manner. Microneedling RF may not be useful for acne scars, but is extremely useful for treating milia and preventing recurrence, i.e. permanent treatment. [6]

Similar conditions may be slightly harder to deal with

a xanthelasma on an eye

Other conditions with similar traits, such as syringomas or xanthomas, may be much tougher to remove and more stubborn.

A syringoma is a benign adnexal tumour of the eccrine sweat duct that usually appears in the eyelid area, though it can also appear on other parts of the body.

A xanthoma (shown above) is a lesion that occurs when fat deposits occur under the skin. They can appear near the eyes but also on hands, limbs, or the neck.

Consult your doctor for proper treatment. [7] [8]

Can self-harm scars be treated in Singapore?

a man with self harm scars on an arm

There are different treatment modalities for hypertrophic scars, from topical skincare to steroid injections, lasers, and even surgery. Certain fractional ablative lasers such CO2 can work, but there is extensive downtime.

Non-ablative fractional lasers (such as the Erbium-Glass and Thulium) have good outcomes with minimal downtime. [9]

Whatever your skin condition may be, make sure that you receive professional medical advice before treating and managing the issue. You can check in with an experienced medical professional and find out about the various options out there.

Would you like to ask any related skincare questions?

You can Ask A Doctor right away, or view the complete list of Human Sessions.

I hope that you've found this guide useful, and perhaps gained more insight into the application process. Most of the admissions-related information (admin and logistics wise) can be found on the official NUS Faculty of Dentistry website.

To help yourself out, you should take note of what people look for when they look for a dentist.

This article was written by Dr Cheng Yu Chua and published on Wednesday, 25 January 2017. Human medically reviewed the article on Wednesday, 25 January 2017. The last update was made on Friday, 18 September 2020.

Disclaimer: Opinions belong to the author and not to the platform.

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