Ghost of acne scars: Pinay dermatologist shares notes, fixes

Time heals all wounds, but acne scars do not have to last forever.

Skin is the human body’s largest and most important protective organ. It’s not just biology. It’s how we connect with the world: by feeling, protecting, breathing, and telling our stories.

People naturally notice the face first. So when acne scars remain, self-esteem naturally plummets. Moving past the physical reminders of acne, however, is about embracing a new beginning for your skin rather than hiding the past.

Dr. Miriam Adraneda, board-certified dermatologist and founder of Adraneda Dermatology & Aesthetics, stated that acne causes three types of skin damage: atrophic (depressed) scars, hypertrophic and keloid (raised) scars, and flat marks, including post-acne pigmentation.

Depressed scars include ice pick scars, which are deep, narrow pits that resemble small punctures or large pores; boxcar scars, which are steep, sharply defined vertical edges that resemble chickenpox scars; and rolling scars, which are broad depressions with sloping, rounded edges that give skin a wavy or uneven texture.

Hypertrophic scars are firm, raised lumps of scar tissue that remain within the original acne spot, whereas keloid scars are thick, overgrown masses of scar tissue that expand beyond the original acne spot and spread into the surrounding skin.

Post-acne pigmentation refers to the flat brown, bluish-gray, or dark spots that remain after inflammation, such as an acne breakout. It is known clinically as post-inflammatory hyperpigmentation (PIH).

“Given these different characteristics of acne scars, structural restoration requires an integrative, multimodal strategy or approach,” said Dr. Adraneda, an acne and skin rejuvenation specialist, who has helped patients achieve healthier, smoother, and more confident-looking skin through personalized, evidence-based treatment plans since 2016. 

“Treating a complex, multi-layered acne scar with just one laser is like trying to fix an entire broken building with only a hammer,” she added.

According to Dr. Adraneda, treating acne scars requires an appropriate, deeper, and custom-tailored strategy, particularly for darker Filipino skin tones.

She pioneered the “6-in-1 Synergistic Acne Scar Treatment” at Adraneda Dermatology & Aesthetics, to address the difficult issue of severe, stubborn, multi-textural skin scarring.

The 6-in-1 system shifts the paradigm by combining advanced technologies with surgical sub-surface techniques.

“Acne scars are rarely uniform. A single patient often presents a complex mix of rolling, boxcar, and icepick scars. So, treating acne scars effectively requires understanding that different types of scars live at different depths of the skin,” Dr. Adraneda pointed out.

“Hence, if you only apply the standard clinic packages that treat these variations, such as a surface laser to a scar that is anchored by deep tissue fibers underneath, the results will be minimal because it leaves deeper structural scarring untouched.”

“Our 6-in-1 Synergistic Treatment addresses both the surface texture and the deep structural anchors simultaneously. This customizable acne scar treatment program has been tested and proven effective multiple times,” she said.

The brand’s 6-in-1 Synergistic Acne Scar Treatment builds on its previously tried-and-true 5-in-1 method, upgrading the skincare routine to a powerful, six-tier system that repairs and renews skin at the cellular level.

A complex combination of deep pits, sharp craters, and uneven skin depressions is experienced by over 80% of individuals who are coping with post-acne scarring, according to data.

Nevertheless, the Philippines frequently employs generalized packages or blanket solutions for standard skin treatments. A significant number of clinics either exclusively utilize basic, superficial chemical peels or standard laser sessions or offer common approaches.

Regrettably, these treatments are rarely able to sufficiently address the structural damage that lies beneath the skin’s surface.

“Fixing the root problem takes a complete plan that works from every angle. Real recovery means looking at the whole picture, not just a quick fix,” emphasized Dr. Adraneda, who has spoken in various local and international forums, conventions, and conferences on diagnosing, treating, and managing acne and its related conditions such as post-acne scarring.

“To achieve deep restoration, the deep fibrous bands pulling the skin down must be released while simultaneously rebuilding the surface and mid-dermis. Otherwise, the scar will remain depressed,” she explained.

The 6-in-1 Synergistic Treatment differs from traditional dermatological practices by integrating six advanced medical techniques into a single, cohesive clinical procedure:

One technique is Cannula Subcision, which physically cuts the deep subcutaneous fibrous strands that anchor rolling scars, allowing the depressed skin to lift and level. The second method is Targeted TCA CROSS, which involves micro-dropping concentrated Trichloroacetic Acid into narrow icepick scars to cause localized dermal remodeling and close deep pits.

The third method is RF Fractional Microneedling, which uses gold-coated needles to deliver intense thermal energy deep into the mid-dermis, breaking down rigid scar tissue and stimulating new collagen growth.

Fourth, Ablative CO2 Laser is intended to completely transform skin texture by creating precise micro-channels to resurface the skin. Fifth, Autologous Platelet-Rich Plasma (PRP) is a treatment in which concentrated platelets from the patient’s own blood are reintroduced to speed up cellular healing and significantly reduce traditional laser downtime.

Finally, Plasma Gel Bio-Fillers, which are made entirely from the patient’s own blood plasma, represent a significant advancement over standard PRP. When transformed into a stable, solid gel, it physically lifts depressed scars and acts as a structural barrier, preventing subcised tissues from reattaching.

Dr. Adraneda stated that the majority of her patients experienced real, significant, and visible improvements in fewer sessions of the 6-in-1 Synergistic Treatment when compared to single-laser packages or traditional methods.

According to her, while initial results may appear after one or two visits, treating deeper scars often requires three to five sessions of the personalized regimen.

However, the Pinay dermatologist emphasized that results vary by individual, and no treatment can guaranty complete scar removal.

That is why, at her clinic, all patients receive a physician-led comprehensive, individualized pre-treatment evaluation to avoid common procedural risks such as post-inflammatory hyperpigmentation, infection, and secondary scarring.

“By combining these six steps, we treat the skin as a dynamic, three-dimensional landscape rather than a flat surface,” she said.

“Best of all is that this protocol is meticulously designed to safely treat darker Filipino skin tones, effectively mitigating the risks of post-inflammatory hyperpigmentation (PIH) often caused by aggressive, unsynergized laser settings,” she added.

Aside from advanced scar remodeling, the clinic provides acne management, facial and laser treatments, anti-aging and rejuvenation, cosmetic surgery and non-surgical enhancements, medical dermatology consultations, skin pigmentation and whitening treatments, hair-growth/removal treatments, and weight management consultations through their sister clinic.