Written and medically reviewed by Dr. Farah Izzati. Last reviewed 2026-08-26.
First, which scars do you actually have
The most common reason acne scar treatment disappoints is not the technique. It is that the technique was right for a different scar shape than the one being treated.
There are four textural patterns and one thing that is frequently mistaken for a scar. Most people have a mixture, which is why a single treatment rarely does the whole job.
| What you have | How it looks | What actually works | From |
|---|---|---|---|
| Ice-pick | Narrow, deep, sharply defined. Looks like a puncture | TCA CROSS, or punch excision for the deepest. Laser barely touches these | From RM399 |
| Rolling | Broad, shallow, undulating. Skin looks uneven in raking light | Subcision to release the tethering, then resurfacing or microneedling | From RM399 |
| Boxcar | Round or oval with sharp vertical walls, like a chickenpox mark | Fractional resurfacing or RF microneedling to soften the edge | From RM1899 |
| Atrophic, diffuse | General thinning and poor texture across an area | Medical microneedling, polynucleotide injections, collagen stimulation | From RM1250 |
| Post-inflammatory erythema | Flat red or brown marks, no texture change | Not a scar. Resolves over months. Sun protection, and patience | No treatment needed |
That last row matters commercially. A patient with flat redness and no textural change does not need a resurfacing course, and we will say so at the consultation rather than after it.
Why Malaysian skin changes the plan
Most published acne scar protocols were developed for Fitzpatrick I to III skin. Applied unmodified to Fitzpatrick IV and V, which is most of our patient population, they carry a risk the original papers did not have to weigh heavily.
The risk is not the scar. It is the pigmentation that can follow the treatment.
Darker skin carries more reactive melanocytes. Aggressive fractional resurfacing can trigger post-inflammatory hyperpigmentation that lasts months and, for many patients, is more visible and more distressing than the scarring they came in with.
So three things change here. Energy is calibrated conservatively rather than to the protocol maximum. Test spots are used where the response is uncertain. And sessions are spaced further apart than the literature assumes, because the skin needs longer to settle between them.
Six gentle sessions beat two aggressive ones in this skin type. Every time. It is slower and it is the reason our patients do not arrive at month four with a new problem.
What each treatment does, plainly
Subcision, from From RM399. A fine needle passed under the scar to cut the fibrous bands tethering it downward. This is the only way to release a rolling scar; nothing applied to the surface reaches the tethering. Frequently combined with a filler or biostimulator placed into the released space to stop it re-adhering.
TCA CROSS, from From RM399. High-strength trichloroacetic acid applied precisely into the base of an ice-pick scar with a fine applicator, provoking collagen from the floor upward. Each scar stings for about ten seconds. It is one of very few things that genuinely works on ice-pick scars, and it usually needs repeating on the same scar three to six times.
RF microneedling, from From RM1899. Insulated needles delivering heat at a controlled dermal depth. My preferred energy device for Fitzpatrick IV and V skin, because it does not rely on light being absorbed by pigment, which is what makes conventional laser riskier here.
Fractional resurfacing, from From RM850. Er:YAG or CO2 creating micro-columns of controlled injury. Effective on boxcar scars and overall texture, with four to seven days of downtime and the highest pigmentation risk of anything on this list, which is why settings matter more than the machine.
Medical microneedling, from From RM1250. Controlled micro-injury triggering collagen remodelling. Gentle, forgiving in darker skin, and the workhorse for diffuse texture rather than for individual deep scars.
Rejuran scar, from From RM1980. Dense polynucleotide injections rebuilding the repair environment inside a depressed scar. Often paired with subcision.
What a course actually costs
Single-session prices are published and easy to compare. They are also not what you will spend, and a clinic quoting only a session price is not quoting the treatment.
A realistic course for moderate mixed scarring is four to eight sessions across six to twelve months, usually combining two or three techniques. In practice that commonly lands between RM3,000 and RM9,000 in total, depending on how much scarring there is, which types, and how your skin responds.
Our full price list is published openly, so you can build that arithmetic yourself before you book. Your own figure is confirmed after assessment, in writing, before you commit.
The RM50 consultation covers a full assessment and a written plan, and is charged whether or not you proceed. Our doctors are not paid commission.
The order we work in
Acne first. Active inflammation is settled before scar work begins, and we want around three months of stability. Treating scars over live acne creates new scarring alongside the old.
Assessment and mapping. Which scar types, where, and in what proportion. This determines everything downstream and is why a plan cannot be quoted over the phone.
Release before resurface. Where rolling scars are present, subcision comes before any surface work. Resurfacing a tethered scar smooths the top of something still being pulled down.
Targeted before general. TCA CROSS on individual ice-pick scars, then broader resurfacing or microneedling for overall texture.
Review, then adjust. Spacing is set by how your skin responds, not by a calendar. In darker skin that usually means longer between sessions than the protocol suggests.
What we will tell you that you may not want to hear
Complete removal is not achievable. The realistic target is 50 to 80 per cent improvement across a full course: skin that looks normal in ordinary light rather than flawless under magnification. Any clinic promising more is selling.
If your acne is still active, we will decline to start scar work.
If what you have is post-inflammatory erythema rather than textural scarring, we will tell you it is going to resolve on its own and decline to sell you a course for it.
And if your expectations and what the evidence supports are far apart, we would rather have that conversation at the first consultation than after you have spent several thousand ringgit finding out.
Who performs this
Acne and acne scar work at AOKLINIK is led by Dr. Farah Izzati, whose practice centres on skin that behaves differently from the skin most published protocols were written for. She has written in detail on acne scars in Asian skin and on why aggressive settings backfire in Malaysian skin.
AOKLINIK is an LCP-credentialled clinic practising in Penang since 2013. Devices are registered with the Medical Device Authority, and you are welcome to ask which device and which setting is being used at any point.
Common questions
It depends on which scar types you have, because each responds to a different tool. Individual sessions at AOKLINIK start from RM399 for subcision or TCA CROSS, RM850 for fractional resurfacing, RM1,250 for medical microneedling and RM1,899 for RF microneedling. A realistic full course of four to eight sessions across modalities commonly runs between RM3,000 and RM9,000. Every figure is published openly and your exact quote is confirmed after assessment.
None of them, on its own. Ice-pick scars need TCA CROSS or punch excision. Rolling scars need subcision to release the tethering underneath. Boxcar scars respond to fractional resurfacing or RF microneedling. Most patients have a mixture, which is why plans combine techniques rather than choosing one.
Moderate scarring commonly needs four to eight sessions across six to twelve months, often using more than one technique. Deeper ice-pick scars may need TCA CROSS repeated three to six times on the same scar. Anyone quoting a session count before examining your skin is guessing.
With the right settings, yes, and this is the single most important question to ask. Fitzpatrick IV and V skin carries more reactive pigment, so aggressive resurfacing risks post-inflammatory hyperpigmentation that can be more troubling than the original scarring. We calibrate energy conservatively, use test spots where indicated, and space sessions further apart than protocols written for lighter skin assume.
No, and anyone promising that is selling. A realistic target across a properly planned course is roughly 50 to 80 per cent improvement: skin that looks normal in ordinary light, rather than flawless under magnification.
Yes, and it is not a delaying tactic. Treating scars while acne is still active means creating new scarring alongside the old, and inflamed skin responds poorly to resurfacing. We want roughly three months of stability first.
Usually not. Post-inflammatory erythema is flat redness that fades on its own over months. It is not a textural scar and it does not need resurfacing. We will tell you if that is what you have rather than selling you a course for something that is resolving.
For broad, soft rolling scars that stretch out when the skin is pulled taut, yes, particularly after subcision has released the tethering. For sharp-edged boxcar or ice-pick scars, no: filler sits beneath an intact scar wall and changes nothing.
This page is general information and does not replace individual assessment. Suitability, the number of sessions required and outcomes vary between individuals and no result can be guaranteed. Devices used are registered with the Medical Device Authority and treatments are performed by registered medical practitioners.