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Acne and Acne Scars

Whiteheads

Whiteheads are the earliest stage of acne, occurring when pores become clogged with sebum and dead skin cells, and the surface of the pore remains closed. They often appear as small, white bumps and can be easy to overlook.
Medically known as closed comedones, this stage marks the beginning of acne development, as acne-causing bacteria (Cutibacterium acnes) start to multiply within the clogged pore.

Blackheads

Blackheads develop when a whitehead progresses and the clogged pore opens up, exposing the trapped sebum to air. As the oil oxidizes, it darkens and forms a black or dark brown spot on the skin. Despite their appearance, blackheads are non-inflammatory and typically do not cause pain or swelling. They are often mistaken for small moles or pigmentation spots due to their color.

Inflamed Acne

Red pimples occur when Cutibacterium acnes (acne-causing bacteria) multiply within the clogged pore and trigger inflammation in the surrounding skin tissue. This inflammation damages nearby cells, causing the pimple to appear red, swollen, and more noticeable. Medically referred to as inflammatory papules, this stage significantly increases the risk of post-acne scarring if not treated properly.

Yellow Acne

Yellow pimples, or pustules, develop when the inflammation from a red pimple intensifies and pus accumulates inside the lesion. Medically known as pustular acne, this stage occurs when inflammatory substances break through the follicle wall and spread to the surrounding tissue, worsening the overall skin damage. As one of the final stages of acne, yellow pimples can easily lead to lasting aftereffects such as pigmentation, raised keloid scars, or depressed acne scars (craters). Proper treatment and care are essential to prevent permanent scarring.

To effectively treat and prevent acne, it’s important to first understand the root causes and how acne develops.

Pore Blockage Caused by Excess Sebum

Deep inside each pore lies a sebaceous gland that produces sebum, an oily substance that normally travels through the pore to the skin’s surface, forming a protective layer that keeps the skin hydrated.
However, when sebum is overproduced or the pore becomes clogged, it can no longer exit the skin properly and begins to accumulate inside the pore.
This trapped sebum becomes a food source for acne-causing bacteria (Cutibacterium acnes) and other microbes, leading to the formation of whiteheads—the initial stage of acne.

Sebum Accumulates in the Pore

As more sebum builds up inside a whitehead, the pressure causes the previously closed pore to widen and open at the surface. When the trapped oil and debris are exposed to air, they oxidize and turn dark, forming what’s known as a blackhead.
At this stage, there is typically no pain or swelling, as inflammation has not yet occurred.

Bacterial Growth in Clogged Pores Causes Inflammation

When non-inflamed whiteheads or blackheads are left untreated, more sebum continues to accumulate inside the pores. This buildup creates an ideal environment for Cutibacterium acnes (C. acnes) and other bacteria to grow. As these bacteria multiply, inflammation occurs, causing the area to become red, swollen, and painful.

Worsening Inflammation and Pus Accumulation

As inflammation progresses, an enzyme called lipase produced by Cutibacterium acnes (formerly Propionibacterium acnes) breaks down the walls of the hair follicles. This allows the inflammation to spread to surrounding tissues, worsening the condition and leading to the formation of pus. The structure of the follicle becomes compromised, creating extra spaces where excess sebum can accumulate—thus repeating the acne cycle. As the follicle’s structure continues to deteriorate, it becomes increasingly difficult for acne to heal.

Acne Heals but Leaves Scars Behind

Even after the inflammation subsides, acne can leave behind various types of scars. These may include persistent redness, pigmentation that appears brown or purple due to discoloration, or pitted scars (known as “craters”) caused by repeated breakouts that destroy the follicle’s structure. Regardless of type, acne scars tend to be difficult to treat. Redness and pigmentation can often be concealed with concealer, but crater-like scars are much harder to hide.

Personalized Acne Treatment Based on Individual Symptoms

At Bibi Clinic, we propose treatments tailored to the type of acne after a medical examination by a doctor.

Tryfill Pro: Instantly boosts blood flow in the skin with the power of carbon dioxide to calm acne inflammation. At the same time, it delivers active ingredients to create a foundation that promotes acne healing.

Silfirm X: By applying the latest "high frequency," it directly targets overactive sebaceous glands, which cause acne. It suppresses the activity of current acne.

Lalapiel: Gently exfoliates the skin with its gentle ingredients, resolving clogged pores and oiliness. It also has a strong anti-inflammatory effect, transforming the skin to be less prone to acne.

Diode Laser: Kills acne-causing bacteria with laser heat, quickly calming red, inflamed pimples.

The treatment you should choose varies from person to person depending on the condition of your acne. If you're unsure of the best way to treat your acne or feel that self-care has its limits, please feel free to consult us.

Why TryfillPro is effective for "deep craters"

The main reason craters don't heal is that hardened tissue deep within the skin is pulling the skin downwards.

TryPhilPro pinpoints and breaks apart these "adhesions" with the power of carbon dioxide. Because beneficial ingredients can be smoothly infused into the opened spaces, it offers high efficacy even for deep unevenness that was previously given up on.

Tailored Acne Scar Treatments from a Wide Range of Options

Acne scars come in various types, including redness, uneven skin tone, and craters (depressions), and each has its appropriate treatment. Our clinic offers a combination of the following treatments tailored to your concerns.

Tryfil Pro: Using carbon dioxide pressure, it detaches the "skin tension" causing the indentations from the inside, and infuses medication to flatten and push up deep craters.

Pico Laser: Fades red acne scars and brown spots with a light shock. The skin resurfacing mode (fractional) also smooths out uneven skin texture.

Silfirm X: High-frequency electricity is passed through the needle tips to activate the "switch" that increases collagen, a component that supports the skin. By making the skin firmer, it diminishes the appearance of indented acne scars.

Lara Peel: Gently removes old keratin from the skin's surface, leading to smoother skin texture and improving roughness and shallow acne scars.

Rejuran Healer: A skin-boosting ingredient that aids skin regeneration is directly injected. It adds volume to depressed areas, plumping them up from within.

Exosome & PRP Therapy: Powerfully backup your skin's innate "repairing power." Promotes regeneration of damaged skin and improves craters.

Acne scars that are just redness or uneven skin tone may fade naturally over time. However, crater-like indentations are very difficult to treat with over-the-counter medications or skincare alone.

If you're looking to eliminate acne scars rather than just cover them up, please feel free to consult with us at our clinic. We'll work with you to find the best treatment plan using specialized medical equipment.

Not Just Treating Acne and Scars—We Help You Build Acne-Resistant Skin

Many patients who visit us for acne treatment only become aware of the issue once painful, swollen red acne appears. However, continuing skincare habits or lifestyle choices that contribute to acne can often lead to recurring breakouts—even after treatment.

At Bibi Clinic, we focus not only on treating existing acne and acne scars but also on preventing future breakouts and minimizing the risk of scarring. Our treatments address not just the visible symptoms but also the root causes of acne, helping you achieve healthier, more resilient skin over the long term.

Bibi Clinic offers acne and acne scar treatments of the same high quality as those in Japan, right here in Bangkok, Thailand. We provide services in both Japanese and English, ensuring that Japanese patients can feel secure receiving cosmetic treatments in Thailand. If you are struggling with acne or acne scars, please consult our clinic.