What is Acne scarring

Acne is a common yet distressing condition that affects both males and females. It is a chronic skin disease of the oil follicle (sebaceous follicle) characterised by four main pathological changes—increased oil/sebum production, comedone formation, colonisation of the skin with Cutibacterium acnes (C. acnes) and resultant inflammation.

Many people suffer from acne in their youth and a smaller number in their adult years. This may result in permanent scarring which can have a significant impact on a person’s self-esteem.

Symptoms

Acne scars can be classified into several categories:

  1. Ice pick scars: pitted scars
  2. Boxcar scars: pitted scars with steep sides and a flat bottom
  3. Rolling scars: the contour is rolling and uneven
  4. Hypertrophic or keloid scars: thick lumpy scars
  5. Atrophic scars: flat, thin or depressed scars

This may be complicated by discolouration or pigmentary changes:

  1. Post-inflammatory erythema: pink or purple flat patches
  2. Hypopigmentation: pale or white marks
  3. Post-inflammatory hyperpigmentation: brown patches, typically seen in people who tan easily or have a darker skin colour

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Many people suffer from acne in their youth and a smaller number in their adult years. This may result in permanent scarring which can have a significant impact on a person’s self-esteem.

Causes

The cause of acne scarring is directly related to the presence of inflammatory/active acne, its duration, the extent of skin involved and the treatments used to manage the condition. One of the very common mistakes that we see often, is ‘picking’ and other self-directed treatment aimed at the inflammatory lesions of acne. This unfortunately often leads to scarring.

Acne scar treatment

As different categories of scars usually coexist in patients, combining several treatment modalities is usually required to improve scarring. It is important to firstly treat active/inflammatory acne to avoid further scarring. A number of techniques can be then be used to treat acne scarring and each technique may be more suited to a particular type of scarring.

1. Ice pick and boxcar scars

These deeper scars are best treated using surgical techniques, such as excision, subcision and punch grafting. They usually co-exist with other types of scarring and, therefore, additional treatment is usually necessary. The trichloracetic acid (TCA) CROSS technique is particularly effective for ice pick scars.

2. Rolling scars

Collagen induction therapy and PICO Genesis™️ FX laser (fractionated picosecond laser) treatment is effective to manage this type of scarring.

3. Hypertrophic or keloid scars

These scars can be treated with direct injection (intralesional injection) of corticosteroid into the scars, combined with silicone gel type dressings.

4. Atrophic scars

Excellent results with this kind of scarring can be achieved with dermal filler.

Laser treatment, including Laser Genesis™️ is an excellent additional treatment for all types of scarring, as it has a beneficial effect on collagen remodeling.

Associated discolouration can be managed with vascular laser and picosecond pigment laser depending on the colour involved.

How are we unique

We specialise in assessing the precise nature of your scarring, formulating a treatment plan using a combination of treatments that will most effectively target the types of scars that you have.

We would like to invite you to contact us via or call us on 02 6239 6388 to discuss further.

  • redness and rosacea

  • sun damage/pigmentation

  • melasma

  • visible vessels

  • moles and skin lesions

  • acne