Acne scarring is a very common condition which affects up to 30% of people with moderate to severe acne. It is crucial to begin early treatment to control breakouts and reduce the chance of scarring. However, for pre-existing scars, we have a number of methods that can be utilised to help decrease their appearance. Often you can have many different types of scarring and we offer personalised scar treatments for each one.
Severity of scar
| Grade | level | Possible types of scars | What you see |
| 1 | Macular | Post inflammatory hyperpigmentation | Colour change but not contour |
| 2 | Mild | Mild rolling, small papular | Can be covered with make-up or disguised by beard shadow |
| 3 | Moderate | Rolling scar, boxcar scar, mild hypertrophic scars | Scar is obvious at social distance of 50cm or greater. Hard to cover even with concealer. Scar may be flattened by stretching skin |
| 4 | Severe | Keloid, hypertrophic scar, ice pick scars, | Scar is obvious at social distance of 50cm or greater. Hard to cover even with concealer. Scar cannot be flattened by stretching skin |
Types of scars
Post inflammatory pigmentation.
This is a skin colour change as a result of acne, usually dark red or purple colour. It is important to protect scars from sun until they fully recover. These can often recover with good home care and may not necessitate in clinic treatments. Azelaic acid cream can help by reducing hyperpigmentation. These are available over the counter from many pharmacies. It is good to use topical vitamin C or niacinamide as well. In clinic treatment includes chemical peels, IPL or laser treatments.
On the other hand, ice-pick scars, rolling scars, boxcar scars, atrophic scars, hypertrophic scars require a tailored, in clinic skin plan.
Ice-pick scars: These are deep, narrow pitted scars, often hard to treat due to depth.
Laser resurfacing, punch grafting, TCA cross and subcision can help with treating ice-pick scars.
Rolling scars: These have broad depression with a sloping edge as if someone scooped ice cream.
Boxcar scars: These have broad depressions with sharply defined edges.
Atrophic scars: These are flat, thin scars.
Microneedling, laser resurfacing, radiofrequency microneedling, superficial filler and subcision can be used to reduce rolling scars, box scars and strophic scars.
Hypertrophic or keloid scars
These are raised scars. Often very tricky to treat due to recurrence. Steroid injection, silicon dressing and skin needling, or surgical revision may be needed.