Condition: Acne scarring

Acne scarring is marks on the skin, most commonly on the face, shoulders and back, that develop are a result of complications of acne. Any degree of acne can cause scarring to develop, but it's most common with the more severe types of acne.

Around 80% of people between the ages of 11 and 30 will have acne and 20% of these will experience scarring as a result. For those who are affected by acne scarring, there are a range of effective treatments available that can help improve the texture, colour and overall appearance of the skin.

There are three main types of acne scars; ice pick scars, rolling scars and boxcar scars. In most cases, patients with acne scarring will have more than one of these types. Each type can be identified by how they appear:

Ice pick scars are small, deep holes in the skin that look like punctures made with a sharp object. These are most common on the forehead and upper cheeks where the skin is thinner.

Rolling scars give the skin a wavy or uneven appearance and are caused by bands of scar tissue forming under the skin. These scars are typically found on the lower cheeks and jaw, where the skin is thicker.

Boxcar scars are round or oval depressions that go deep into the skin. These scars are common on the lower cheeks and jaw.

In people with darker skin, acne often leaves long-lasting pigmented blemishes, called post-inflammatory hyperpigmentation.

In very severe cases hypertrophic or keloid scars can occur. This type of scar tissue is raised off the skin and can be itchy, tender or painful. It’s caused by an overgrowth of fibrous tissues in the skin and is most often seen on the chest, back, shoulders and jawline.

Acne causes inflammation in the deeper layer of the skin called the dermis. This inflammation can damage the elastic fibres in the skin that give it its smoothness and elasticity, resulting in an irregular skin contour with dips and dents.

Severe acne is more likely to lead to scarring but it can also happen after mild acne. Scarring can occur when nodules or cysts burst, causing trauma and damage to nearby skin, or in milder cases, it can be caused by skin picking or spot-squeezing.

At OneWelbeck, our specialist dermatologists can make a diagnosis of acne scarring by taking your medical history and examining your skin. They will also be able to identify the types of scarring present in order to recommend the most appropriate and effective treatment for you.

Before effective treatment for acne scarring can be given, it’s important to ensure that all active acne has first been ‘switched off’ with effective treatment – if more spots occur during treatment, they may cause further scarring.

Treatment options then include resurfacing the skin with chemical peels, lasers, dermabrasion and microdermabrasion, cosmetic surgical procedures to remove scars and tethered skin, and steroid injections, dermal fillers and microneedling to even out irregular skin contours and improve skin texture.