Acne Scrarring: Concerns

What Is Acne Scarring?

Flat, soft or sunken cheeks, whether as a result of ageing or natural bone structure, can contribute to an appearance of tiredness or hollowness and can lead to a prematurely aged look. Over time, the loss of facial volume and changes in skin elasticity may lead to flattened contours, affecting the overall harmony and youthful appearance of the face.
Symptoms of flat or sunken cheeks

Any type of acne or blemishes can lead to scarring the skin, but it’s more common when the spot is very inflamed and large – like a pustule, nodule or cyst. Scarring is also more common when you pick or squeeze spots, so it’s important to avoid furthering any inflammation when you experience a breakout, however tempting it is to try to get rid of it quicker!


Pigmentation or discolouration after the spot has healed is referred to as Post Inflammatory Hyperpigmentation (PIH), while atrophic scarring presents as an uneven and dimpled appearance of the skin.


There are 3 main types of atrophic acne scars, where there is a loss of volume and depression in the skin.

    • Ice pick scars – small, deep indentations that look like a sharp object has punctured the skin.
    • Rolling scars – are bands of scar tissue that form under the skin that give the surface an appearance of undulating or uneven texture.
    • Boxcar scars – round or oval craters with defined edges, tend to occur on the lower part of the face where skin is thicker.

Pigmented acne scarring, or PIH, arises from a build-up of melanin as part of the skin’s natural healing process. While PIH can take months or even years to fade, pitted scars do not tend to improve over time without treatment.


The probability of experiencing acne scarring can be influenced by genetics, skincare products/routines and current skin condition; but usually, acne scarring results from inflamed blemishes like cysts, papules, and pustules. These larger spots form in the skin’s deeper layers, that cause trauma to the surrounding tissues, creating gaps in the surface of the skin when healing. The upper layers of the skin then sink, causing a pitted, dimpled look. The skin’s response to trauma or inflammation is to form new collagen fibres to heal the area, and this process can also stimulate the formation of excess melanin, creating a darker area called Post Inflammatory Hyperpigmentation.


Post Inflammatory Hyperpigmentation is usually only temporary, but can be deep in the skin, so can take multiple treatments and consistency to resolve. See our PIH page for more information. (link to PIH concern page)

Atrophic scarring doesn’t tend to resolve on it’s own, but the appearance can be drastically improved with a number of treatments that we offer at SkinHD.


Microneedling – a course of microneedling sessions can be a transformative solution for acne scarring; by creating a controlled micro-injury to the skin it forces your skin to go into ‘healing mode’. This stimulates the natural formation of extra collagen and elastin, plumping out any pitted scars and creating a much more even texture and smooth appearance to the skin. Optimal results are typically noticeable 6-8 weeks after treatment and continue to enhance skin quality for up to a year. The best results are often seen after a course of 4-6 sessions at 2-6 week intervals.


WOW facial – similar to microneedling, WOW facials involve creating a controlled micron-injury to the skin with a small stamping device, which allows a cocktail of skin-boosting vitamins, minerals and active ingredients to help stimulate collagen production, boost hydration and smooth the appearance of the skin. Typically a course of treatments are required for optimal results.


Skincare – Having a consistent skincare routine using active ingredients, such as AHAs, retinoids and vitamin C can enhance cell turnover, encourage collagen production and help fade hyperpigmentation. Topical treatments with niacinamide may help reduce inflammation and redness that can be associated with acne scars. Additionally, sunscreen is essential to prevent further darkening of scars due to sun exposure.


Prescription strength topical creams such as tretinoin can help to stimulate collagen production and improve the texture of the skin. A consultation with one of our medical prescribers can determine if this is a suitable product for you and your symptoms.


Chemical Peels – a course of chemical peels can effectively improve the appearance of acne scarring by promoting exfoliation and skin renewal. During a chemical peel, a solution is applied to the skin, causing controlled damage to the top layers, causing them to exfoliate away and encourages the growth of new, healthier skin. A course of chemical peels can help reduce the depth of scars, fade hyperpigmentation and improve overall skin texture. Different strengths of peels are available, allowing for customisation based on the severity of scarring.


Redensity 1 – Redensity 1 is an injectable Skin Booster treatment that falls between a standard dermal filler and mesotherapy treatments, due to its unique formula that contains a blend of hyaluronic acid, amino acids and antioxidants. While dermal fillers are not typically the first line of treatment for acne scars, Redensity 1 may help improve the appearance of scarring with it’s hydrating and skin-revitalising properties. When injected into targeted areas, it can plump the skin, filling in depressed scars and promotes a smoother skin surface. Additionally, the combination of antioxidants and vitamins contribute to overall skin health and radiance. A full course of treatments (3 sessions) is recommended for optimal results.

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