Overview
What is acne scarring?
Acne scarring develops when deep inflammation from acne breaks down the skin’s structure. During healing, the body produces either too much or too little collagen, resulting in raised, pitted, or discoloured marks.
There are several main types of acne scars:
- Atrophic scars: Depressed marks such as ice-pick, boxcar, or rolling scars caused by collagen loss.
- Hypertrophic scars: Raised scars formed by excess collagen during healing.
- Keloid scars: Thick, firm, overgrown tissue extending beyond the original spot.
- Post-inflammatory pigmentation: Dark or red patches that remain after a breakout has healed.
Acne scars can appear anywhere acne has developed — most often on the cheeks, forehead, chin, and back. They vary in depth, shape, and colour and may become more visible in certain lighting.
Symptoms and Causes
How acne scars form
cne scarring occurs when inflamed spots such as cysts or nodules penetrate deep into the skin and damage tissue. When the skin repairs itself, it may not produce collagen evenly, leaving behind depressions or raised areas.
Common signs include:
- Uneven or rough skin texture
- Visible indentations or pits
- Raised, thickened scars
- Persistent redness or pigmentation after acne heals
What causes acne scarring?
Several factors increase the risk of developing scars:
- Severe or cystic acne: Deep inflammation damages the skin’s deeper layers.
- Picking or squeezing spots: Causes further injury and delays healing.
- Genetics: Some individuals are more prone to scarring due to inherited skin traits.
- Delayed treatment: Prolonged inflammation increases the risk of permanent damage.
- Sun exposure or smoking: Slows skin repair and worsens pigmentation.
Diagnosis and Tests
A dermatologist or skin specialist can identify acne scarring through a visual examination. The assessment focuses on scar type, depth, and distribution.
In some cases, additional analysis may be recommended to plan treatment, such as:
- Skin mapping or 3D imaging: To assess depth and texture irregularities.
- Acne activity check: Ensuring active breakouts are controlled before treatment begins.
This detailed evaluation allows clinicians to recommend the most effective, targeted approach for smoother skin.
Management and Treatment
How acne scarring is treated
Although acne scars are permanent, professional treatments can significantly improve the skin’s texture and appearance. The best approach depends on scar type, severity, and skin tone.
Treatment options
- Chemical peels: Gently exfoliate and resurface the skin to fade mild scarring and pigmentation.
- Laser resurfacing: Fractional and CO₂ lasers stimulate collagen to remodel the skin and smooth deeper scars.
- Microneedling or radiofrequency therapy: Promotes collagen production and gradual resurfacing.
- Dermal fillers: Lift sunken scars for a smoother contour.
- Subcision: A minor surgical technique that releases fibrous bands beneath indented scars.
- Topical treatments: Prescription creams or retinoids that improve tone and promote cell turnover.
- Combination therapy: Using multiple methods for enhanced, long-lasting results.
Most treatments involve little downtime and deliver progressive improvements over several months.
Outlook/Prognosis
Acne scars do not fade completely on their own, but with modern aesthetic and dermatological treatments, significant improvement is achievable. The skin becomes smoother, more even, and visibly healthier with continued care.
A consistent skincare routine and early acne management help prevent new scars from forming. Ongoing sun protection and professional follow-up visits maintain long-term results.
Prevention
While not all scars can be prevented, the following steps can help minimise your risk:
- Treat acne early: Reduce inflammation before it causes permanent damage.
- Avoid picking or squeezing: Prevents deeper skin trauma and infection.
- Use gentle skincare: Avoid harsh scrubbing or drying products that irritate skin.
- Apply sunscreen daily: Protects against pigmentation and scar darkening.
- Follow medical advice: Seek professional help for persistent or severe acne.
- Support skin health: Maintain hydration, a balanced diet, and healthy lifestyle habits.
Early intervention and consistent care are key to reducing scarring and maintaining smooth, clear skin.
