Acne Scars

Acne scars can be a horrible reminder of the days when pimples and other eruptions would clog the face. Although it is usually experienced by teenagers, a large percentage of all adults suffer from acne breakouts at some stage of life. While the condition often fades away in time, post-acne scars and pits are difficult to remove.

It is important to educate yourself about your treatment options for post acne scar removal - its not one size fits all.

Acne Cause and Effect

As an acne cyst forms, the neck of the sebaceous gland expands, filling with bacteria. Cells and sebum that are unable to pass through to the skin's surface. Eventually the cyst ruptures this "foreign matter" deep within the dermis, quickly attacked by white blood cells responsible for fighting infection.

95% of acne patients will develop scarring to some degree, the earlier the treatment appropriate for the severity of the outbreak is initiated, the better the odds are that scar formation will be mild .

Delaying acne therapy by 3 or more years is likely to increase one's risk of more significant acne scarring. In other words, the longer you keep your scars they more they "want to stay" with you and the harder task it is to smooth them out.

Types of acne scars and grading:

As with many skin conditions acne scars are graded.

Grade 1.

  • Visible from a distance of 50cm
  • Can be covered up with makeup
  • Eg Macular scarring which is flat scarring that is characterised by increased or decreased pigmentation

Grade 2.

  • Visible from a distance of less than 50cm
  • Can covered up with makeup
  • Eg Rolling scars folds in the skin and are usually caused by tethering of the skin to underlying structures

Grade 3.

  • Visible from a distance of more than 50cm
  • Can not be covered up easily with makeup
  • Eg Boxing scars, deep divots – very deep scars that involve loss of subcutaneous tissue volume;
    Hypertrophic scarring– where there is a raised and often pigmented scar as a result of acne


Grade 4.

  • Severe scarring -
  • Can not be covered up with makeup
  • Eg deeper hyperthropic scars; Keloid scars - red/purple/brown in color and is significantly raised; "out of boundaries" - disproportionate to the size of the initial trauma caused by the acne

Acne Scarring Treatments

Often, a combination of treatments that is suited to an individual’s pattern of acne scarring is recommended. There are various types of acne scars including ‘ice-pick’, depressed, rolling, raised or hypertrophic, and red or white scars, and each can require a different approach to treatment. Treatment of acne scarring almost always requires repeated treatments over a number of months for best results. Your skin therapist will be able to recommend a treatment plan that is best suited to your skin's condition and the scars.

The combination treatment approach may include one or as many as needed of the following therapies:

  1. Topical Antioxidant therapy - This includes potent Vitamin A serums and gels can both prevent and clear blemishes before they lead to scar formation, making them an important tool in acne therapy. Many excellent options are available. Medi8 Retinol 3R, 6R and 10TR are the best on the market. Not only they prevent scar formation, they aid in acne clearance and anti-ageing as well.
  2. Injectable Fillers - Acne scarring often involves some loss of volume from beneath the surface of the skin, leading to depressed scars and hollow-appearing areas. Fillers can help reverse this change. We use non-permanent fillers because of their excellent safety profile. However, it is typical to achieve some permanent improvement with them. The longer skin is held in a good position, the more likely it is to stay in that position when the temporary filler has dissolved. We also use fillers to hold the skin in a good position while the skin is healing and remodelling itself
  3. Laser/ IPL and LED treatments - Light-based treatments such as Laser and IPL are excellent collagen boosters and skin healers. While they can take away the color in acne scars and soften scars' appearance they do not have a very good track record of treatment of more advanced deeper pits. Once can expect a noticeable result after consistent treatments of between 4 and 8 sessions, usually performed once every 2-4 weeks, depending on clinic's protocols and individual client's needs. Although LED treatments are often used to aid healing process skin after other, more aggressive forms of treatments, they are not always a necessary part of protocol.
  4. Chemical Peels - A chemical peel involves the application of a high-potency acid upon the skin. Some acids penetrate horizontally, some vertically, some clamp onto skin in an "organised patchy" pattern. Different acids achieve different results, depending on indication of the acid. Generally, the more potent the acid, the deeper the penetration into the skin. Personally, I find this more beneficial for post inflammatory skin color changes and the most minor of acne scars.
  5. Skin needling - In my opinion, probably the most effective method of treating superficial acne scars, especially because of its minimal downtime. It works by puncturing the skin with multiple fine needles. This sends the skin into a wound healing state, stimulates all of the growth factors, collagen and elastin production and a chain other beneficial reparative reactions. This results in general improvements of skin's condition, including wrinkles and helps to lift up any ‘indented’ scars. The advantage of this treatment is the fact that it can be used on all skin types including darker skin types. People of Asian, Indian, African, and European backgrounds are able to have this treatment with minimal risk of pigmentory changes in comparison to laser treatments. Skin needling, also known as dermal needling, generally requires several treatments, usually once every 8 weeks to ensure that skin's maximum recovery and repairative mechanisms potentials have been reached before the next set of reactions is activated. Recovery is fast. Redness turns into a pink, flushed look overnight and completely goes away within a week.


Post acne scarring is preventable. Don't put off acne treatment therapy. The earlier it is dealt with, the less likely acne scars will be in your future. Prevention is the best and most effective form of treatment.



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