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9th June, 20205 min read

What can I do about my acne scars?

Medical reviewer:Healthily's medical team
Author:Tomas Duffin
Last reviewed: 10/06/2020
Medically reviewed

All of Healthily's articles undergo medical safety checks to verify that the information is medically safe. View more details in our safety page, or read our editorial policy.

Acne scars can be anxiety inducing and are a significant problem in adults as well as teenagers -- affecting around 1 in 3 people with moderate to severe acne.

But there are things you can do to treat them.

What is acne and acne scarring?

Acne is a common skin condition that causes spots, oily skin and sometimes hot red patches that may be painful.

Any form of acne can lead to scarring, but it’s more common with the most severe form of acne spot, such large nodules or cysts. These are more likely to burst and leave a scar on the skin after healing.

But scarring also occurs if you squeeze or pick your spots.

Scarring is a natural part of the healing process, where the body creates collagen (a type of protein) to repair a wound in your skin tissue. Collagen builds up at the site of the wound to both heal and strengthen it, causing it to become lumpy. But over time, this goes down.

If your acne scars are interfering with your life, particularly if they are making you feel stressed or depressed, you should see a doctor.

How can I prevent acne scars?

Preventing acne is key to reducing scarring, using self-care techniques to reduce the number of breakouts you have. These techniques include:

  • not washing affected areas of the skin more than twice a day
  • washing affected areas with mild soap or cleanser and lukewarm water
  • leaving spots alone
  • avoiding using too much make-up and cosmetics

What are the different types of acne scars?

Pitted scars (ice pick scars)

Pitted scars are small, deep, narrow and sunken marks in your skin that are wider at the surface of your skin, narrowing as they go down into the skin.

These are one of the harder types of scar to treat and tend to occur more on the forehead or upper cheeks, where your skin is thinner.

Rolling scars

Rolling scars are indentations in the skin with sloping edges that give skin a wavy, uneven appearance.

These are more common on the lower cheek or jaw, where your skin is thicker.

Boxcar scars

Boxcar scars are round craters in the skin with sharp defined borders. These are also more common in places like your lower cheeks or jaw, where skin is thicker.

Keloid scars

Keloid scars are thick, lumpy, raised marks in your skin, which are larger than the original bump or cyst. These result from overgown tissue around the original wound and are more common on your chest, back and shoulders.

How do I treat acne scars?

Treatment for acne scarring is based on improving the texture and appearance of acne scars rather than removing them entirely.

Some treatments can be applied to all types of scarring, while others are specific to certain types.

The following methods can be applied to all forms of scarring.

Dermabrasion

This is a surgical skin resurfacing technique that uses a rotating tool to remove the outer layers of skin.

Improvements are usually seen after a few months.

Laser resurfacing

This directs focused beams of light at scars to remove damaged skin layer by layer. This should produce new, smooth-looking skin.

Injections

Treatment can involve injecting collagen into the skin to boost natural collagen levels or fat transfer to fill in uneven skin texture.

Skin needling

This involves creating a controlled skin injury using needles to promote the body to produce more collagen at the site of the scarring.

Other treatments for pitted and boxcar scars

The unique structure of pitted and boxcar scars means the following treatments may work more effectively.

Punch excision, elevation and grafting

This involves surgically removing the scar and, in severe cases, replacing it with a skin graft.

Chemical peels

A chemical solution is applied to the face causing the skin to peel off and promoting the growth of new skin cells.

Subcision

A surgical technique that removes the upper layer of skin from the underlying scar tissue. This creates a blood clot that pushes up the scar so it’s level with the rest of the skin.

Other treatments for keloid scars

Topical steroids

Topical steroids are usually applied directly to the scar for a few weeks. The

Steroid injections

Steroid injections are usually injected directly into the scar to soften and flatten them.

Silicone gels or sheets

Silicone gels are applied to scars for a minimum of 12 hours a day for at least 3 months.

Surgery to remove the keloid lump.

Surgery is usually combined with steroid injections immediately afterwards to minimise the risk of scars coming back. Keloid scars can return even after successful treatment.

When to see a doctor about your acne scars

A doctor can help if over-the-counter treatments aren’t working for your acne or scarring.

They can also help if you are experiencing feelings of anxiety, stress, social withdrawal or depression as a result of your acne scarring.

A doctor may recommend medication or refer you to a therapist to help you overcome negative thoughts (cognitive behavioural therapy).

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