Why does acne scarring occur & what can we do about it?

Dec 3, 2024

3 min read

Acne scarring happens when the skin's healing process after acne lesions involves either too much or too little collagen production. The severity of the acne, the type of acne lesion, how the skin is treated, and factors like picking or sun exposure can all affect the likelihood and type of scarring. Inflammation, especially in deeper or cystic acne, plays a central role in scarring because it damages the skin's underlying structure. Proper skincare, early treatment, and avoiding picking acne can help prevent or minimise scarring.

While acne scarring can be distressing, there are many treatment options available, ranging from topical treatments to advanced procedures like laser therapy and microneedling. The key is to act early and consult a specialist for personalized recommendations based on your skin type and the severity of your scars.

At Dr Sharyn Rai Aesthetics, we have formulated a package called 'Act on Acne', which is designed to help those with acne scarring and recognise uneven skin and pigmentation.

There is a variety of methods used to help target acne scarring, and here are a few of those options.

Treatment Options for Acne Scarring

Topical Treatments
- Retinoids: Retinoids, such as tretinoin, can help accelerate skin turnover, reduce pigmentation, and improve skin texture over time. They are one of the most effective treatments for acne scars.
- Chemical Peels: Peels containing ingredients like glycolic acid or salicylic acid can help exfoliate the skin, improving the appearance of scars and uneven pigmentation.
- Vitamin C: This antioxidant helps reduce hyperpigmentation and promotes collagen production, which can improve skin texture and tone.
- Niacinamide: Known for its anti-inflammatory properties, niacinamide can help reduce redness and pigmentation associated with acne scars.
Microneedling
- Microneedling involves tiny needles that create micro-injuries in the skin, stimulating collagen production. It can help improve skin texture and reduce the appearance of atrophic scars, such as ice pick and boxcar scars.
Laser Treatments
- Fractional Laser: Lasers like CO2 or fractional erbium lasers can target deeper layers of the skin to promote collagen remodeling and improve scar texture.
- PicoSure Laser: A newer laser treatment that uses picosecond pulses to break up pigment and stimulate collagen production, helping to improve both hyperpigmentation and texture.
- Non-ablative Lasers: These lasers (such as the Nd:YAG) work by stimulating collagen growth without damaging the outer skin layer, which can be beneficial for less severe scarring.
Dermal Fillers
- For certain types of atrophic scars, such as rolling or boxcar scars, dermal fillers (e.g., hyaluronic acid) can be injected to raise the depressed areas of skin, giving it a smoother, more even appearance.
Subcision
- This procedure involves using a needle to break up the fibrous tissue that anchors the scar, allowing the skin to rise and smooth out. It's often used for deeper scars, such as rolling scars.
Platelet-Rich Plasma (PRP) Therapy
- PRP involves drawing a small amount of your blood, processing it to concentrate the platelets, and then injecting it into the skin to promote healing and collagen production.
Cryotherapy
- Used for hypertrophic or keloid scars, cryotherapy involves freezing the scar tissue to reduce the size and appearance of raised scars.

Preventing Acne Scarring

Early Treatment: Treating acne early with topical treatments, oral medications, or even hormonal therapy (for those with hormonal acne) can help prevent severe outbreaks and scarring.
Avoid Picking: Picking or squeezing acne can make scarring worse. Hands can introduce bacteria and cause more inflammation.
Sun Protection: Scars tend to darken when exposed to the sun. Using sunscreen regularly can prevent PIH and help scars fade more quickly.
Gentle Skin Care: Use gentle, non-comedogenic skincare products to prevent further irritation and breakouts.