Acne Scarring

Acne is a common condition. About 80% of people between the ages of 11 and 30 will have acne and one out of five of that population will develop scarring. As a GP, I know how significant the psychological impact of scarring can be on your personal life. 

Your skin needs to be acne-free before you start treatment for your acne scars. 

Acne scarring is difficult to treat. Most treatments reduce the size of the acne scars and make them less visible. Before you try to treat your scars, it is important to know what type of scarring you have. Each type responds to treatment differently and some treatments are better for particular types than others. An examination by one of our dermatologists can diagnose the type of acne scarring you have and determine its severity.

 Additionally, your skin tone should also be considered when deciding on the best course of treatment. For example, for darker skin types, deep skin laser treatments would not be recommended due to higher chances of scarring and pigmentation. 

At the ESS Clinic, we recommend the following treatments to improve the appearance of acne scarring: 

  • Optimising skincare regimes 
  • Subcision surgery 
  • Polynucleotides 
  • Dermal fillers 
  • Keloid injections.

We do NOT offer laser resurfacing or dermabrasion treatments. Dr Shereen Rahman believes that chemical skin peels and skin needling often do not reach deep enough layers of the skin to achieve significant results.

ACNE SCARRING FAQs

The majority of acne scars result from an inflammatory response causing destruction of collagen fibres in the dermis (the deeper layer of the skin). Further injury such as ‘picking’ at active acne lesions can also increase the likelihood of developing acne scars
  • Wear sunblock: Sunlight is important because your skin uses light energy to help make vitamin D. However, too much sun can darken scarring. The darker your skin colour, the more obvious your scars will be.

  • Don’t pick, scratch or squeeze: This can cause extra damage to your skin by increasing inflammation and consequently increasing scarring.

  • Treat your active acne: Either with products you buy or treatments recommended by your GP.
Atrophic or depressed scars
  • Ice pick scars: These are narrow, V-shaped scars that go deep into the skin. They can look like small round or oval holes, like a chickenpox scar. These are the most difficult scars to treat because they can extend far under the surface of the skin. You’ll find them on your forehead and upper cheeks, where your skin is thinner.

  • Box scars: These are wide, U-shaped scars that have sharp edges which go deep into the skin. They can be shallow or deep. These scars are common on the lower cheeks and jaw. The shallower they are, the better they respond to treatments.

  • Rolling scars: These are wide depressions that typically have rounded edges and an irregular, rolling appearance. These scars are typically found on the lower cheeks and jaw, where your skin is thicker.

Hypertrophic or Keloid scars
These scars are most common with chest and back acne. They sit above the surface of the surrounding skin and are caused by high collagen production during wound healing. They can be be itchy, tender or painful.
Subcision is a minor surgical procedure used for treating acne scars.

Subcision is performed under local anaesthetic using a special medical instrument (called a cannular) that is inserted through a puncture in the skin surface. The aim is to break the fibrotic strands that are tethering the scar to the underlying tissue.

The release of the fibrotic strands and new collagen deposition, caused by wound healing, leads to cosmetic improvement of the scar.

Subcision may not be suitable in the following circumstances:

  • Patients with a history of hypertrophic or keloid scars
  • Current or recent (within 12 months) systemic oral retinoid (e.g. Acitretin, Isotretinoin)
  • Bleeding or blood clotting disorders
  • Active skin infection
Dr Shereen Rahman believes that optimal results are achieved when Subcision is used in combination with Polynucleotides. By stimulating collagen production, Polynucleotides restore the skins elasticity and fullness. This is particularly beneficial for individuals with acne scars, as the enhanced collagen production helps to fill in and smooth out depressed scars.

Please visit our page on Polynucleotides for further information.

Pricing

£350

Subcision to localised areas of scarring

£600

Subcision and one Polynucleotide treatment

£1250

Subcision and a course of 3 Polynucleotide treatments