Acne scarring

What is acne scarring?
Permanent textural changes in the skin resulting from acne.
Red and brown marks are not technically scars, and usually resolve with time and/or topical treatments.

What treatments can help?
It depends on the type of scarring, but options include topical agents such as retinoids and benzoyl peroxide, as well as treatments such as radiofrequency, skin needling, lasers, dermal fillers, TCA CROSS,
punch elevation and excision, subcision, and corticosteroid injections.

One of the most common concerns about having acne is the risk of scarring. Early and appropriate treatment is the best way to reduce the risk. However, if you’re left with scarring, there are many things that can be done to improve it.

What is acne scarring? 

Acne scarring refers to permanent indents and textural changes on the skin. 

Colour changes that occur following acne, such as red and brown marks on the skin, are not referred to as scarring, as these usually resolve with time. 

What are the different types of acne scarring? 

There are several different types of acne scars:

Ice pick scars are deep, narrow scars. 

Box car scars are broad, shallow, depressed scars with steep edges. 

Rolling scars are wider, undulating scars with sloping edges. 

Keloid and hypertrophic scars are raised lumpy scars, most commonly seen on the chest, shoulders and back. 

How can I prevent acne scarring?

The best way to prevent acne scarring is the early treatment of acne, and the avoidance of trauma to the skin (squeezing or picking pimples). 

How can I treat acne scarring?

Treatment depends on the type of scars and the skin type of the patient, and often requires a combination of different treatments. For flat red and brown marks, sun protection and topical agents such as azelaic acid and hydroquinone can be helpful. Vascular lasers and intense pulsed light can also be helpful for redness.

Options for depressed scars include radiofrequency, skin needling, non-ablative and ablative lasers, dermal fillers, and TCA CROSS. Procedures such as punch elevation, punch excision and subcision may be used for some types of scarring. Corticosteroid injections may be used for hypertrophic or keloid scars. There’s some evidence that topical treatments such as topical retinoids and benzoyl peroxide may improve scarring.

References
Bhargava S, Cunha PR, Lee J, Kroumpouzos G. Acne Scarring Management: Systematic Review and Evaluation of the Evidence. Am J Clin Dermatol. 2018 Aug;19(4):459-477.

Connolly D, Vu HL, Mariwalla K, Saedi N. Acne Scarring-Pathogenesis, Evaluation, and Treatment Options. J Clin Aesthet Dermatol. 2017;10(9):12-23.

Levy LL, Zeichner JA. Management of acne scarring, part II: a comparative review of non-laser-based, minimally invasive approaches. Am J Clin Dermatol. 2012 Oct 1;13(5):331-40. 

Tan J, Tanghetti E, Baldwin H, Stein Gold L, Lain E. The Role of Topical Retinoids in Prevention and Treatment of Atrophic Acne Scarring: Und

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ABOUT THE AUTHOR

Dr-Julia-Rhodes

Spotlight on Skin was created by award-winning Melbourne-based dermatologist, Dr Julia Rhodes.

Julia knows first-hand how overwhelming the skincare world can be, and that’s with over 10 years of experience practicing dermatology. Given that even she gets overwhelmed, she appreciates how hard it can be for those of you without a scientific background to make sense of all the information available, and choose products that are right for your skin…