Types of Acne Scars
What is the difference between acne marks and acne scars?
Flat, coloured marks
Post inflammatory erythema (PIE)
Post inflammatory hyperpigmentation (PIH)
These marks usually resolve over a few months although some aesthetic treatments may speed up this process
Textural scars
Depressed (atrophic) scars
Boxcar
Rolling
Ice pick
Raised scars
Hypertrophic
Keloid
These scars usually do not resolve without intervention.
How Do Acne Scars Develop?
Acne scars develop when inflammation damages the normal structure of the skin during the healing process. This can lead to multiple inflammatory pathways with different end results.
These pathways can affect:
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Blood vessels - results in vasodilation or enlargement of vessels
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Pigment - results in melanogenesis or pigment deposition
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Collagen and Elastin - results in under or over production of collagen and elastin
When healing occurs, the skin may not regenerate in the same way it existed before the acne lesion formed, resulting in visible scars.
What Causes Acne Scars?
The primary cause of acne scars is inflammation.
The greater the inflammation, the greater the risk of permanent skin changes.
Factors associated with an increased risk of acne scarring include:
Acne Scar Treatments
The most appropriate treatment depends on:
Most patients require a combination approach as different scar types often coexist within the same individual.
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Scar type
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Scar depth
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Skin type
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Presence of active acne
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Downtime preferences
Acne Marks
PIE (red marks)
Aims to reduce vascularity and redness.
PIH (brown marks)
Aims to break up pigmentation.
Depressed (Atrophic) Acne Scars
Ice Pick, Boxcar Scars, Rolling Scars
Aims to release existing scar tissue and remodel the skin with new collagen.
Raised Acne Scars
Aims to reduce the collagen load to flatten scars.
Keloid
Hypertrophic Scars
Aims to reduce the collagen load to flatten scars and reduce redness
Can Acne Scars Be Completely Removed?
Acne scars are permanent structural changes within the skin.
What Lifestyle Measures Can I Take To Improve My Acne?
Lifestyle factors rarely act as the sole cause of acne, but they can influence inflammation, hormones, oil production and skin barrier function. Small adjustments can often improve outcomes and work alongside medical treatments.
Optimise sleep
Sleep supports tissue repair and collagen remodelling.
Manage stress
Stress may worsen acne and contribute indirectly to ongoing inflammation.
Eat A Nutrient-Dense Diet
A balanced diet supports overall skin health and healing.
Treat Active Acne Early
Preventing future acne lesions helps reduce the risk of additional scars.
Avoid squeezing
pimples
Picking remains one of the most important modifiable risk factors for acne scarring.
Smoking
cessation
Smoking may impair wound healing and collagen production.
Skincare And Acne Scars
Skincare cannot remove established acne scars but may support overall skin quality.
Key principles include:
Gentle cleansing
Appropriate moisturisation
Daily sunscreen use
Avoiding excessive exfoliation
Avoiding manipulation or picking of lesions
Daily sunscreen use is particularly important to minimise post-inflammatory pigmentation.
When Should You Seek Medical Advice?
Medical assessment may be beneficial if:
Early assessment can help identify the most appropriate treatment options.
Acne Scars FAQs
*This information is for educational purposes only and is not intended as a substitute for medical advice. We recommend a clinical consultation for a plan tailored to your unique anatomy.*
