How to get rid of acne scars
Reviewed by Dr Neel Patel
If you’ve experienced acne at any time in your life, you might have some scarring as a result. The majority of people would no doubt like to avoid scarring on their face, neck or back, so we’ve taken a look into acne scarring. We’ll explore how to treat acne scars, as well as how to prevent them in the first place.
What are acne scars?
Scarring is a common complication of acne, particularly in people who have moderate or severe acne. Scarring can occur when acne spots burst, or are picked or squeezed. The skin around the spot is damaged, and scars develop, which is a permanent change.
What do acne scars look like?
As everyone’s skin is different, some people’s acne will heal with only minimal damage, while other people will have lasting scars.
The appearance of acne scars depends on the type of acne and severity of your acne. Acne scars can look like small deep holes in the skin, they can make the skin look bumpy and uneven or they can look like craters in the skin. Read on to find out more about the types of acne scars.
What causes acne scars?
Any type of acne spot can leave a scar if it damages the skin, however scarring is most likely when nearby skin is damaged following a burst nodules or cysts - these are the most severe varieties of acne spot. Nodules are large, hard bumps that sit under the skin, while cysts are large pus-filled spots that look like boils.
Types of acne scar
There are 3 main types of acne scar which appear differently on the skin. These atrophic scars are usually indented and can make the appearance of your skin look imbalanced.
Ice pick scars
Ice pick scars look like small, deep holes in the skin, as though the skin has been punctured.
How ice pick scars look under the skin's surface:
Rolling scars
Rolling scars are where the skin looks bumpy and uneven.
How rolling scars look under the skin's surface:
Boxcar scars
Boxcar scars are individual depressions, or craters, in the skin.
How boxcar scars look under the skin's surface:
Hypertrophic and keloid scars
In certain people, the body can have an abnormal response to the damaged skin. This can result in more severe, raised scarring such as hypertrophic or keloid scars. These scars are more severe and appear as raised lesions. They’re more common on the chest, back and shoulders and in people with black skin.
How keloid scars look under the skin's surface:
How long does it take acne scars to fade?
Deep or raised scars don't really fade as such, and unfortunately those types of scars are likely to be permanent. Over time they will look less red and angry, which softens the appearance.
Usually scars look a shade lighter than your usual skin tone, but some skin types, particularly dark or black skin, turn darker where the spots have been, which is called post inflammatory hyperpigmentation (PIH).
Can you remove acne scars naturally?
If your scarring is very mild, or you don’t want any of the cosmetic procedures suggested below, you can try a product such as Bio Oil. These are moisturising skin treatments that are said to reduce the appearance of scars.
If you are concerned about your acne scars, or developing acne scars you should see your GP.
How to treat acne scars
In more severe cases, the treatments listed below are the most common in tackling acne scarring. But it’s worth noting that, while the kinds of scarring treatment listed below can have a noticeable effect on acne scarring, they cannot completely remove the appearance of scars.
Dermabrasion
This is a cosmetic procedure where the top layer of the skin is removed, typically with a special instrument that is rolled across the skin.
Removing the top layer of the skin can reduce the appearance of acne scarring and the make the skin smoother, however this technique is not as effective with deep scars.
You may need two or three dermabrasion procedures for an effect to be seen. After each procedure your skin may be red, sore and swollen for several months while it heals.
Laser therapy
This is where lasers are used to remove outer layers of the skin (as with dermabrasion) and to stimulate collagen production, both of which can improve the appearance of scars.
As with dermabrasion, laser therapy can cause redness, swelling and pain, with symptoms lasting for weeks.
Punch excision, elevation and grafting
Punch techniques are types of minor surgery carried out to remove acne scars.
Excision is usually used for ice pick scars. The scar is cut out of the skin using a special tool, and the wound is stitched flat.
Elevation is usually used for boxcar scars. This technique involves cutting out the bottom of the scar and lifting it up so that it sits level with the surrounding skin, giving a smoother appearance.
Grafting is for deep ice pick scars and involves taking a skin graft from somewhere else on the body (usually the back of the ear). The scar is removed and the hole is plugged with the skin graft.
Subcision
Subcision is another type of surgery used for acne scarring, and specifically rolling scars. The upper layer of the skin is separated from the scar tissue, allowing blood to clot over the scarring and lift up the skin to make it smoother.
Microneedling
This is where a special tool is rolled across the skin, creating lots of tiny wounds within the scar tissue. These wounds heal quickly, and during the process produce new collagen which helps smooth out the affected skin.
The procedure causes redness and irritation, but for no longer than a few days. Multiple treatments are needed, typically every four to six weeks.
Chemical peels
A chemical peel is a cosmetic procedure whereby outer layers of skin are removed using glycolic or salicylic acid. As with dermabrasion or laser therapy, this can help reduce the appearance of scars.
Dermal fillers
To temporarily plump up the skin and reduce the appearance of scars you can receive dermal fillers under the skin.
How to prevent acne scars
It’s not always easy but there are some steps you can take to reduce your risk acne scarring:
Don’t squeeze or pick breakouts
Not only can burst spots damage the skin and cause scarring, squeezing and picking can also lead to infection.
Use the correct acne treatment
Make sure you’re using the correct treatments for your acne. If your symptoms are severe you should be using prescription treatments, not simple over-the-counter products.
Daily skincare routine
Establish a daily skincare routine. Acne is not caused by poor hygiene, but keeping your skin clean can help to reduce the blockages in the skin that cause acne spots.
Be gentle on your skin
Avoid scrubbing your face or using harsh skincare products. Keeping your skin clean is important, but washing it too harshly can cause damage.
Wear sun protection
Wear sun lotion to protect scars as they are healing. Sun damage can slow down the healing process. Find out how to look after acne in the sun in our article.
Quit smoking
Studies have shown that scars don’t heal as well in smokers. Read our top tips for how to stop smoking and find out what products are available to help.
Conclusion
Severe acne can leave scars, making your skin look bumpy and uneven. Creams and other topical treatment can help with mild scarring and discolouration (post inflammatory hyperpigmentation or PIH), but deeper or bumpy scars may need different treatment, either through a specialised skin clinic or a dermatologist. we have skin care advice that can help to lessen the appearance of your scars and ways you can help prevent acne from causing scars.
If you are concerned about your acne spots or scarring, make an appointment with your GP or use our free acne assessment.
References
https://www.acnesupport.org.uk/scarring/
https://www.nhs.uk/conditions/acne/complications/
https://www.acnesupport.org.uk/scarring/keloid-scars-test/
https://www.acnesupport.org.uk/scarring/skin-discolouration-staining/
https://knowyourskin.britishskinfoundation.org.uk/condition/acne/
https://www.hey.nhs.uk/patient-leaflet/scar-information/
