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  • Writer's pictureBotany Skin Clinic

Acne Scar Treatments

Updated: Nov 6, 2023

Multiple treatments stimulate and renew the skin collagen.

Various Treatments start from $150 | Typical Session 50mins

There are various types of acne scars, each treated with different methods: -Acne scarring treatments need to be matched to the patient’s acne scarring type, skin type, and recovery time permitted. -There are various types of acne scarring, classified based on their severity and morphology. -Treatment of acne scarring on olive or darker skin types carries the risk of post-inflammatory hyperpigmentation. Non-laser treatments carry less risk of this than laser treatments. -Laser treatments include laser resurfacing with the carbon dioxide laser or erbium lasers, or fractional laser treatment like the fractional CO2 lasers. -Non-laser treatments include the skin needling, and TCA CROSS. -Generally, multiple treatments are required for the best results, and acne scarring can be improved in most cases but not completely resolve

What type of acne scars are there?

Macular scarring

  • This type of acne scarring is characterised by flat areas of increased and decreased pigmentation as a result of acne. Although there are not any indentations in the skin or raised scars, this is considered as a scar by many patients who have this problem.

Boxcar scars

  • These acne scars are superficial punched out scars that have sharp vertical edges on cross-section and can be round or oval shaped when seen from above.

Rolling scars

  • These acne scars appear as undulations in the skin and are usually caused by tethering of the skin to be underlying structures

Deep divots

  • These are simply very deep scars that involve loss of subcutaneous tissue volume and result in a large divot.

Ice-pick scars

  • Deep but small holes in the skin, similar to the indentation left by an ice-pick.

Hypertrophic scarring

  • Where there is a raised and often pigmented scar as a result of acne.

Keloid scars

  • Where the size of the scar is significantly raised, red/purple, and disproportionate to the size of the initial trauma caused by the acne.

What severity categories of acne scars are there?

Grade 1

Macular scarring or flat scarring that is characterised by flat areas of increased or decreased pigmentation visible from greater than 50cm.

Grade 2

Mild disease that is visible at distances of less than 50cm and can be covered by make-up. Examples include mild rolling acne scars.

Grade 3

A moderate disease that is visible at 50cm or greater and is not easily covered with make-up or the normal shadow of a shaved beard hair. Stretching the skin can flatten the scar. Examples include more significant rolling scars, shallow boxcar scars, and mild to moderate hypertrophic scars.

Grade 4

Severe disease as in grade 3 but scarring is not flattened by stretching the skin. Examples include severe boxcar scars, deep divots, ice pick scars, and hypertrophic/keloid scarring (very raised/pigmented scars).

 Skincare of acne scarring

Acne commonly induces changes to skin pigmentation and skin tone. This occurs particularly on olive or darker skin types affected by acne. Hyperpigmentation can occur after trauma to the skin induced by an acne lesion. The hyperpigmentation that occurs is usually a result of inflammation caused from acne and is called post-inflammatory hyperpigmentation. Hypopigmentation, or a loss of pigmentation, can also occur as a result of acne, can often be permanent.

Redness of the skin is common after an acne lesion has passed.

In many cases, these changes in skin pigmentation tend to resolve themselves with time, once the active acne has subsided. Often patients will want to expedite this process, as natural regression of this problem can often take more than a year. The key priority is to treat any active acne, and often using medical grade skin care can be helpful. Retinoids, or analogues of vitamin A, can help skin turnover and keratinisation (which can block pores) and reduce acne.  

Using a non-comedogenic sunscreen can also help to reduce post-acne skin tone changes. Occasionally, a skin lightening agent can be used to help treat hyperpigmentation caused by acne also.

It is important to also address on the general quality of the skin as well as treating the acne scars per session. This helps to reduce the overall appearance of acne scarring.


Laser Treatments for Acne Scarring 

  • Fractional CO2 Laser

  • Q-switch Nd:YAG Laser

  • Micro-needling

  • Micro-needling with RF

  • Micro-needling with Plasma

Non-Laser treatment for Acne Scarring

Surgical skin needling is an older but very effective method of treating superficial acne scars by puncturing the skin with multiple fine 3mm (long) needles attached to a small rolling pin. This stimulates collagen production and helps to lift any ‘indented’ or atrophic acne scars. The advantage of this treatment is the fact that it can be used on all skin types including olive and dark skin types.

People of Asian, Indian, African, and European background can have this treatment with less risk pigmentation changes in comparison to laser treatments post-needling. Also, it penetrates very deeply so that collagen can be stimulated on deeper acne scars. Usually, it takes 3 to 7 days to recover from the treatment, depending on the degree of the treatment.

Micro-needling is another form of skin needling that utilises fine needles attached to a stamping device that oscillates up and down to create thousands of micro-injuries to the skin. It generally is a lot less invasive than surgical skin needling (described above), and although it has less downtime, generally requires more treatments to achieve similar results.

TCA CROSS is a simple yet effective method of improving acne scarring. It is most commonly used for small indented acne scars. It involves careful placement of high concentrations of trichloroacetic acid into the scar with a toothpick. This stimulates the production of new collagen and remodelling of existing collagen to fill in the acne scar. The advantage of this treatment is that it is localised to the problem only and not the unaffected skin.

Submission is another technique that is suitable for treating depressed acne scars. The size of the scar usually needs to be fairly large or deep. It involves putting a special needle under the depressed scar. Often acne scars are depressed because the skin is tethered to the underlying tissues

Chemical peels are another method of treating more superficial acne scarring. Generally, medium to deep chemical peels are required to achieve a significant result, but a series of more superficial chemical peels could help achieve some improvement in milder acne scarring without significant downtime.

Number of Treatment and treatment result expectation

Although there have been many advances in the treatment of acne scarring, it remains a difficult skin concern to correct. In most cases, an improvement is achieved, but due to the nature of the problem (scarring), it is not possible to completely remove scarring in most cases.

Most of the treatments described require multiple treatments to achieve the best result. Each treatment stimulates remodelling of the skin’s collagen, and to get the best results. As a general rule, we allow 2 months as a minimum period between treatments. This time interval between treatments is a balance between the time required for new collagen to form and the patient’s desires to achieve results quickly. New collagen formation can occur for up to 1-year post-treatment, but patients are usually reluctant to wait a full year prior to deciding to retreat.


Pop in for a free consultation with the nurse. Consultation with the Doctor is $150 and must be booked in advance. We are located in the heart of Botany Town Center Next to TSB bank.

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