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What Are Acne Scars?

Acne is a common condition which has affected around 28 percent of the population at some stage in their lives.

The majority of this group, an estimated 95 percent, say that the presence of acne materially impacts their daily lives and emotional wellbeing.

A common complication of acne is acne scarring. Scarring occurs when the body works too hard to heal the wounds caused by acne and produces excess collagen that builds up in the skin. This excess collagen then stays in place permanently, causing the appearance of scars.

Acne can produce a range of scars. Some are sunken, also known as atrophic, while others are raised. These are known as hypertrophic scars. The three main types of acne scars - ice pick scars, rolling scars and boxcar scars. These scars can be prominent and cause sufferers a great deal of mental and emotional distress.

Any type of acne spot can lead to scarring, but it is a more common complication of nodules and cysts, the most serious types of spots. 

Nodules are hard, painful acne lesions which are buried deep under the skin and can last for weeks or months. Cysts are large lumps filled with pus and there is a high risk of permanent scarring if these are not treated promptly. Acne scarring occurs when nodules and cysts burst, damaging the skin nearby.

Scarring can also happen as a result of picking or squeezing spots. This is something which should always be avoided.

Luckily there are a number of acne scar treatments available which can dramatically reduce the appearance of acne scarring. The results may vary depending on which treatment you have and the extent and severity of your acne scarring. It is important to have realistic expectations as to what acne scar treatment can achieve.

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What causes acne scarring?

Any scars, whether caused by acne or not, are part of the skin’s normal healing process after it has been damaged.

Most superficial wounds heal without leaving scars behind. But when the dermis, the second and thickest layer of skin, is damaged, then this is what causes scars to form.

When the follicle or pore becomes swollen with bacteria, dead skin cells and excess oil, this can cause a break in the follicle wall. If this break is particularly deep, this material spills into the dermis, destroying healthy skin tissue. The body produces extra collagen as a wound healing response. If the skin does not create enough fibroblasts during the healing process, then this causes a scar to form. Scarring may also occur if the skin makes too many fibroblasts.

Larger spots which are buried deeper in the skin, for example cysts and nodules, are most likely to leave scars behind. But by squeezing spots of any size, you run the risk of scarring as this forces the debris deeper into the dermis, spreading the infection. You should also avoid picking scabs, as this can hamper the body’s natural healing process and increases the risk of scarring.

Prevention is always better than cure, so if you are someone who is prone to acne, particularly severe acne, you should seek treatment in order to reduce the risk of acne scarring.

What are the different types of acne scars?

Acne scars form when the skin produces too little or too much collagen as it heals. There are a number of different types of acne scar, and these all present in different ways. These are the most common types of scars left behind by acne.

These look like small, deep holes in the surface of your skin. As the name suggests, this gives the appearance that the skin has been punctured with a sharp object. Because ice pick scars have a narrow opening with extensive scarring underneath, this means this type of acne scarring can be more difficult to manage.

Rolling scars are caused by bands of scar tissue that form underneath the skin. These bands give the surface of the skin a rolling and uneven appearance.

This type of scar presents as round or oval depressions, or craters, in the skin.

When acne scars cause the skin to look uneven, this is known as cobblestone scars. Cobblestone scars are usually easier to correct than other types of acne scars.

This type of scarring leads to indentations in the skin. They are caused by the skin not creating enough fibroblasts during the healing process. Fibroblasts are cells that are needed as the skin recovers from a wound. The appearance of atrophic scars can get worse with age. This is because the skin loses its youthful firmness, leading to sagging and wrinkling. This causes atrophic scars to look more pronounced. We often see older people seeking acne scar treatment for atrophic scars.

These are the opposite to atrophic scars. This type of scar is raised above the surface of the skin and is caused by an overproduction of fibroblasts during the healing process. Hypertrophic scars can be raised and red but, unlike keloid scars, they do not spread beyond the site of the injury. This type of scar may mature and regress over time.

Keloid scars are similar to hypertrophic scars but they tend to be much thicker than the original spot that was present. They are highly visible, and raised well above the surface and continue to grow beyond the site of the original wound. They can be red or brown in appearance and are known to cause itching, tenderness, burning or pain in some people.

Anyone can get a keloid scar, but they are more common in people with dark skin. Keloid scars can last for years. Sometimes keloid scars do not form until months or even years after the initial injury.

If you have had a keloid scar previously, then it is highly likely that you will develop one again.

Although these are technically not scars, dark spots can be an unwelcome reminder of acne. These dark spots are caused by hyperpigmentation, or a deeper colouration where acne has healed. People with darker skin are particularly prone to hyperpigmentation.

Unfortunately, it is unlikely that acne scars can be completely eliminated. However some new cutting edge treatment methods are now able to produce substantial, sustained improvement in the appearance of acne scarring.

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What treatment is available for acne scarring?

Broadly speaking, the treatment of atrophic acne scarring falls into one of three categories:

  • Repairing the skin tone and consistency
  • Adjusting dermal thickness
  • Resurfacing of the skin

At the Cadogan Clinic we offer an array of the very best treatments to combat acne scarring:

Chemical peels help to lighten dark spots and achieve a smoother texture and tone, while unclogging pores to help prevent any future acne breakouts. Chemical skin peels work by removing the dead skin cells and stimulating the growth of new cells. This results in rejuvenated and healthier looking skin. Chemical skin peels are far more effective at removing dead skin cells than other facial exfoliants. Chemical skin peels can be tailored to meet the needs of each individual patient.

However it is worth noting that this particular treatment may not be as effective in tackling particularly severe raised or depressed scars.

Also known as phototherapy, Intense Pulse Light (IPL) treatment is one of the most effective treatments for smoothing out skin tone and texture and can help treat a variety of different skin conditions, including acne scarring.

IPL therapy clears the skin via intense pulse light therapy and helps to improve an array of the most common skin complaints. You will need to have several treatments in order to achieve the best result. The final result may not be visible for several months after the final treatment.

This treatment is not suitable for pregnant women or people who have taken strong antibiotics to tackle acne in the previous six months.

Laser treatment for acne scars sees a dermatologist focusing light on the top layers of skin in order to break up scar tissue. This simultaneously encourages the growth of new skin cells to replace the scar tissue.

If you have active acne, a darker skin tone or very wrinkled skin, then you may not be the best candidate for this treatment. If this is the case, our expert dermatologist will recommend an alternative treatment for you.

Microneedling works in a similar way to chemical skin peels, IPL and laser skin resurfacing, by encouraging the growth of new, healthy skin cells. This treatment works by puncturing holes into the skin, stimulating collagen growth and improving overall skin tone and texture. This is an effective way to reduce the appearance of acne scarring.

:  Lasermar™ and Enerjet™ are highly effective forms of acne scar treatment. These two devices are at the cutting edge of technology and are the most up to date acne scar treatment options available. 

This particular treatment does not use any needles. Instead, a machine delivers kinetic energy and a healing compound to a controlled depth, stimulating collagen production and thickening the dermis, the inner layer of the skin. On the outside, high energy therapy corrects imperfections on the skin’s surface. As this treatment stimulates collagen production as a wound healing response, your skin will continue to feel the benefit of high energy therapy long after the treatment has finished.

There are very few practitioners who are qualified to deliver these forms of treatment. However our team of expert dermatologists are fully qualified and experienced at delivering this particular form of acne scar treatment.

The choice of treatment will depend on the severity of your scars, which part of the body is affected, your medical history and the characteristics of your skin. At your initial consultation, our expert dermatologist will discuss your acne scar removal and decide which treatment is best suited to meet your needs.

Why Do People Have It?

  • Permanently reduce or remove acne scarring
  • Restored skin tone and texture
  • Smooth, healthy skin
  • Smaller pores 

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Frequently Asked Questions

Lasemar™ is a subcutaneous single bare fiber and the latest innovation in the field. In this procedure, laser energy is delivered under the skin through a single-use fibreoptic, thinner than the diameter of a single hair, allowing much deeper and complex scarring to be addressed.

Enerjet™ is an air pressure device and a second major innovation in acne scarring. The Enerjet™ injects medications at very high pressure into the skin, in a pain-free needle-free way. The compressed injection blasts the scar, filling the resulting cavity with medication that the body replaces with its own collagen.

Both of these high energy devices are extremely powerful and involve the very latest in high energy technology. When in the right hands (only very few practitioners are qualified to handle the high energy levels of these machines) the results they are able to achieve are the very best in the marketplace.

Before you decide to undergo acne scar treatment, you should ensure that any acne you have has been treated. This is because new acne breakouts can lead to new scars, meaning you will not see the best results from your acne scar treatment. Inflammation caused by breakouts can also reduce the effectiveness of acne scar treatment.

Some acne scar treatments can’t be carried out alongside certain acne medications. One of our expert dermatologists will be able to advise you further on this at your initial consultation at the Cadogan Clinic.

acne scarring effectively, several sessions will be needed to ensure the best possible result. These will be spaced several weeks apart. The number of sessions required will depend on the severity of the acne scarring.

This varies depending on which acne scar treatment you are having done. Overall, acne scarring treatment is not painful. However you may feel some discomfort when undergoing laser skin resurfacing. This is because this procedure uses light and heat to treat damaged skin cells. This should resolve itself within  a few days.

A potential side effect of laser skin resurfacing is infection, which can cause pain. If you experience pain during or after any of your treatments, you should inform your dermatologist.

This varies from person to person. It depends on which treatment is being used and the extent of the acne scarring being treated. You will see results of your treatment after the very first session, regardless of which treatment is selected. However you will need to complete the full course in order to see your full results.

You are likely to need between one and three acne scar treatments, which will be spaced several weeks apart. It may take between seven and 10 days before you can see any significant difference in your condition. The final result of the treatment may take several months to show.

This will depend on your pre-existing condition and the nature of your treatment. Your dermatologist will advise you on what to expect following your initial consultation.

It is possible for some acne scars to fade over time. However this isn’t always the case, particularly with scars left behind from cystic acne.

When it comes to keloid or atrophic scars, these tend to get worse with age. This is due to the skin losing its firmness as part of the natural ageing process. This can lead to atrophic scars in particular looking more pronounced. One of our expert dermatologists will be able to advise you on which treatment is best suited to you.

The biggest thing you can do to minimise the chance of acne scars is to not pick or squeeze spots. Scabs should also be left alone to heal. If you suffer from outbreaks of acne, particularly if you have severe acne, you should seek treatment. Prompt treatment will further cut the chance of scars, particularly if you frequently get cysts or nodules.

There are several natural remedies which purport to minimise acne scarring, including rosehip seed oil, blackseed oil, honey, lemon juice and aloe vera. Although there is evidence to suggest that some of these may help, none are a substitute for proper acne scar treatment from a qualified dermatologist.

How to find us

The Cadogan Clinic is based at 120 Sloane Street in Chelsea, just off Sloane Square and the Kings Road.

We are accessible by all major bus routes that pass through Sloane Square and Sloane Street, as well as Sloane Square tube station.

We are just a 5 minute walk northwards up Sloane Street once you have arrived at Sloane Square.

Local pay parking is available just around the corner from the Clinic on Cadogan Gate, Cadogan Square and Cadogan Gardens. Our local residential parking zone is the Royal Borough of Kensington & Chelsea.

Address: 120 Sloane Street, Chelsea, London, SW1X 9BW

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