What is acne scarring?

Acne scarring is usually an after-effect of cystic acne or inflamed blemishes. Some people are left with pigmentation (darker or lighter patches of skin) after their blemishes have healed, and some may be left with pitted facial scarring from acne, where the skin appears uneven and dimpled.

What causes pitted acne scarring?

Inflamed blemishes or acne such as cysts, papules and pustules can result in pitted acne scarring. This is because the cysts form on the bottom layers of the skin and when the cyst has healed it leaves behind a gap between the skin’s layers. The upper layers of skin above ‘sink’ to fill the gap, causing a pitted, dimpled appearance.

Types of pitted acne scarring include:

• Box scars: steep round scars which resemble the scars left behind after chicken pox.

• Rolling scars: wide, shallow undulations in the skin caused by damage beneath the surface.

• Ice pick scars: deep, narrow scars, which may resemble large open pores.

Some people may be more susceptible to pitted acne scarring if they have thin skin. This can be caused by low collagen levels (i.e. in ageing or sun-damaged skin), over-exfoliation or genetics.

What causes pigmented acne scarring, or dark marks?

Post-inflammatory hyperpigmentation or dark marks (also known as macular scars) left behind after acne has healed are caused by a buildup of melanin in the skin. They aren’t strictly ‘scars’ as they aren’t usually permanent, however, they may take months or even years to disappear altogether without treatment.

People with dark skin tones are more susceptible to post-inflammatory hyperpigmentation.

How can I prevent acne scarring?

Acne scarring can’t always be prevented, but there are steps you can take to minimise the after-effects of acne, including:

• Protecting your skin from sun exposure

• Avoiding picking, squeezing or scratching your acne

• Seeking advice and professional treatments designed to target acne whilst it is active

• Medication

Natural remedies for acne scarring

Some commonly used natural remedies for acne scarring include:

• Vitamin E-rich natural moisturisers such as aloe vera gel, olive oil or coconut oil. Vitamin E is known for its healing properties and for improving skin radiance.

• Lemon juice - used historically to fade freckles and lighten hair.

• Natural exfoliators (to encourage cell renewal) such as sugar, salt or oats, applied to damp skin in a gentle, circular motion.

Treatments for acne scarring

There are a number of effective professional skin treatments designed to diminish the appearance of acne scars. These include:

• Skin peels: an acid/enzyme-based deep exfoliation treatment designed to penetrate down to the dermis and target dark marks, discolouration and uneven texture.

• Microdermabrasion: tiny exfoliating crystals are blasted onto the skin to remove the top layer of skin cells, encouraging cell renewal and targeting dark marks.

• Microneedling: thousands of miniscule contact points are made on the surface of the skin, encouraging your body’s natural healing process to rejuvenate and repair the skin, plumping out areas of pitted scarring.

• Laser resurfacing: a powerful laser is used to destroy targeted areas of damaged skin cells and encourage new cell turnover for a smoother, more-even complexion.