Comprehensive Guide to Acne Scarring: Causes, Types, Treatments, and Prevention

By Dr. Raquel Amado on the 25th June 2024

Acne scars can be a persistent and distressing reminder of past skin issues, affecting both appearance and self-esteem. This comprehensive guide aims to provide an in-depth understanding of acne scarring, including its causes, types, treatments, and preventive measures.


Understanding Acne Scarring

Causes of Acne Scarring

Acne scarring occurs as a result of the skin’s healing process following inflammation or damage from acne. When the skin is damaged, the body produces collagen to repair the affected area. If the body produces too little or too much collagen, it results in a scar. The severity of the scar can depend on various factors, including:

  • Inflammatory Response: Severe inflammation, such as cystic acne, can damage the skin more extensively, leading to scarring.
  • Delay in Treatment: Not treating acne promptly or effectively can increase the likelihood of scarring.
  • Genetics: Some individuals are more prone to scarring due to their genetic makeup. Read here about our genetic test for acne and rosacea.
  • Skin Picking or Squeezing: Picking or squeezing pimples can damage the skin and increase the risk of scarring.


Types of Acne Scars

Acne scars can be broadly categorised into two types: atrophic (depressed) scars and hypertrophic (raised) scars. Each type has distinct characteristics and requires different treatment approaches.

  • Atrophic Scars:
    • Ice Pick Scars: Deep, narrow scars that extend into the dermis. They resemble small, deep holes in the skin.
    • Boxcar Scars: Broad, rectangular depressions with well-defined edges. These scars are usually shallow or deep.
    • Rolling Scars: Broad depressions with sloping edges, giving the skin a wave-like appearance.
  • Hypertrophic Scars:
    • Keloid Scars: Raised, thickened scars that extend beyond the original wound area. These scars are often more common on the chest, back, and shoulders.

Treatments for Acne Scars

There are numerous treatment options available for acne scars, each tailored to specific scar types and skin conditions. Consulting with a dermatologist is essential to determine the most appropriate treatment plan.

  • Topical Treatments:
    • Retinoids: Topical retinoids can help reduce the appearance of mild scars by promoting cell turnover and collagen production.
    • Silicone Gels: Silicone-based products can help flatten and soften raised scars.
  • Chemical Peels:
    • Superficial Peels: Use mild, superficial acids like glycolic or salicylic acid to exfoliate the outer layer of the skin, reducing mild scarring.
    • Medium to Deep Peels: Use stronger acids to penetrate deeper into the skin, addressing more severe scars.
  • Microdermabrasion and Dermabrasion:
    • Microdermabrasion: Uses fine crystals to exfoliate the skin, improving mild scarring.
    • Dermabrasion: A more intensive procedure that removes the top layer of skin, often used for more severe scars.
  • Laser Treatments:
    • Ablative Lasers: Remove the top layer of skin and stimulate collagen production, effective for deeper scars.
    • Non-Ablative Lasers: Stimulate collagen production without removing the top layer of skin, suitable for mild to moderate scars.
  • Microneedling:
    • Involves the use of tiny needles to create micro-injuries in the skin, promoting collagen and elastin production. This can improve the appearance of scars over time.
  • Dermal Fillers:
    • Injectable fillers can be used to raise depressed scars, making them less noticeable.
  • Subcision:
    • A minor surgical procedure where a needle is inserted under the scar to break up the fibrous tissue pulling the skin down, allowing it to rise.
  • Punch Techniques:
    • Punch Excision: Involves cutting out the scar and stitching the wound.
    • Punch Elevation: The base of the scar is elevated to the level of the surrounding skin.
  • Steroid Injections:
    • Used to flatten and reduce the size of raised scars, such as keloids.

Preventing Acne Scars

Preventing acne scars involves proactive measures to manage acne and avoid behaviours that can exacerbate scarring.

  • Early and Effective Acne Treatment:
    • Seeking treatment early can prevent severe acne and reduce the risk of scarring. Over-the-counter products with ingredients like benzoyl peroxide and salicylic acid can be effective for mild acne, while prescription medications may be needed for more severe cases.
  • Avoid Picking or Squeezing Pimples:
    • Picking or squeezing pimples can lead to skin damage and increase the risk of scarring. It’s essential to resist the urge to touch or manipulate acne lesions.
  • Use Sunscreen:
    • Sun exposure can worsen the appearance of scars. Using a broad-spectrum sunscreen with at least SPF 30 can protect the skin and prevent scars from darkening.
  • Maintain a Skincare Routine:
    • A consistent skincare routine that includes cleansing, exfoliating, and moisturising can help keep the skin healthy and reduce the risk of acne and scarring.
  • Healthy Diet and Lifestyle:
    • A balanced diet rich in vitamins and antioxidants can promote skin health. Staying hydrated and managing stress can also help prevent acne breakouts.



Acne scarring can have a significant impact on one’s appearance and self-esteem, but understanding the causes, types, and treatments can empower individuals to take control of their skin health. Early intervention, effective treatment, and preventive measures are key to minimising the risk of scarring and achieving clearer, healthier skin. If you’re struggling with acne scars, consulting with us can provide you with personalised recommendations and treatment options tailored to your specific needs.


Treatment at Dr. Raquel’s Skin Clinic

Acne scarring treatment is available at Dr. Raquel’s Skin Clinic. If acne scarring is your concern, book a skin consultation with us. We will assess your skin and advise on the best treatment plan tailored specifically for your acne scarring needs. Take the first step towards clearer skin and renewed confidence by scheduling your appointment today.


Book Online Or Get In Touch

Elevate your skincare journey with Dr Raquel and Maja. Book your consultation at Dr Raquel Skin and Medical Cosmetics today. Contact us at 01732 525875 or drop us an email at




Images courtesy of SkinPen Ltd.