Acne Scarring
Treatment
Medically reviewed by Dr Martin Wade | Consultant Dermatologist and Medical Director | Last updated on August 2026
Acne scarring can leave lasting indentations, uneven texture, and changes in the skin’s surface after active breakouts have settled. Scars can develop across the face, chest and back, with their depth and appearance influenced by the type of acne, the inflammation involved and how the skin heals.
Acne scars vary considerably in shape, depth and behaviour. At London Real Skin, we assess scarring, current skin condition, skin tone, and treatment history before creating a plan tailored to the specific changes you want to achieve.
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What Is Acne Scarring?
Acne scarring refers to structural changes that remain after an acne lesion has healed. Damage caused by deeper inflammation can disrupt collagen within the skin, leaving indented, raised or uneven areas. Flat red or brown marks can also persist after acne, but these are post-inflammatory hyperpigmentation rather than true textural scars and may require a different treatment approach.
Acne scars differ in depth and structure, so a detailed assessment is needed to identify the most suitable treatment approach.
What Types of Acne Scars Are There?
Acne scars are classified according to their shape, depth and whether tissue has been lost or overproduced during healing. Several types can appear within the same area, which is why a personalised combination of treatments is sometimes required.
Ice Pick Scars
Ice pick scars are narrow, deep indentations that extend into the skin. Their depth and defined shape can make them more resistant to treatments intended for broader or shallower scars.
Boxcar Scars
Boxcar scars are round or oval depressions with clearly defined edges. They can be shallow or deep and frequently appear across the cheeks and temples.
Rolling Scars
Rolling scars are broader indentations with softer, sloping edges. They develop when fibrous bands beneath the skin pull the surface downwards, creating an uneven or undulating texture.
Hypertrophic and Keloid Scars
Hypertrophic and keloid scars form when the skin produces excess tissue during healing, creating a raised scar rather than an indentation. They require a different treatment strategy from atrophic scars and must be assessed carefully before any procedure is recommended.
What Causes Acne Scarring?
Scarring is more likely when inflammation extends into the deeper layers of the skin and disrupts the surrounding tissue. Individual healing responses also affect whether a breakout leaves a lasting change.
Factors that can increase the likelihood of acne scarring include:
- Deep inflammatory acne
- Acne nodules and cysts
- Repeated or prolonged breakouts
- Picking, squeezing or scratching spots
- Delayed control of active acne
- Damage to collagen during the healing process
- Genetic susceptibility to scarring
- A tendency to develop hypertrophic or keloid scars
How We Assess Acne Scarring
A detailed assessment allows us to identify ice pick, boxcar, rolling and raised scars, as well as redness, pigmentation and enlarged pores that can appear alongside them. We also consider the depth and distribution of the scarring, current acne activity, skin sensitivity and any previous procedures.
Your skin tone, medical history, tolerance for downtime and preferred outcome all influence treatment planning. One procedure can be enough for a more consistent scar pattern, while mixed or established scarring can benefit from a staged combination of treatments addressing different depths and textures.
Acne Scarring Treatment Options at London Real Skin
There is no single best acne scar treatment for every type of scarring. The procedure we recommend will depend on the scar pattern, treatment area, skin condition, and level of recovery that best suit your lifestyle.
Laser Skin Resurfacing
Laser skin resurfacing creates controlled thermal injury within selected areas of the skin, stimulating collagen remodelling and renewed cell turnover. At London Real Skin, iPixel laser technology can be used to improve deeper textural scarring, uneven skin texture and enlarged pores, with the treatment strength adjusted to the skin and degree of correction required.
RF Microneedling
RF microneedling combines controlled microchannels with radiofrequency energy delivered beneath the skin’s surface. This stimulates collagen remodelling at targeted depths and can improve indented acne scars, enlarged pores and uneven texture. Treatment settings are selected based on the scar pattern, treatment area, and skin type.
Microneedling with Exosomes
Microneedling with exosomes combines medical microneedling using the XCellaris Pro Twist with Purasomes, a professional exosome-based formulation. The controlled microchannels stimulate collagen renewal within selected indented scars, while Purasomes supports the wider regenerative process and recovery. Deeper, tethered or mixed scarring can still require additional treatment as part of a broader plan.
Dermal Fillers
Hyaluronic acid dermal filler can be placed beneath selected depressed scars to lift the skin and reduce the shadow created by the indentation. This approach is most relevant to rolling or atrophic scars and is not used for all forms of acne scarring.
What to Expect From Acne Scarring Treatment
Your experience will depend on the procedure or combination selected during your assessment. Before treatment begins, we will explain which scars are being targeted, the expected recovery and the degree of improvement the proposed plan is designed to achieve.
Consultation and Scar Assessment
Your practitioner will examine the skin closely and identify the types, depths and distribution of your scars. We will also review active acne, pigmentation, medical history, current medication, previous treatments and the amount of downtime you can accommodate.
Your Treatment Plan
Once the scarring has been assessed, we will recommend the procedure, number of sessions and treatment intervals most suited to your skin. Where several scar types are present, the plan can be staged so that each procedure addresses a specific element of the concern.
Treatment and Comfort
The treatment area will be prepared according to the chosen procedure, with topical anaesthetic used where appropriate. Appointment length and treatment sensation vary between laser resurfacing, RF microneedling, microneedling with exosomes and dermal filler, and these details will be explained before you proceed.
Recovery and Results
Redness, swelling, tenderness, dryness, or temporary changes in skin texture may occur, although the expected recovery period varies by procedure. Dermal filler produces an immediate lift that settles as swelling reduces, while collagen-remodelling treatments create progressive improvement over the following weeks and months.
Why Choose London Real Skin for Acne Scarring Treatment?
Accurate scar classification is central to treatment planning. Our dermatologist-led team assesses scar structure, skin tone, active breakouts, and pigmentation before selecting the treatment depth and technology, allowing us to create a plan tailored to the scars and broader skin concerns identified during the consultation.
Our approach includes:
- Detailed assessment of scar type and depth
- Treatment planning for different skin tones
- Options for the face, chest and back
- Access to laser resurfacing, RF microneedling and dermal fillers
- Microneedling with Purasomes exosome support
- Combination plans for mixed scar patterns
- Experienced aesthetic practitioners
- Clear guidance on risks, recovery and expected improvement
- Complimentary consultations
- A CQC-registered clinic in Holborn
Book an Acne Scarring Consultation in London
If you are considering acne scar treatment in London, book a complimentary consultation at London Real Skin. We will assess the type and extent of the scarring, explain the available options and create a treatment plan based on your skin, preferred recovery and goals.
Acne Scarring FAQs
Does active acne need to be controlled before treating acne scars?
Active inflammatory acne generally needs to be managed before an intensive scar-remodelling procedure begins. Continuing breakouts can create new scars and make it harder to accurately assess the established damage.
Which acne scarring treatment is right for me?
The right treatment depends on whether your scars are narrow, broad, tethered, raised or part of a mixed pattern. Your skin tone, current skin health, treatment history and acceptable downtime are also considered before a recommendation is made.
Can acne scars be removed completely?
Treatment can significantly improve the depth, texture and visibility of acne scars, but complete removal is not always realistic. The result depends on the type and severity of scarring, the treatment selected and how your skin responds.
Can older acne scars still be treated?
Older scars can still respond to treatment because laser resurfacing and microneedling procedures stimulate new remodelling within the skin. More established or deeper scars can require a longer course or a combination of approaches.
Is acne scarring treatment suitable for every skin tone?
Acne scarring can be treated across a wide range of skin tones, but the technology, intensity, and recovery plan must be carefully selected. Skin with a greater tendency towards post-inflammatory pigmentation requires particularly considered treatment planning.
How many acne scarring treatments will I need?
The number of sessions depends on the type of scar, the treatment selected, and the degree of improvement needed. Some individuals benefit from a single procedure, while mixed or deeper scarring may require a staged plan over several months.
Can acne scarring treatments be combined?
Yes. Different treatments can address distinct elements of scarring, such as deeper indentations, tethered areas, enlarged pores, or overall texture. Where a combination is recommended, the procedures will be sequenced to allow appropriate healing between appointments.
Is acne scarring treatment painful?
Sensation varies according to the procedure and treatment depth. Topical anaesthetic and other comfort measures can be used where appropriate, and your practitioner will explain what the selected treatment feels like beforehand.
How much downtime will I need?
Recovery can range from temporary redness after microneedling to a more noticeable healing period after stronger laser resurfacing. You will receive a clear recovery estimate and aftercare instructions once the procedure and treatment intensity have been selected.
How long do acne scarring treatment results last?
Collagen remodelling can produce lasting structural improvement, although the skin will continue to change naturally over time. Dermal filler is temporary and requires maintenance if you want to preserve the lift beneath selected depressed scars.
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London Real Skin, 233 High Holborn, London WC1V 7DN.
Call 020 7183 5892 or email info@londonrealskin.com.
A short walk from Holborn and Chancery Lane Underground stations.
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Wednesday – Friday 10.00 – 19.30
Saturday 09.30 – 17.30 · Sunday closed
