What are acne scars?
Acne scars are changes in skin texture or pigmentation that remain after acne has healed. They form when the skin’s natural repair process is disrupted, often due to inflammation, trauma such as picking, or deeper lesions like cysts and nodules.
Unlike active acne, scarring tends to be long-lasting and may affect confidence, makeup application, and how evenly light reflects on the skin’s surface.
What causes acne scarring?
Cause #1 – Inflammation from active acne
When inflammation damages the surrounding tissue, particularly in deeper forms of acne like cysts and nodules, the skin’s ability to heal evenly is disrupted. This can leave behind indentations or raised areas.
Cause #2 – Picking or squeezing
Forcefully removing blackheads or pimples can damage the skin and interfere with normal healing, increasing the risk of long-term scarring.
Cause #3 – Delayed treatment
Leaving acne untreated can allow inflammation to persist and lead to deeper lesions that are more likely to scar.
Cause #4 – Genetics
Some individuals are more prone to scarring based on their skin type, healing response, and collagen production.
Types of Acne Scars
Understanding the type of acne scar is important in choosing the right treatment:
Atrophic Scars (Indentations)
- Ice Pick Scars: Deep, narrow scars that look like small holes or enlarged pores.
- Boxcar Scars: Wide, rectangular indentations with sharp edges.
- Rolling Scars: Wavy or undulating depressions in the skin, often due to tethering of the skin to deeper layers.
Hypertrophic or Raised Scars
- Thick, firm scars that stay within the boundary of the original lesion. More common on the chest, shoulders, and jawline.
Post-Inflammatory Hyperpigmentation (PIH)
- Dark spots left after acne heals, especially in medium to darker skin tones. These are not true scars but can persist for months.
Post-Inflammatory Erythema (PIE)
- Red or pink marks that remain after acne clears, more common in lighter skin tones.
Why do some people scar and others don’t?
Factor #1 – Acne severity
Deeper or more inflamed breakouts are more likely to damage tissue and lead to long-term scarring.
Factor #2 – Skin tone and type
People with deeper skin tones are more prone to post-inflammatory pigmentation, while lighter skin types often experience redness or surface pitting.
Factor #3 – Healing response
Everyone’s skin heals differently. Genetics, immune response, and collagen behaviour all influence whether scars form or fade.
Factor #4 – Early intervention
Addressing acne early can help limit inflammation, reduce healing time, and lower the chance of scarring.
The impact of acne scars
Acne scars affect more than just skin texture.
Common concerns include:
- Visible pits, waves, or dark spots that persist after breakouts
- Difficulty applying makeup evenly
- Uneven skin tone or texture in photos or bright lighting
- Ongoing frustration after acne clears
- Reduced confidence, particularly in social or professional settings
Frequently Asked Questions
Q: What’s the best treatment for acne scars in Australia?
A: It depends on the type of scarring. Treatments such as radiofrequency microneedling, fractional lasers, and subcision may help improve texture, while chemical peels and targeted skincare may support more even pigmentation. A qualified healthcare professional can assess your skin and develop a personalised plan.
Q: How long does it take to see improvement?
A: Most professional treatments require a series of sessions, usually between three and six, with gradual improvements appearing over several months. Deeper scars may take longer and often benefit from a structured, ongoing treatment plan.
Q: Can acne scars be removed completely?
A: Some people achieve near-complete improvement, while others notice softer, less visible scars rather than full removal. Results vary depending on the scar type, skin characteristics, and how the skin responds to treatment over time.
Q: Can I treat acne scars while I still have active breakouts?
A: It’s usually best to manage active acne first, as ongoing inflammation can interfere with scar treatments. In some cases, both concerns may be addressed together under the guidance of a qualified healthcare professional.
Q: Are acne scar treatments covered by Medicare?
A: Generally no. Treatments for acne scarring are considered cosmetic procedures and are not covered by Medicare in Australia. In limited cases where treatment is medically necessary, your healthcare professional can advise if any referral options apply.
