Every Question You’ve Ever Asked About Acne Scars, Answered

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A breakout is the ‘gift’ that keeps on giving. For starters, the scar it leaves behind can take weeks – if not months – to heal. And be they red or brown, broad or narrow, raised or depressed, acne scars are one of the biggest beauty banes for men and women alike.

But while they’re notoriously hard to treat, the good news here is that you can drastically reduce their appearance and even make them disappear for good, according to skin guru Dr. Marwa Ali. Speaking exclusively to Savoir Flair, the resident aesthetic doctor at The Wellness Clinic, Harrods delves into all things acne scars, revealing everything from how they’re formed to the best (and worst) ways to treat them.


harrods wellness clinic
Photo: Courtesy of Evening Standard

What is acne, and how is it caused?
Acne is a medical condition that can affect individuals from their early teens well into adulthood. It generally peaks during the adolescent years and then again in the late twenties. There are a number of contributing factors that lead to the development of acne; it is most commonly caused by hormonal imbalance that leads to the increased production of excess sebum (oil) in the skin. The excess oil and dead skin cells can block the pores (the external opening of the hair follicle in the skin), resulting in the development of acne. Similarly, heavy oil-based makeup can clog up the pores in the same way. Occasionally, this skin condition can also be hereditary.

What are acne scars, and why do people get them?
Acne scars are formed as a result of deep trauma to the follicle wall, which occurs due to the inflammatory response to a lesion (acne spot) such as a papule, pustule, or cyst. The appearance of the scar can worsen over time as fibrous tissue formation occurs. It’s also worth noting that, in addition to the formation of scars, acne can result in the development of post-inflammatory hyper-pigmentation (PIH).

What are the different types of acne scars?
Ice pick scars are deep, narrow, and pitted in nature, while boxcar scars cause broad depressions with a sharp and defined edge. Similarly, rolling scars cause broad depressions, but with a sloping edge. Atrophic scars are flat, thin scars or depressed scars and, lastly, hypertrophic or keloid scars are thick and raised.

Any tips on what not to do as an acne sufferer?
The worst thing you can do is neglect your skin health. This includes using oil-based makeup or skincare, having poor hygiene, and picking at your acne spots – this can spread bacteria and further inflame the lesion. You must remember that any active acne must be treated prior to embarking on the treatment of acne scarring. A good skincare routine is essential and can prevent the development of acne and, therefore, scarring. Prevention is better than cure.

What products help treat acne scars?
As treating existing acne is the first step – and hygiene is paramount in reducing the risk of acne – a good skincare routine is essential for maintaining skin health, treating active acne, and improving the appearance of scars. An exfoliator is an important addition to remove and lift dead skin cells that can clog the pores. A light peel, such as two percent salicylic acid, will help renew the skin’s surface by preventing the build-up of keratin (dead skin cells) and keep acne at bay.

Inflammatory acne can be treated with the use of a topical prescription anti-inflammatory that reduces acne-causing bacteria. By applying a vitamin A derivative (such as retinol) at night, we can reduce the production of sebum and therefore prevent the development of acne. It also helps to improve pigmentation as well as the general texture of the skin. To further reduce post-inflammatory hyper-pigmentation, a course of medications can be prescribed by a specialist doctor to lighten and further improve the appearance of a scar.

What are the best treatments to treat acne scars?
Generally, I like to treat acne scarring combining a trio of treatments; I call this ‘M Acne Triple Therapy’ and it involves a three-step approach. The first step sees subcision, which is a semi-surgical procedure involving the use of a needle or cannula to break down and release the fibrous scar tissue within the skin. This is followed by the injection of a bio-stimulator in the region of the scar to stimulate the production of collagen.

Step two involves both micro-needling and PRP (platelet-rich plasma) treatments that work to further stimulate collagen production by inducing controlled micro-injuries to the skin. The injection of plasma (rich in growth factors, stem cells, and nutrients) aids cellular repair. The final stage involves bespoke skin resurfacing; this can be done using a skin peel of various strengths or energy-based devices such as laser.

To book an appointment with Dr. Marwa Ali, call (+44) 020 7225 5678 or e-mail thewellnessclinic@harrods.com

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