Understanding acne scar treatment
Acne scars are not all the same. Ice-pick scars are narrow and deep, boxcar scars have sharp edges, rolling scars are tethered to the tissue underneath, and some marks are not scars at all but flat pigmentation that will fade with time and sun protection.
Because the types differ, so do the treatments. Tethered rolling scars respond to subcision, which releases the fibrous bands pulling the skin down. Narrow ice-pick scars are often better treated with CROSS. Texture and shallow scarring improve with microneedling, MNRF or fractional laser. Most faces need a combination.
Realistic expectations matter here. Published experience with scar procedures describes meaningful improvement in depth and texture over a series of sessions, not complete removal. Your dermatologist will tell you which of your scars are likely to improve most, and which will improve least.
This may suit you if
- Depressed scars left after acne has settled
- Uneven skin texture that shows up in side lighting
- Rolling or tethered scars on the cheeks
- Patients whose active acne is already under control
What happens at the clinic
- 1
Scar mapping
Your scars are examined and categorised by type and depth, and photographs are taken with your consent so change can be compared objectively.
- 2
Active acne first
If acne is still active, that is treated first — resurfacing inflamed skin risks new marks and poorer results.
- 3
Combination plan
A sequence is planned: for example subcision for tethered scars, CROSS for ice-pick scars, and microneedling, MNRF or fractional laser for overall texture.
- 4
Spaced sessions and review
Sessions are spaced four to six weeks apart to let collagen remodelling happen between visits, with review photographs along the way.
Aftercare
- Strict sun protection between sessions
- Gentle cleansing and barrier repair for the first few days
- No scrubs, actives or facials until you are told it is safe
- Attend sessions at the spacing advised — rushing them does not speed up collagen
Possible side effects
- Redness, swelling and peeling for a few days after resurfacing procedures
- Temporary post-inflammatory pigmentation, more likely in deeper skin tones
- Bruising after subcision
- Incomplete improvement — some scar types respond less than others
