acne scars:

diagnosis and advanced treatment options sydney

Acne scars are a common concern after moderate or severe acne, especially if inflammation is deep or breakouts are picked or squeezed. Scarring may appear as changes in skin texture—such as depressions, raised areas, or persistent red or brown marks. Accurate diagnosis of your scar type, skin tone, and individual needs is essential for effective acne scar treatment.

Types of Acne Scars

Atrophic Scars

Ice Pick Scars: Deep, narrow pitted scars
Boxcar Scars: Broad, shallow or deep scars with defined edges
Rolling Scars: Soft undulations caused by tethered skin

Hypertrophic and Keloid Scars: Raised, firm scars, often on the jawline, chest, or back
Post-Inflammatory Colour Changes: Red (erythema) or brown (hyperpigmentation) marks remaining after acne clears (not true scars but commonly distressing)

Acne Scar Treatment Options

The most effective results are achieved with a personalised, combination approach. Your acne scar treatment plan will be tailored to your skin, scar type, and goals.

1. Subcision

Best for rolling scars, subcision uses a fine needle or cannula to release the fibrous bands under the skin, allowing the surface to lift and remodel. This procedure is often combined with other therapies for enhanced results and may involve mild swelling or bruising for several days.

2. TCA CROSS (Trichloroacetic Acid)

Ideal for ice pick and deep boxcar scars, this technique applies a high-strength TCA solution to the base of each scar, stimulating new collagen and skin remodelling. Several treatments are usually needed, and care is taken with darker skin types due to pigmentation risk.

3. Skin Collagen Support

Suitable for improving skin firmness and texture, Skin Collagen Support uses advanced procedures to stimulate your skin’s natural collagen production, helping to smooth and refine atrophic acne scars.

4. Facial Volume Support

For shallow atrophic scars, Facial Volume Support restores natural-looking volume beneath depressed scars, lifting and smoothing the skin’s surface. This is often used alongside subcision for best results.

5. Intralesional Treatments

For raised (hypertrophic or keloid) scars, a gentle solution is injected directly into the scar to soften and flatten it. Multiple sessions may be required for optimal results.

6. Laser and Light-Based Therapies

Fractional ablative resurfacing lasers (such as fractional CO₂ and erbium:YAG) target mixed atrophic scars, stimulate collagen, and improve skin texture. Vascular lasers (pulsed dye or Nd:YAG) treat persistent redness, while pigment lasers can address brown marks. Combination therapy with lasers and other modalities often provides the best cosmetic outcomes.

What to Expect from Acne Scar Treatment

Most acne scar treatments are performed as a series to achieve gradual, long-lasting improvement. Combination therapy generally delivers the highest level of cosmetic improvement. While complete scar removal is not possible, significant improvement in skin appearance, texture, and self-confidence can be achieved.

Why Choose Dr Liz Dawes-Higgs, Specialist Dermatologist in Sydney?

Acne scar treatment requires specialist assessment and careful planning to achieve the safest and most effective results. As a dermatologist with advanced training and experience in acne scar management, Dr Liz uses the latest technologies and evidence-based techniques to provide safe, tailored care for every patient.