September 2022

We all know acne is common but were you aware that some 30% of those who suffer with acne may develop scarring as a result of their skin problems? This is more likely to occur in those who have deep, red spots known as nodules or cysts. Other factors related to scar development include family history of acne, acne location, and acne duration. Acne scars are more common on the face than the back and chest. The presence of scarring increases with acne duration and reaches a peak after a person has had acne for 2-3 years.

Whilst acne itself has been associated with mental health concerns, the bad news is that acne scarring itself can also lead to problems with quality of life. Those who have scarring often wish to hide or cover their scars as they feel embarrassed or self-conscious about their skin. Scars can be a source of frustration, sadness, anger and anxiety. Studies have shown that individuals with acne scarring feel their appearance can interfere with their professional relationships and future employment. Rather shockingly, published survey data also shows that observers infer that acne scars reflect neglectfulness of one’s health and skincare care habits, as well as appearance.

It is therefore not surprising that so many people that come to clinic are not only keen to have their acne treated but also the scarring it has left behind. One of the biggest mistakes I see in clinic, however, is when an attempt is made to treat the acne scarring whilst the acne is ongoing. I see many patients who have had treatments such as peels, micro-needling, and lasers for scarring who are still getting new spots. This is not a good way to treat the skin and I always say that acne and acne scarring should be thought of as a two step process. Firstly, the acne itself needs switching off; secondly, once it is switched off, then focus can shift to treating scarring.

Why is this? Well, there are a couple of reasons. Firstly, it’s a waste of your time and money to have scar treatments when you’re still getting new spots. The process creating the scarring is ongoing so even if some scars improve, you are still getting new ones. It’s a bit like driving with the handbrake on - it’s not going to give you the results you want and you’ll spend a lot of cash in the process. Secondly, many scar treatments themselves can lead to a flare-up or worsening of active acne. Thirdly, some treatments like laser require heavy moisturising agents to aid healing of the skin barrier - putting greasy ointments on already acne-prone skin is just going to cause more acne.


It will save you time and money in the long-run to do things in a logical order and you should ideally consider it as a two step process. I personally do scar treatments such as laser but my patients know that I won’t even think about doing these until I am confident we are on top of the acne itself first. It takes time and requires patience and often a combination of different treatments to achieve realistic results.  But in the meantime, if you are thinking about embarking on acne scarring treatment then think carefully about whether your skin is ready for it!

Dr Anjali Mahto, Consultant Dermatologist

Donate    Find out more about acne

Read Neesha's skin story about acne scarring    Read Lucy's skin story about acne

By donating to skin disease research, you are helping us to find treatments and cures for common conditions like rosacea, acne and psoriasis through to potential killers like melanoma skin cancer. Thank you.