Acne Scarring Requires More Than Skincare Alone
Written by Dr. Maha Shariff · May 21, 2026 · Acne Scarring
Topical skincare plays an important role in acne management and, when used consistently, can make a meaningful difference to overall skin health and clarity. However, if atrophic (depressed) scarring has formed, skincare alone cannot change the underlying structure of the skin.
Topical skincare plays an important role in acne management and, when used consistently, can make a meaningful difference to overall skin health and clarity.
However, if atrophic (depressed) scarring has formed, skincare alone cannot change the underlying structure of the skin. For this reason, the most effective approach is usually a combined treatment plan, tailored to the type of scarring present.
Atrophic acne scarring in neutral lighting
What skincare and topical treatments can help with:
- Reducing active acne lesions and inflammation
- Preventing new comedones (blocked pores)
- Improving post-inflammatory erythema (PIE)
- Improving post-inflammatory pigmentation (PIH)
- Supporting overall skin barrier function
- Maintenance of skin health
What are atrophic acne scars?
Atrophic scars form after inflammation disrupts normal collagen organisation within the dermis. As the skin heals, collagen may be lost or remodelled irregularly, leading to long-lasting textural change. These changes become more apparent once active inflammation has settled.
Main types of atrophic scars:
- Icepick scars – narrow, deep depressions
- Boxcar scars – wider, well-defined depressions
- Rolling scars – undulating texture caused by fibrous tethering beneath the skin
It is also common for pigmentation (PIH) to coexist with scarring, contributing to overall uneven skin appearance.
How are atrophic acne scars treated?
Because atrophic scars sit deeper within the skin, improvement requires treatments that stimulate collagen remodelling over time and target the underlying dermal structure.
Evidence-based treatment options include:
- Microneedling (collagen induction therapy)
- Targeted chemical resurfacing techniques, including medium-depth peel applications for selected atrophic scars
- Fractional laser and radiofrequency devices
Not every patient will require the same approach, and in some cases a more conservative plan is appropriate.
Assessment and skin preparation
Before any treatment, a detailed clinical assessment is carried out, including:
- Skin type and sensitivity
- Presence of active acne or inflammation
- Risk of post-inflammatory pigmentation
- Skin barrier function
- Previous treatment response
- Full medical history (including medications, history of pigmentation, and previous skin reactions)
Depending on these factors, a period of skin preparation may be required before procedural treatment begins to optimise safety and outcomes.
How scarring fits into your overall acne treatment plan
A stepwise approach is used in acne and scar management:
- Supporting skin barrier function first
- Controlling active acne
- Addressing pigmentation where present
- Introducing procedural treatments for scarring gradually where required
Skincare remains important throughout but acts as supportive care rather than a corrective treatment for scarring.
Treatment planning and expectations
Acne scarring treatment is typically delivered over several months or longer. Visible improvements may include smoother skin texture, reduced shadowing from scars, and improved overall skin quality.
The aim is meaningful improvement rather than complete removal of scars.
Next step
If you are concerned about acne scarring, the first step is a clinical assessment to understand your skin type, scar pattern and create a personalised treatment plan.
Scarring Consultation
Consultations are personal and medically led by Dr. Maha Shariff at our West London clinic.
- Clinical assessment of scar types
- Custom prep-skincare design
- Dermapen 4 and procedural planning
References
- Goodman GJ, Baron JA. Postacne scarring: a qualitative global scarring grading system. Dermatologic Surgery. 2006.
- Aust MC et al. Percutaneous collagen induction therapy. Plastic and Reconstructive Surgery. 2008.
- Iriarte C et al. Microneedling for skin rejuvenation. Dermatologic Surgery. 2017.
- Tierney EP et al. Fractional CO₂ laser resurfacing for acne scars. Dermatologic Surgery. 2009.
- Hantash BM et al. Fractional photothermolysis histology. Lasers in Surgery and Medicine. 2007.
- Orentreich DS, Orentreich N. Subcision technique for depressed scars. Dermatologic Surgery. 1995.
- American Academy of Dermatology (AAD) – Acne scarring guidance
- British Association of Dermatologists (BAD) – Acne resources