Acne scars: what you need to know

Acne scars are most often caused by severe acne such as nodules or cysts. When these spots burst they damage the nearby skin, causing scarring. Acne scars can also be caused by picking or squeezing your spots, so it is important to avoid this.

There are three main types of acne scar:

• Ice pick scars. These are small, deep holes in the surface of your skin that appear like the skin has been punctured by a sharp instrument. Ice pick scars are caused when an infection from a cyst works its way to the surface of the skin.
• Boxcar scars. These are broad depressions with sharply defined edges. Boxcar scars form when too little collagen is produced during wound healing.
• Rolling scars. These have smooth edges that give the skin an uneven or rolling appearance. They are caused by bands of scar tissue that form under the skin.

Unfortunately, there is no easy treatment for acne scar removal. Under the NHS, the options are classed as cosmetic surgery and so are usually unavailable. The types of treatment available to reduce acne scars are:

• Dermabrasion. This involves removing the top layer of skin, either using lasers or a specially made wire brush.
• Laser treatments. These treatments can either remove a small patch of skin to encourage new skin, or stimulate growth of new collagen to repair some of the damage.
• Punch techniques. If you have ice pick or boxcar scars, punch techniques surgically remove the scars and then seal, elevate or ‘plug’ the wound.
• Subcision. If you have rolling scars, subcision involves removing the upper layer of skin from the underlying scar tissue. This helps form new connective tissue, pushing up the scar to be level with the surface of the skin.

While many people want to instantly banish acne scars, learning to cope with them is equally important. Acne scars can often cause anxiety, stress and depression. If you find you have little interest in seeing your friends or are anxious to leave home, it is important to speak to your GP.