Acne Scars
& Marks
Acne can leave four different things behind: scars, brown marks, red marks and rough texture. They look alike, but each one needs a different treatment, so the plan starts with telling them apart.
Will it work for me?
Most people have more than one of these. Find yours below.
Likely to improve
- Soft dips across the cheeks that smooth out when you stretch the skin. These are rolling scars. They lift with filler and remodel with a device course.
- Shallow dents with defined edges. These are boxcar scars. Microneedling and polynucleotides work here.
- Flat brown or grey marks where spots used to be. This is pigmentation. It fades with peels, light therapy and sun protection.
- Flat pink or red marks. This is leftover redness in the small vessels. It settles with light therapy and time.
- Rough texture and open pores. A device course refines these.
Harder to change
- Narrow, deep pits. These are icepick scars. Needles and injectables only reach the top of them, so improvement is partial.
- Deep scars that pull when you move your face. The scar is tethered below. Filler helps, but complete correction is unusual.
- Raised or thickened scars. These are a different problem and need a different plan.
- Spots that are still active and sore. Treat the acne first.
Dr Gohar Shah assesses every scar in person before any treatment is planned.
Book a free consultationIf your acne is still active — painful, cystic, inflamed, or getting worse — that usually needs to be brought under control before any work on marks or scarring makes sense. Treating the surface while the underlying acne is still flaring tends to disappoint, and in some cases isn't appropriate at all.
Active acne is a medical condition. The right first step is usually your GP, an NHS dermatology referral, or another appropriate registered medical service, who can look at medical options for the acne itself.
How scars are treated here
No single treatment fixes acne scarring, because the scars sit at different depths. So a plan is built in layers, from the deepest problem up.
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1
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2
Lift rolling scars
A hyaluronic acid filler (Juvéderm Volift) is placed beneath each rolling scar. It raises the floor of the dip straight away. In the controlled trial of this gel, the improvement was still there at two years.
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3
Support shallow dents
Polynucleotide injections (Plinest or Rejuran S) go into the skin under shallow scars, usually three or four sessions a few weeks apart. They support the skin's own repair rather than filling the scar.
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4
Fade marks and calm redness
Chemical peels and Dermalux light therapy, with strict sun protection throughout the course.
A full plan runs over three to six months. Results keep building for up to a year after the last session.
Acne Scars & Marks
Questions Answered
Can you get rid of acne scars completely?
It depends on the type of scarring. Shallow rolling and boxcar scars tend to soften well over a course of treatment, and improvement can be significant. Deep icepick scars and tethered scarring are more resistant — they can improve partially, but complete resolution is unusual. We'll tell you honestly at consultation what's realistic for what's actually there.
What's the difference between acne scars and the marks left after a spot?
A true scar is a structural change in the skin — a depression or texture difference that won't fade on its own. Most of the flat marks left after a spot heals are either post-inflammatory pigmentation (PIH), a brown or grey discolouration, or post-inflammatory erythema (PIE), a flat pink or red vascular mark. These can be stubborn, but they're not structural — they respond to quite different treatments than scarring does. Telling them apart changes the plan.
I still get the occasional breakout — is it too soon?
The occasional spot doesn't necessarily mean it's too soon. What matters is whether the acne is active and inflamed on an ongoing basis — cystic, painful, or worsening. If that's the case, bringing it under control first (usually via your GP or a dermatology referral) makes more sense before working on what it's left behind. If you're not sure which side of that line you're on, that's a fair thing to raise at consultation — we'll give you an honest view.
Does treatment work on darker skin tones?
Yes, though the approach matters. Darker skin tones carry a higher risk of post-inflammatory pigmentation from certain treatments, so the choice of modality, depth and aftercare is adjusted accordingly. We assess skin tone as part of every consultation and choose parameters with that in mind. Sun protection between sessions is especially important for managing PIH risk in deeper skin tones — we'll explain what that means in practice.
Does filler (Juvéderm Volift) work on acne scars?
For rolling scars, yes. A soft hyaluronic acid gel is placed beneath each scar to lift its floor. It has controlled trial evidence for rolling scars, and the results held at two years. It is not used for icepick scars. Because it is hyaluronic acid, it can be dissolved if needed.
What are polynucleotides (Plinest, Rejuran S)?
Purified DNA fragments, taken from salmon, in an injectable gel. They are placed in the skin to support its own repair. The evidence in acne scars is small but positive, so we use them as a supporting step, not a stand-alone treatment. They are not suitable if you have a fish allergy.
How long does a plan take?
Three to six months for most people. Texture and tone change first, often within four to six weeks. Scars change more slowly, because collagen takes months to rebuild, and improvement continues for up to a year after the final session.
If acne has left marks, scarring
or uneven texture behind
A consultation is where we work out what's actually there and what can realistically be improved.
Questions? Contact us