Acne Scar Treatment in London: Advanced Options for Smoother Skin

Understanding Acne Scars

Acne scars are the longer-term footprints left by inflammation in the skin. When a deep spot or cyst damages collagen and elastin, the repair process can lay down tissue in an irregular way. If too little support is rebuilt, the surface sinks, creating depressed scars such as ice-pick, boxcar and rolling types. If excessive collagen forms, particularly on the chest, shoulders or jawline, raised scars (hypertrophic or keloid) can occur. In addition to true scars, many patients also see lingering redness (post-inflammatory erythema) or dark marks (post-inflammatory hyperpigmentation). These are not scars but they amplify how visible scarring appears in certain lighting and photographs.

Types of Acne Scars

Ice-pick scars

Small, narrow and deep, like a pinpoint opening tapering downwards. Because they run vertically and are anchored, they can be challenging to lift with surface-only treatments.

Boxcar scars

Round or oval depressions with sharper edges, often on the cheeks or temples. Depth varies from shallow to deep; edges cast shadows in side-light.

Rolling scars

Undulating depressions with gentle slopes caused by tethers between lower skin layers and the surface. When these are released, surface smoothness improves significantly.

Hypertrophic and keloid scars

Thicker, raised scars caused by excess collagen. Hypertrophic scars remain within the original spot’s footprint; keloids extend beyond it. They can be itchy or tender and may occur months after the acne has settled.

Colour change (marks) vs. scarring

Red marks are due to superficial blood vessels in healing skin; brown/grey marks follow inflammation in melanin-producing cells. These are treatable and often fade over time with sun protection and pigment-safe strategies, but they require a different approach from textural scars.

Why Do Some People Scar More?

The main drivers are acne severity, delay to effective treatment, and skin trauma such as squeezing or picking. Genetics also play a role. In skin of colour, the pattern may include more prominent pigmentation changes and a higher tendency to raised scars on the chest/shoulders. Hormonal or nodulocystic acne carries a higher risk of atrophic (depressed) scarring if not addressed early.

Assessment at Skinhorizon

Every scar pattern is unique. During your consultation we assess scars under natural and angled light, map their types and depth, and feel for tethering. We look for signs of ongoing acne activity because active breakouts must be calmed first to prevent new scars forming. We discuss your lifestyle, downtime tolerance and goals, then create a realistic, staged plan. Photography helps measure progress accurately.

Treatment Planning: Why Combinations Work Best

No single treatment corrects all scar types. The best results usually come from thoughtful combinations, scheduled over months, to address different elements: releasing tethers, stimulating collagen, refining the surface, and managing colour changes. We prioritise safety, especially in deeper skin tones where post-treatment pigmentation must be minimised with careful preparation and aftercare.

Treatment Options

Subcision (for rolling/tethered scars)

A fine instrument is used to release fibrous bands pulling the surface down. Once the tether is released, the overlying skin lifts and shadowing decreases. Subcision is often paired with other methods such as microneedling or energy-based devices to stimulate further remodelling. Bruising and mild swelling are expected for several days.

TCA CROSS (for ice-pick and select boxcar scars)

TCA CROSS (Chemical Reconstruction Of Skin Scars) uses a focussed application of trichloroacetic acid into narrow scars to trigger a controlled collagen response from the base upwards. Several sessions, spaced weeks apart, gradually reduce depth and soften edges.

Microneedling and RF Microneedling

Microneedling makes precise micro-channels that stimulate collagen production; radiofrequency (RF) microneedling adds heat at depth to enhance tightening and remodelling. These are versatile for rolling and shallow boxcar scars with predictable downtime and are often part of combination plans in a series of sessions.

Fractional Laser Resurfacing

Fractional ablative or non-ablative lasers target microscopic columns of skin, encouraging controlled renewal. Parameters are chosen to match scar type, skin tone and downtime preference. Lasers can significantly refine texture and are frequently timed after subcision or TCA CROSS once the foundation work is done.

Chemical Peels

Superficial to medium-depth peels can smooth fine irregularities, brighten dullness and support treatment of marks. They are typically used as part of a layered plan rather than the sole treatment for deep scars. In deeper skin tones, we choose pigment-safe acids and pace sessions to minimise the risk of post-inflammatory hyperpigmentation.

Dermal Fillers (select atrophic scars)

For certain depressed scars, small amounts of filler can lift the surface, particularly after subcision. Choice of product and technique is conservative and tailored. Effects are immediate, and subsequent collagen stimulation may extend benefits.

Steroid Injections & Silicone Therapy (raised scars)

Hypertrophic and keloid scars respond to intralesional corticosteroid injections, sometimes combined with other agents. Silicone gels or sheets help flatten and soften scars over time and can reduce itch. Sessions are spaced to monitor response and minimise thinning of surrounding skin.

Care for Redness and Dark Marks

Redness settles naturally but can be supported with vascular-targeting strategies when appropriate. Dark marks fade with diligent sun protection and pigment-safe skincare such as azelaic acid; timelines vary by skin tone and the depth of inflammation.

Skin of Colour & Sensitive Skin Considerations

In Fitzpatrick IV–VI skin tones, the priority is effective remodelling while protecting against post-inflammatory hyperpigmentation. We introduce pre-treatment skincare that strengthens the barrier, choose energy settings and acids conservatively, and extend intervals between sessions if needed. Sensitive skin benefits from simplified routines and slower titration of actives to maintain comfort.

How Many Sessions Will I Need?

Expect a programme rather than a single procedure. As a guide, many patients complete a series of 3–6 sessions over 4–8 months, often mixing methods (for example, subcision plus RF-microneedling, then fractional laser refinement). Improvements accumulate: early changes reduce obvious tethering and shadowing; later stages smooth the surface and even the tone. We define milestones at the outset so you know what to expect.

Downtime, Comfort & Safety

Most treatments involve short, planned downtime. Redness and mild swelling are common for 24–72 hours; pinpoint crusting or bronzing can occur after lasers or deeper peels. We provide clear aftercare to protect the barrier and reduce the chance of pigmentation changes. Numbing methods are used to keep you comfortable. If you are prone to cold sores, antiviral prophylaxis is arranged for treatments around the lips.

At-Home Support & Prevention

• Sun protection: broad-spectrum SPF daily to prevent darkening of marks and support even remodelling.
• Barrier support: gentle cleanser and moisturiser; avoid harsh scrubs or devices that could trigger irritation.
• Active acne control: ongoing management reduces the risk of new scars; let us know if breakouts return.
• Hands-off habits: avoid squeezing or picking; hydrocolloid patches can protect healing areas on the body when appropriate.
• Healthy routines: adequate sleep, stress management and consistent skincare help results last.

Realistic Results

While no treatment “erases” scars, modern combinations can deliver meaningful, visible improvements in smoothness, light reflection and confidence. Photographs in consistent lighting often show progress more clearly than the mirror. We will be transparent about expected changes for each scar type and build a plan that fits your calendar and comfort level.

Why Choose Skinhorizon?

Our consultant-led approach focuses on precision diagnosis and staged, evidence-based combinations tailored to your skin type. Safety and predictability come first: we pace treatments to your downtime and adjust for sensitive or higher-melanin skin. You’ll receive clear written guidance and a direct route to advice between sessions.

Your First Visit — What to Expect

1. Assessment: map scar types, depth and tethering under angled light; check for ongoing acne activity.
2. Plan: agree a staged combination (e.g., subcision → microneedling/RF → fractional laser; or TCA CROSS for ice-pick scars).
3. Preparation: barrier-friendly skincare and sun protection to reduce risks and improve healing.
4. Treatment day: comfort measures, procedure, and concise aftercare with what to expect day-by-day.
5. Review: photographically track progress and fine-tune the sequence for best outcomes.