A dermatologist tells us how to fix those annoying scars and bumps caused by acne.

Acne scarring SUCKS. Like, massively. You fight for clear skin for what feels like your entire life, and just when you think your acne has buggered off for good you're awarded some kind of cruel trophy to remind you of all the heartache - acne scarring. What fun! 

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Obviously the best way to prevent acne scarring in the first place is by just not having any acne or pimples, but - yeah - it's not like we make the choice whether to have unblemished skin. It's nothing really to do with how you're looking after your skin, either - it's just a shit thing that can happen. 

And like acne itself, it really knocks your confidence around. 

There are ways to prevent and treat pimple scars, though. We spoke to dermatologist Dr Cara McDonald from Complete Skin Specialists Dermatology and asked her for all of the best ways to deal with these annoying marks.

What is acne scarring? 

Before getting into specific treatment options, it's probably worth trying to understand what acne scarring is. Because apparently those red-purplish marks left behind are really just hyperpigmentation - which is separate from acne scarring. 

Those marks don't exactly change the actual texture of the skin - so that's kind of in a category of its own.

According to McDonald, "Acne scars are permanent textural or colour changes and indentations that occur on the skin as a result of acne. This should be differentiated from the temporary red and brown marks seen earlier after acne, known as post-inflammatory hyperpigmentation, as these marks will almost always improve over time." 

Good to know.

I have acne. Does that mean I'll probably get acne scarring?

Not necessarily. But there are a few things that might increase your chances of experiencing it. 

Some people are more likely to experience acne scarring if they have inflammatory acne (the painful red bumps under your skin that make you feel like you're growing a twin on your face) and do not treat it (the longer you have it, the more likely you are to develop scars). 

You're also more likely to experience scarring if you tend to pick, squeeze or pop your pimples on the reg. If you have other family members who developed acne scars, this will also up your chances of experiencing scarring. Genes play a big role in this (thanks, mum and dad).

Why is this happening to me? What's causing it?

So, why do we develop these marks in the first place? 

"The basic process in acne is due to a blockage within the pore (mostly composed of skin cells and oil) followed by infection and inflammation around that pore," said McDonald. 

Basically, the scar is a pore that has stretched and not returned to its original size.

"In some cases, large deep cysts are formed. The inflammation damages the surrounding layer of skin, the dermis, which heals with abnormal collagen and tethering in the skin leading to indentations and depressions," said McDonald. 

"There can also be damage to the melanocytes (pigment cells) causing colour change." 

The type of scar will depend on how much collagen your body makes - for example, depressed acne scars mean your body is producing too little collagen, whereas raised scars means your body is producing too much collagen as it tries to heal the skin (but kinda just effs things up in the process). 

"Some areas can 'over-heal' leaving raised hypertrophic or keloid scars," she adds.

What kind of skincare will help clear it up?

According to McDonald, unfortunately most acne scars will not improve with skincare alone. 

"Scarring will only improve with methods using safe, controlled breakdown of the old scars and subsequent regeneration of new skin." 

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"Skincare during the acne period is vital to reduce the risk of forming scars. The more inflammation in the skin, the worse the scarring tends to be, therefore controlling acne early and effectively is best for scar prevention."  

Okay. What kind of ingredients will help clear and prevent more scarring?

McDonald said exfoliating ingredients are key. But we're not talking about physical exfoliation (put that exfoliating mitt down, girl), we're talking acids.

"Ingredients such as retinols and salicylic acid help to prevent blockages in the pores and niacinamide (vitamin B3) will reduce inflammation."  

Most importantly, no touchy-touchy! "Avoid squeezing, picking, excessive cleansing and harsh products on acne-prone skin, as these all increase inflammation and the risk of scaring."

What about in-clinic treatments? Any worth trying?

There are a whole heap of effective in-clinic options that can help heal and clear up scarring, but the right treatment all depends on the individual's skin type and the severity of the scars. 

"There are many permeations and combinations that should be tailored specifically to each case," said McDonald.

So, what are some of the best options to check out? 

"For depressed scars, physical treatments to break up the abnormal collagen and/or stimulate new collagen formation are most effective. Energy-based devices (such as radiofrequency needling and resurfacing lasers) are the most common treatments used." 

However, McDonald said often these kinds of treatments need to be used in combination with surgical procedures such as 'subcision' (acne scar surgery), dermal fillers to lift the scars and acid-based deep peels.

Basically, the best way to do it is to chat to a skin expert before you jump in and get random laser treatments willy-nilly. They'll be able to assess your skin, the severity of your scars and tell you what kind of treatment combo will work best.

"Unfortunately, many people are 'sold' skincare, superficial peels and micro-needling for acne scarring, but these have limited effect on deep scars." 

Sigh. 

Just keep in mind that if it sounds too good to be true, it probably is. There's no secret ingredient or miracle gadget that makes scars totally disappear, so don't expect miracles.

Do those at-home light treatments actually work?

Those at-home light therapy masks and handheld devices are bloody *everywhere* right now, and a lot of them promise to reduce the appearance of acne scarring. But are they actually worth splashing out on? Or are they a total gimmick?

"LED light has a proven ability to decrease inflammation and stimulate collagen production in the skin," said McDonald. "Unfortunately, this won’t be great enough to see an improvement in most acne scars." 

Boo! 

In saying this, McDonald said these light therapy treatments are good for preventing the formation of acne scars, so DO hit them up if you're experiencing acne. 

"It is however useful to reduce the inflammation during active acne, which will decrease the risk of developing scars down the track. LED light can also help settle the post-inflammatory hyperpigmentation and changes seen after early acne to improve the appearance of the skin."

How long does it take to get rid of acne scarring?

Bad news: This isn't a quick-fix kinda thing. Your acne and pimple scars won't clear up overnight - it will take time and a combination of treatments before you see them fade. 

"Acne scarring is one of the most difficult conditions we treat," said McDonald. "Scarring has a tremendous impact on confidence, self-esteem and social functioning and is generally expensive and time-consuming to treat effectively."

Don't get discouraged, though. For the best results, it's all about getting on that preventative train, and focusing on halting the formation of acne scars. 

"The most important thing is to manage active inflammatory acne early and proactively," she said. "Our treatment options for acne are extensive and effective, so my advice is: treat early and prevent scarring whenever possible."

Feature: Getty

Do you have acne scarring? What's your experience with different skin treatments? Share your thoughts with us in the comment section below.