Acne Scarring

A large number of people suffered from acne in their youth and unfortuatnely this may have resulted in permanent scarring. Many people are self conscious about this scarring. Dr Bernard Leung at Facial Artistry has a number of ways to improve the appearance of acne and facial scarring.

Acne scars can be classified into several types:

  • Ice pick scars – these are pitted scars
  • Box car scars – pitted scars with steep sides a flat bottom
  • Rolling scars – the contour is rolling and uneven
  • Hypertrophic or keloid scars – these are thick lumpy scars
  • Atrophic scars – these are flat, thin or depressed scars

This may be complicated by discolouration or pigmentary changes:

  • Post inflammatory erythema – pink or purple flat patches
  • Hypopigmentation – pale or white marks
  • Post inflammatory hyperpigmentation – brown patches, typically seen in people who tans easily or who have darker skin


A number of techniques can be used to treat facial scarring and each technique may be more suited to a particular type of scarring.

Ice pick and Box car scars

These deeper scars are best treated by surgical techniques, such as excision, subcision and punch grafting. They usually co-exist with other types of scarring and therefore additional treatment is usually necessary. Trichloracetic acid (TCA) CROSS technique is particularly effective for ice pick scars, as shown in a study published in the Dermatological Surgery journal in 2010

Rolling scars

The same study published in the Dermatological Surgery journal also showed that collagen induction therapy is the most effective treatment in managing this type of scarring. It is more effective than some of the most marketed non-ablative laser treatment such as Fraxel. At Facial Artistry, Dr Leung uses several collagen induction therapy techniques, often in conjunction with ablative fractional resurfacing (Pearl Fractional) to achieve the optimal result for this type of scarring.

Hypertrophic or keloid scars

These scars are difficult to manage as aggressive treatment such as Fraxel type laser can worsen them. They can be treated with either topical corticosteroid or direct injection (intralesional injection) of corticosteroid into the scars, combined with silicone gel type dressing. Cryotherapy (cold treatment with liquid nitrogen) can also be effective. However, this particular type of scarring is prone to recurrence, even after apparently successful treatment.

Atrophic scars

Excellent results with this kind of scarring can be achieved with dermal filler.

Laser Genesis is an excellent additional treatment for all these type of scarring, as it has a beneficial effect on collagen remodelling. At Facial Artistry, we recognise that each type of acne scar does not occur in isolation. We specialise in assessing the precise nature of your scarring, formulating a treatment plan using a combination of treatments that will most effectively target the type of scarring that you have.

To request an appointment with Dr Bernard Leung please email us or call us on 02 6255 8988.