Acne scarring treatment

Identifying what you actually have

Much of what patients call scarring is post-inflammatory erythema or hyperpigmentation — flat red or brown marks that will fade with time, sun protection and pigment-directed treatment. These are not scars, and treating them with aggressive resurfacing is unnecessary.

True atrophic scars are losses of tissue and fall into recognised patterns. Ice pick scars are narrow and deep. Boxcar scars have sharp vertical edges. Rolling scars are broad, shallow depressions tethered from below. Each responds best to a different approach, and most people have a mixture.

Hypertrophic and keloid scarring, more common on the chest, shoulders and back, requires a different strategy again.

Matching treatment to scar type

Rolling scars often respond to subcision, which releases the tethering bands beneath. Boxcar scars respond to fractional resurfacing that remodels the edges. Ice pick scars frequently need focal treatment such as TCA CROSS rather than general resurfacing. Broad volume loss may benefit from collagen-stimulating injectables.

A realistic plan usually combines modalities in sequence over months. Anyone offering a single treatment for all scarring has not assessed the scars.

Active acne comes first

Resurfacing skin that is still producing new inflammatory lesions creates fresh scars while treating old ones. Active acne is brought under control before scar treatment begins. This ordering is not negotiable, and it is the reason some patients are asked to wait.

Expectations

Meaningful improvement is achievable. Complete erasure is not. A realistic target is a substantial reduction in scar visibility — skin that reads as normal in ordinary light rather than skin that has never scarred. Improvement is gradual, continuing for months after treatment as collagen remodels.

Risks and limitations

No treatment is without risk, and you are entitled to the full picture before you decide rather than a summary afterwards. These are discussed with you individually at consultation, in the context of your own history.

• Redness, swelling and peeling after resurfacing, lasting days to weeks
• Post-inflammatory hyperpigmentation, particularly in deeper skin tones
• Infection, including reactivation of cold sores
• Worsening of scarring, uncommon but possible
• Incomplete improvement requiring further sessions
• Prolonged redness after fractional treatments

Where you would be seen

Consultations and minor skin surgery take place at CLNQ Manchester on the ground floor of the South Tower at Deansgate Square, and at CLNQ Knutsford on King Street in Cheshire. Patients travel from across Greater Manchester and Cheshire — Altrincham, Hale, Bowdon, Wilmslow, Alderley Edge and Didsbury are all within easy reach of one or other site.

Where a lesion needs a theatre rather than a treatment room, the procedure is arranged at Deansgate Hospital, a CQC-registered private hospital a few minutes away in Manchester city centre. Any specimen requiring histology goes to a UK histopathology laboratory and the result is discussed with you directly.

• CLNQ Manchester — Deansgate Square 11 Owen Street, Manchester M15 4YB Ground floor of the South Tower at Deansgate Square, Manchester city centre.
• CLNQ Knutsford — Cheshire 49-51 King Street, Knutsford WA16 6DX King Street, Knutsford, serving Cheshire and the surrounding area.
• Deansgate Hospital Madison House, 37 Little Peter Street, Manchester M15 4QJ CQC-registered private hospital in Manchester city centre, for procedures needing a theatre.

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