The truth about acne scarring Part 1: Reducing and preventing

Here are a few important things I tell all my patients who have acne and are worried about acne scarring.

Nearly every patient I see with acne is anxious about the potential of acne scarring. It’s a real psychological burden. And for many people the thought of permanent scarring is harder to deal with than the acne itself.

I completely understand where they’re coming from. I suffered from terrible acne as a teenager and the challenge I faced in getting it treated – and the impact that had on me – is one of the reasons I decided to become a dermatologist. This has made me passionate about getting the facts straight on acne, acne scarring, and the treatment options available so my patients don’t have to worry.

Here’s what you need to know. 

  1. The first step is to treat the acne – not the scarring

Most of my acne patients ask me to start treating scarring immediately because they feel so distressed about it. This is completely understandable, but it isn’t the best approach. We have to remember that acne is a medical condition – not a cosmetic one – and so our first priority is to get the acne itself medically treated. This will reduce – or even eradicate – the chances of long term scarring and prevent any further damage to the skin. If we try to treat the symptoms and side effects of acne first, rather than the cause, it’s like fighting a losing battle.

  1. What looks like scarring might not be scarring at all

Something else to be aware of is what patients often think is acne scarring isn’t scarring at all and won’t be permanent. This is because acne is an inflammatory skin condition. The inflammation can cause pigmentation and textural changes to the skin that may look like scarring but is actually not permanent. A lot of it will heal by itself. This is another reason why we need to focus on treating the acne first: so we can see how the skin heals naturally before making an assessment about any residual scarring that may need treatment

  1. Time can be a healer. Yes… really

It may not be what most people want to hear, but it’s true: once the acne is being treated, time really can be a healer. Skin does an amazing job of healing all by itself over time. Even the darker or red marks that can appear on the skin will go away by themselves as the acne starts to heal. The best approach is to leave the skin to settle down before assessing any potential scarring. Patience is required here and it can take anything between 3-9 months before we start getting a clear picture of what residual scarring might be present. Then we can decide on the right treatment plan for your individual needs.

  1. Always try to focus on prevention

The earlier you can treat the acne, the better the long-term outcome. In fact, most people who receive early treatment for acne don’t have scarring. If they do it’s often so minor that they aren’t particularly bothered by it. If and when more significant scarring does happen, don’t worry. There are many great options in place to treat it. While there is no single miracle cure, the vast majority of patients feel very happy with the results we get from the available treatments. 
Read my next post, The truth about acne scarring Part 2, for more information about treatment options for acne scarring.