Few people are left with acne scarring as teenage pimples clear. But for some people who have acne cysts and nodules, not everything clears when the acne does.

Roughly one in every five people who get acne, will develop scars, according to the Cleveland Clinic. This can range from moderate to severe scarring, and there is no predicting who will be affected by this. 

Acne scars occur when acne blemishes become inflamed and cause a breakdown of the walls of the pore. The greater and deeper the ‘overspill’ into the surrounding tissue, the greater the possibility of permanent scarring. Scarring occurs when the skin forms collagen fibres at the site of a wound or an inflamed pore in an effort to repair the damage. Pimple popping can increase the risk of this happening.

There are two types of acne scarring: the first when there is a loss of tissue, and the second when there is an excess of tissue. Ice pick scars are deep and look as if they were caused by a sharp instrument. Box car scars are wider than ice pick scars and have vertical sides. Rolling scars give the skin a wavy look, and hypertrophic scars stand out above the skin’s surface. 

Before any treatment can be considered for acne scarring, it is essential that the acne is cleared up – otherwise new scars will simply replace the ones that have been treated or reduced. These treatments can include over-the-counter creams and treatments that unclog pores and dry out the skin. Benzoyl Peroxide has been shown to unclog pores with minimum side effects. Some lotions, such as jojoba oil, might have anti-inflammatory properties. Hormonal treatments can also work, but you will need a prescription for those.

There are several treatments for reducing scarring caused by acne, which range from home treatments to surgery. Speak to a dermatologist before you make any decisions about which one is best for you. There is no one treatment that will be best for everyone – it depends on what you can afford, and the severity of the scarring that you are treating. Here’s a quick rundown on your options.

• Home treatments consist of using medicated creams (which often contain azelaic acid or hydroxyl acid) to help limit the contrast between a scar and the unscarred skin. 
• Soft tissue fillers. Collagen or fat is injected under the skin to make the indentations of the scars less visible. Repeat treatments are needed, though. Steroid injections can also make a difference.
• Laser treatment focuses light on the damaged skin, breaking up the scar tissue. This encourages new skin cells to grow. This has largely replaced dermabrasion, where the top layer of skin is removed, making acne scars less noticeable.
• A chemical peel uses a chemical solution to remove the top layer of skin, and improve the skin’s appearance. Glycolic acid (AHA) is one type of solution used for this procedure.
• Skin needling makes use of a device which is rolled over the skin to stimulate the formation of collagen.
• Surgery can be used to cut out individual scars and repairing the wound either by using stitches or by making use of a skin graft.
• Botox treatments can relax the area of skin around the scar. These results are not permanent.

(Sources: Cleveland Clinic, Mayoclinic, American Academy of Dermatology)