The four things people call acne scarring
Much of what is described as scarring is actually post-inflammatory hyperpigmentation — flat brown or red marks left after a breakout. These are not scars, and they behave completely differently from textural damage.
- Flat marks — pigment or redness with no change in skin surface
- Rolling scars — broad, shallow undulations that show in raking light
- Boxcar scars — wider depressions with defined edges
- Icepick scars — narrow, deep tracks that respond least to surface treatments
Most people have a mixture. That is why a plan built around one treatment rarely addresses everything, and why assessment comes before any recommendation.
How scarring is assessed
Assessment happens under directional lighting, because flat lighting hides texture. Your nurse looks at scar type and distribution, whether acne is still active, how your skin responds to inflammation, and how it has behaved after previous treatments.
Resurfacing skin that is still breaking out tends to produce more scarring, not less. Where acne is active, the first conversation is about getting it settled — often with your GP or a dermatologist — before textural work begins.
What may be discussed
Depending on what the assessment finds, the conversation may cover microneedling for texture and collagen support, professional exfoliation for surface tone and pigment, or light-based therapy where redness is the main feature. Some scarring is best referred on, and you will be told if that is the case.
Every option is explained with its limitations, risks and expected number of sessions before you decide anything. Nothing is booked on the day of the assessment unless you want it to be.
Realistic timeframes
Textural change works through collagen remodelling, which takes months rather than weeks. A typical plan runs across a season or more, with review points where progress is compared against photographs taken at baseline.
Sun protection is not optional in this plan. Queensland UV drives pigmentation, and a course of treatment without daily SPF 50+ will underperform — see the skin health and sun protection guide.