Acne Scarring : Textural Marks, Pitting and Post-Acne Changes

By Dr Amber Halliday, MRCGP MBBS BSc (Hons) | GP & Aesthetic Practitioner | Blue Bird Aesthetics, Worthing | Last reviewed: July 2026

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Who Is This For?

✓ Acne is controlled and you have textural marks or pitting remaining
✓ Rolling scars, boxcar scars or uneven skin surface from previous acne
✓ Post-inflammatory marks that have not faded after 6 or more months

✗ Active inflamed acne — this must be controlled first
✗ Expecting complete scar elimination — meaningful improvement is realistic, elimination is not
✗ Currently on isotretinoin or used it within the last 6 months

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In Short

Active acne must be controlled before scar treatment begins — these are two separate phases.
Microneedling is the primary treatment for atrophic (depressed) scarring with solid clinical evidence.
A course of 4-6 sessions is typical; results continue improving for months after the course ends.
Complete elimination of significant scarring is not realistic — meaningful improvement is.

Scar Types and How They Respond

Rolling scars — broad, shallow, gently sloping. Best response to microneedling.
Boxcar scars — wider, sharper-edged depressions. Good response to microneedling; deeper types may benefit from NeoGen.
Ice-pick scars — narrow, deep, V-shaped. Most challenging; respond less well to microneedling alone.
Post-inflammatory hyperpigmentation (PIH) — flat dark marks, not structural scarring. Responds well to peels and brightening skincare.

Treatments That Help

The Active Acne Rule

Microneedling cannot be performed over active inflamed acne. As a GP, Dr Halliday can assist with medical management of active acne as part of the consultation process before scar treatment begins.

Your Treatment Pathway

Confirm acne is controlled→Scar type assessment at consultation→Skincare foundation established→Microneedling course 4-6 sessions→Review at 6 months→NeoGen if further improvement desired

Frequently Asked Questions

Will my acne scars ever fully disappear?

With a dedicated treatment course, meaningful improvement is achievable for most patients. Complete elimination of significant structural scarring is not realistic from non-surgical treatment. Noticeably smoother skin and significantly less visible scars is the realistic goal.

Can I have microneedling while I still have active acne?

No. Microneedling is contraindicated over active inflamed acne — it can spread bacteria and worsen inflammation. Active acne must be controlled first.

How many sessions are needed?

For acne scarring: four to six sessions spaced 4-6 weeks apart. This is more than the three-session course for general skin quality because structural scar remodelling requires more repeated healing cycles.

Are all acne scars the same?

No. Type matters significantly. Rolling and boxcar scars respond better to microneedling than ice-pick scars. A clinical assessment at consultation determines which types you have and the most appropriate approach.

Can chemical peels help with acne scarring?

For post-inflammatory hyperpigmentation (flat dark marks), yes. For structural textural scarring (rolling, boxcar), peels help overall skin quality but microneedling or NeoGen is more targeted.

Acne Scarring : Textural Marks, Pitting and Post-Acne Changes

By Dr Amber Halliday, MRCGP MBBS BSc (Hons) | GP & Aesthetic Practitioner | Blue Bird Aesthetics, Worthing | Last reviewed: July 2026

Scar Types and How They Respond

Treatments That Help

The Active Acne Rule

Your Treatment Pathway

Frequently Asked Questions

Related Concerns

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Further Reading – Dr Halliday’s Clinical Guides

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