Acne scars can affect how you see yourself and how comfortable you feel day to day. At South Yarra Dermatology, we understand the impact scarring has beyond the physical marks. We use evidence-based treatments tailored to your specific scar type and skin, working toward meaningful improvement that helps you feel more confident and at ease in your own skin.
Before we discuss treatments, we take time to see the complete picture. We examine your skin as it is today: the types of scars present, whether acne remains active, and which areas concern you most. This helps us create a plan that addresses not just the visible marks, but the outcomes you want to achieve.
When you understand your scar type and what results are possible, the process feels clearer and more manageable. You know what to expect, what each step accomplishes, and how your skin can improve over time.
Before we discuss treatments, we take time to see the complete picture. We examine your skin as it is today: the types of scars present, whether acne remains active, and which areas concern you most. This helps us create a plan that addresses not just the visible marks, but the outcomes you want to achieve.
When you understand your scar type and what results are possible, the process feels clearer and more manageable. You know what to expect, what each step accomplishes, and how your skin can improve over time.
Every scar tells a different story, and so does every approach to treating it. Before recommending treatments, we take time to understand your scarring: what type you have, how long it’s been present, and how it affects your daily life. We assess scar depth, texture, and your skin’s characteristics to create a treatment plan tailored to your specific needs and goals.
Best for: Rolling scars, boxcar scars with tethering, moderate to deep depressions
Downtime: Initial swelling and bruising resolve within 7-10 days; gradual improvement continues for 4-8 weeks
Subcision releases the fibrous bands that tether depressed scars to deeper tissue, allowing the skin to lift toward its natural contour. Using a fine needle, we gently break these attachments beneath the surface, prompting collagen production to fill the space. Results develop gradually as your skin rebuilds structure, with visible improvement emerging around three months.
Best for: Ice-pick scars, deep boxcar scars with defined borders, localised deep depressions
Down time: Scabs form within 24-48 hours and shed over 5-7 days; pink healing skin fades over 2-4 weeks
TCA Cross targets deep, narrow scars by applying high-strength trichloroacetic acid directly into each depression. This controlled injury triggers collagen formation exactly where it’s needed most. Scabs form within days and heal over one to two weeks, with fading redness over several weeks.
Best for: Rolling scars, broad shallow depressions, atrophic scars with volume loss, specific boxcar scars
Down time: Immediate visible improvement; minor swelling and possible bruising resolve within 3-7 days; results last 6-18 months
Dermal fillers instantly smooth shallow or rolling scars by lifting depressions from beneath the skin. Minor swelling or bruising may occur for a few days, but results are visible immediately and last 6 to 18 months. Periodic touch-ups can maintain improvements and complement long-term resurfacing treatments such as laser therapy.
Best for: Broad areas of textural scarring, shallow boxcar scars, rolling scars, post-inflammatory pigment changes
Down time: Ablative lasers: 7-14 days, significant redness/crusting; Non-ablative lasers: 2-5 days, mild redness
Laser therapy refines uneven skin texture and softens scars by stimulating collagen remodelling through controlled thermal energy. Ablative lasers resurface the skin for substantial renewal, while non-ablative options remodel deeper layers with minimal downtime.
Your first consultation focuses on understanding your history: when your acne started, which treatments you have tried, what your current routine includes, and how your scars affect your daily life. Using specialised lighting, we study your skin closely to identify the types and depth of scars present. Most patients have a combination of scar types, each requiring a different approach.
From there, we create a treatment plan that is realistic, personalised, and aligned with your goals. We explain your options, clarify what to expect, and ensure every step fits comfortably into your life. Our goal is not just smoother skin, but a renewed sense of confidence in how you see yourself.
Treatment requirements vary considerably based on scar severity, type, and your improvement goals. Mild rolling scars might show meaningful improvement after 2–3 laser sessions, while severe mixed scarring with deep ice-pick and boxcar scars could require 6–8 sessions combining multiple modalities over 12–18 months.
During your consultation, we’ll provide realistic estimates specific to your situation, but understand that scar treatment rarely follows perfectly predictable timelines. Your skin’s response influences our ongoing treatment decisions. Some patients see significant improvement early and choose to stop, while others commit to extended protocols to achieve maximum possible results. We adjust recommendations based on progress, your satisfaction level, and diminishing returns as you approach your skin’s limits for improvement.
Scar depth, shape, and underlying tissue damage determine treatment responsiveness. Shallow rolling scars with intact dermal tissue respond well to laser resurfacing because there’s an adequate structural foundation to remodel. Deep ice-pick scars that tunnel through multiple skin layers resist most treatments because the architectural damage is severe. Even aggressive approaches might reduce depth but can’t fully restore normal skin structure. Severely tethered scars anchored to underlying tissue won’t improve with surface treatments until subcision releases those attachments.
Your genetic healing capacity also plays a role. Some people produce collagen robustly in response to controlled injury, while others generate more modest responses despite identical treatments. We can’t predict your exact results, but our assessment of your specific scar characteristics helps us forecast which areas will improve most versus which will require managing expectations.
Appropriately selected and skillfully performed treatments should never worsen your scarring, though temporary worsening during healing phases is completely normal and expected. After ablative laser treatment, your skin looks significantly worse for 7–10 days before revealing improvement. TCA cross creates an intentional injury that appears concerning initially but heals with reduced scar depth.
The key distinction is temporary treatment effects versus actual complications like new scarring, permanent pigmentation changes, or worsened texture. These complications are rare with experienced providers but can occur with overly aggressive settings, inappropriate treatment selection for your skin type, or poor technique. This is precisely why choosing an experienced dermatologist specialising in scar treatment matters. We’ve refined our approaches over thousands of treatments, understand the margins between effective and excessive, and know how to adjust protocols for safety while maintaining efficacy.
Darker skin can absolutely be treated, but requires specialised expertise, careful treatment selection, and appropriate protocols that differ from approaches used on fair skin. The primary risk involves post-inflammatory hyperpigmentation or hypopigmentation, where treated areas darken or lighten compared to surrounding skin.
We mitigate these risks through multiple strategies: selecting laser wavelengths and settings recommended for darker skin tones, using conservative energy levels initially and advancing carefully based on your response, extending intervals between treatments to allow complete healing, implementing rigorous pre-treatment and post-treatment skincare protocols, and avoiding treatments during high sun exposure seasons.
Non-ablative fractional lasers generally offer better safety profiles than aggressive ablative options for darker skin. TCA cross, when performed carefully at appropriate concentrations, works well across all skin tones. Our extensive experience treating a diverse population means we’ve successfully managed acne scarring in patients across all backgrounds and ethnicities.
Active acne and acne scarring require coordinated management, with the general principle being that ongoing inflammation should be controlled before pursuing aggressive scar treatments. Continuing breakouts in areas you’re trying to resurface or remodel create new damage that undermines your progress. However, this doesn’t mean your acne must be perfectly clear before beginning scar treatment. Mild, occasional breakouts don’t preclude starting protocols.
We typically implement a two-pronged approach: establishing effective acne control through appropriate prescription medications or skincare adjustments while simultaneously beginning appropriate scar treatments once inflammation is adequately managed. For patients with severe, ongoing cystic acne, we might recommend delaying scar treatment until better control is achieved. After isotretinoin, we wait 6–12 months before performing certain procedures to ensure your skin has regained normal healing capacity.
During your consultation, we’ll assess your current acne status and recommend the optimal timing and sequencing for addressing both concerns effectively.
Acne scar treatment costs vary based on the specific procedures required, treatment area size, and number of sessions needed. During consultation, we provide detailed cost estimates specific to your recommended treatment plan.
Unfortunately, acne scar treatment is almost universally considered cosmetic rather than medically necessary, meaning insurance doesn’t cover costs. We understand cost creates real barriers for many patients. We’re happy to discuss phased treatment approaches where we prioritise the most impactful interventions first, allowing you to spread costs over time while still making meaningful progress. Some patients choose to address smaller areas initially, evaluate results and budget impact, then expand treatment to additional areas subsequently.
Between-treatment skincare significantly influences results. Sun protection is absolutely critical. UV exposure increases pigmentation risks, degrades collagen you’re working to build, and impairs healing. Daily broad-spectrum SPF 50+ applied generously is essential. Gentle cleansing and moisturising support healing without irritation. Avoid harsh scrubs, strong acids, or aggressive products during recovery periods.
We often prescribe specific products to enhance healing and stimulate collagen production, such as tretinoin, vitamin C serums, or prescription pigment-stabilising agents. Following these recommendations consistently matters considerably. Staying hydrated, eating nutrient-rich foods, avoiding smoking, and getting adequate sleep all support optimal healing. Avoid picking at scabs or healing skin, even though the temptation can be intense.
We provide detailed written protocols after each treatment session. Don’t hesitate to contact us if you’re uncertain about any aspect of aftercare. Proper post-treatment care often makes the difference between excellent and modest results.
Treated scars don’t “come back” because we’ve structurally remodelled the tissue. The collagen we’ve stimulated, the tethering we’ve released, or the volume we’ve added creates lasting changes to your skin architecture.
However, several scenarios might create the impression of recurring scarring. Natural ageing causes volume loss and collagen degradation over the years, which can make remaining mild irregularities more noticeable with time. New acne breakouts can create new scars if acne control isn’t maintained. Temporary filler results do fade over 6–18 months as the hyaluronic acid naturally metabolises. Some improvement from certain treatments relies on ongoing collagen remodelling that peaks several months post-treatment but may partially regress over subsequent years.
Maintaining results long-term involves continued acne prevention, appropriate skincare supporting collagen health and sun protection, and occasional maintenance treatments to sustain improvements. You’re not frozen at your immediate post-treatment result forever, but the improvements you’ve achieved do persist even as natural ageing continues.
Most structural improvements from subcision, TCA cross, and laser therapy persist long-term because these treatments fundamentally alter scar architecture through collagen remodelling and tissue restructuring. The new collagen you’ve built and the tethering you’ve released create lasting changes. However, “permanent” doesn’t mean “frozen in time”.
Natural ageing continues affecting all skin. Over 5–10 years, you’ll notice gradual changes as volume naturally decreases and skin elasticity declines. These processes might make remaining mild irregularities slightly more apparent, though you’ll still maintain substantial improvement over your pre-treatment baseline.
Dermal filler results for scars are explicitly temporary, lasting 6–18 months depending on the specific product and your individual metabolism. Many patients maintain filler results through periodic touch-up sessions every 8–12 months. Maintenance considerations also include preventing new scarring through ongoing acne management. All the scar treatment in the world won’t help if you’re continuously creating new damage through uncontrolled breakouts.
Pain tolerance varies considerably between individuals, making it difficult to predict your exact experience, but we can discuss typical sensations and our comfort measures. Subcision involves local anaesthetic injection followed by deep pressure and tugging sensations. Most patients tolerate this well. TCA cross creates intense burning for 5–10 seconds per scar during application. It’s unpleasant but very brief. Dermal filler injection involves multiple small needle sticks with pressure sensations. This is generally well-tolerated, especially with contemporary fillers containing lidocaine. Laser treatments range from tolerable prickling with non-ablative devices to significant heat and pain with ablative lasers despite topical anaesthetic.
We employ multiple pain management strategies, including prescription numbing cream, cooling devices during treatment, and occasionally nerve blocks for extensive treatments. Most patients find the discomfort manageable and worth the results. If you have concerns about pain, discuss these during consultation. We’d rather adjust protocols or provide stronger pain management than have you avoid necessary procedures due to fear.
Post-inflammatory pigmentation appears as flat, darker areas where acne has healed. These typically fade gradually with appropriate care and sun protection. True scarring involves textural changes to the skin and may require specialised treatments to improve. Early, effective treatment helps prevent both concerns.
