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    Acne & spots

    Scarring

    Severe acne can leave scars, which will fade with time. Various treatments are available, but none is completely satisfactory.

    Laser. If the scars are extensive but not too deep, and the acne has burnt out, laser treatment is a possibility. In the UK, it is difficult (but not impossible) to obtain laser treatment under the National Health Service, but it is available from private clinics. It is claimed to be particularly effective for flat, ‘tissue-paper’ scars and for pitted ‘ice-pick’ scars, but not as good for thick, lumpy scars. However, there is little evidence that it is really effective (British Journal of Dermatology 2000;142:413–23), and it is costly in private clinics. If you are considering it, discuss it with your doctor first.

    Collagen injections. Some specialist clinics use collagen injections to plump out flat ‘tissue-paper’ scars and pitted ‘ice-pick’ scars.

    Liquid nitrogen/steroid injection. Lumpy cysts can sometimes be treated by freezing with liquid nitrogen or injecting with triamcinolone steroid. These are not treatments for scars.

    Dermabrasion, ‘planing down’ of the skin using a high-speed wire brush, used to be a common method of dealing with acne scars. It is no longer used very often because of the risk of infection.

    Silicone sheets. You can buy silicone sheets (‘silicone skin’) from pharmacies. You may have to ask your pharmacist to order them. You apply the sheet to your skin like a face mask. It is claimed that this can help lumpy scars, but its effectiveness is questionable.

    Surgery. Scars which are deep and disfiguring can sometimes be cut out by a plastic surgeon.

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