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Acne Scarring

I am just writing a lecture on Acne Scaring and we seem to have a few enquires about this of late.

Acne scaring really affects patients physically and mentally and therefore should be prevented at all costs..

Over 90% of acne patients develop some degree of scarring and there is often a lag time of up to 3 years between the acne spot and a scar. The severity of the acne and the ability of patients to heal are also factors in developing scars as it spot picking which increases the risk of an eventual scar. . We do not know who will scar significantly and probably around 15 % will have significant scaring. Therefore early pro-active treatment of acne is important.

I would therefore strongly advise that patients go to their GP and ask for treatment which actually treats their acne . This is likely to be a topical agent such as the retinoid Adapalene , benzyl peroxide available over the counter or a topical antibiotic. If this fails to work after three months an oral antibiotic for at least three months course should be added. Treatments take time so you need to give them at least three months. You may need to rotate your antibiotic every few months to prevent bacterial resistance.

The contraceptive pill Dianette whilst slightly increasing the risk of a deep vein thrombosis is often helpful particularly in older women with jawline acne which is androgen (male hormone which women have) sensitive. Some GPs will cite the increased risk of Dianette, Yasmin appears to be the alternative probably not quite as good.

Spironolactone also works and this is a diuretic but it is off licence and I suspect there are few GPs who will provide this.

If your acne is severe, begins to scar early, or fails to respond to treatment ask for a referral early for oral Isotretinoin from a Dermatology clinic.

In our clinic we often add LED light treatment which can also be helpful.

Remember acne scarring can be often prevented ! Treatment of scars is expensive and time-consuming.