Acne scarring

No. Substantial improvement is realistic; complete erasure is not. Most people are very satisfied with 50–70% improvement, because that is the difference between scarring you notice in every mirror and scarring you stop thinking about.

Run a fingertip over the area, or look at it in side lighting. If you can feel a dip or a raised area, it is a scar. If the skin is smooth and only the colour differs, it is discolouration — which is much easier to treat and often fades on its own.

Ice pick (narrow and deep), boxcar (sharp-edged craters), rolling (broad, wavy undulations), tethered (pulled down by bands under the skin) and raised — hypertrophic or keloid. Enlarged, scarred pores are common too. Red marks (post-inflammatory erythema) and brown marks (post-inflammatory hyperpigmentation) are colour changes, not textural scars.

No. Scar age matters far less than most people assume. Scars that are decades old respond much as recent ones do — depth and type are what determine the result.

As the face loses volume and collagen with age, rolling and tethered scars deepen and cast more shadow. This is one reason treatment later in life often combines scar release with volume support.

Three things matter most: how long the acne was active before it was controlled, how deep the inflammation went, and genetics. Picking makes individual lesions worse but is not why you have widespread scarring, and neither is diet or your cleanser.

Yes. The chest and back scar differently to the face — raised and keloid scars are more common there — so the plan often leans on injections and vascular laser rather than resurfacing.

Control the acne early and effectively. How long acne stays active before it is controlled is the single biggest predictor of scarring. If you are still breaking out, see your GP or dermatologist now rather than waiting.

There is no single best treatment — there is a best treatment for each scar type. Ice pick scars need TCA CROSS or punch techniques, rolling and tethered scars need subcision, boxcar scars respond to fractional laser, and raised scars need injections. Most people need two or three of these in a planned order.

A typical course is 3–5 procedures, 4–8 weeks apart, often combining two or three techniques in a single session. Your report gives a projected range for your grade and scar mix.

Yes. New breakouts create new scars, and inflamed skin responds unpredictably to resurfacing. If your acne is still active it is addressed first — it is not a delaying tactic, it is the reason the treatment works.

Occasional, yes. Active inflammatory acne, no — control comes first.

CROSS stands for chemical reconstruction of skin scars. A high-strength trichloroacetic acid is placed precisely into each scar, triggering collagen to rebuild it from the base. It is the best-matched treatment for ice pick scars and enlarged pores, and my published work extends it to boxcar and polymorphic scars.

A fine cannula or needle is passed under the skin to cut the fibrous bands that tether rolling scars down. Nothing applied from the surface can release a tether, which is why subcision is central to treating rolling scars.

For boxcar scars, rolling scars and overall texture, yes. It cannot reach the base of a deep ice pick scar or release a tethered scar, which is why it works best as one part of a combined plan rather than on its own.

It helps mild texture, but it will never reach the base of an ice pick scar or release a tethered one. Sold as a complete answer to moderate scarring, it is not.

Fillers can lift broad rolling scars and restore lost volume — but only once tethered scars have been released. Filler under a tethered scar lifts briefly and pulls back down.

Often yes. They are a separate workstream from the texture and frequently improve faster than the scars themselves, which is encouraging early on.

In my published TCA study, patients on isotretinoin at the same time showed no appreciable increase in healing time or complications. Whether that applies to your treatment plan depends on the procedure, and is decided at your consultation.

Almost certainly not. Bring the details to your consultation — in most cases the procedure was capable of treating only one of your scar types.

TCA CROSS and vascular laser are brief and tolerable with topical anaesthetic. Fractional ablative resurfacing and subcision are done under local anaesthetic, and often with sedation, because doing them properly is not comfortable.

From none to about a week depending on the technique. TCA CROSS leaves small crusts for five to seven days; fractional ablative laser means three to five days of weeping, then two to four weeks of pinkness; subcision can bruise for one to two weeks.

Some change is visible within weeks, but collagen keeps remodelling for 6–12 months after your final session. The result at three months is not the final result.

The collagen rebuilt inside a treated scar is permanent. Your skin will continue to age, and new acne can cause new scars, but the improvement itself does not wear off.

Yes, with the right plan. The main risk is post-inflammatory hyperpigmentation, managed with test spots, adjusted settings, pigment preparation beforehand and strict sun avoidance afterwards. Focal treatments such as TCA CROSS suit darker skin particularly well.

Autumn and winter make the essential sun avoidance after resurfacing much easier, particularly in Queensland. Focal treatments can be done year-round with good sun protection.

Get active acne under control, avoid sun and tanning beforehand, and — in darker skin types — follow the pigment-preparation plan in your report for several weeks before resurfacing.

Indicative ranges are published on this page — for example $990–$2,990 per session for CO₂ or hybrid fractional laser resurfacing, and $890–$1,990 per session for TCA CROSS. Your written report gives a firm, staged cost for your case before you commit to anything.

Partly. When a specialist dermatologist is involved in scar treatment, Medicare provides a substantial rebate — procedures such as subcision, nerve blocks and fully ablative laser resurfacing are partially covered. Vascular laser attracts a rebate where I am involved in the treatment and you have a valid referral. Rebates generally do not apply to fractional laser, TCA CROSS or soft-tissue injectables. Overseas patients are not eligible for Medicare.

Not to be seen, though a GP referral is useful and may attract a Medicare rebate on the consultation itself.

The assessment, the grading, the plan and the costings, yes. The procedures are performed in Brisbane or Sydney.

Three clear photographs of the scarred area: front-on, a side or angled view, and a close-up. Use natural lighting, ideally from the side, and no makeup.

Yes. Many patients complete the virtual consultation first, then plan travel around a staged programme so that sessions line up with their time in Brisbane or Sydney.