What is the best treatment for mature skin with acne box scars?

Dr Sophie Shotter replies:

Mature skin with box acne scars:

Often even if you think you’ve escaped acne scarring, as your skin matures and changes and you lose significant amounts of collagen, acne scarring becomes more visible. We see this a lot particularly around the chin. There are some good treatment options, depending on your tolerance for downtime:

1. Excision – you can treat deep scars by cutting them out and using a small localised stitch which then heals better than the original scar.

2. Resurfacing – with either laser or peels. This involves significant risk and downtime and needs to be in the hands of expert practitioners only.

3. Fractional laser – these will involve a course of treatment with more mild downtime. Results are good but not usually as dramatic as using resurfacing treatments.

4. Radiofrequency micro needling – there is a huge wealth of different devices available which will work to varying degrees. These treatments usually involve mild to moderate downtime and risk. Some devices achieve results in a single treatment (Profound) whereas others may need a course.

5. Microneedling – still a firm favourite. This can achieve good results, particularly if combined with peels. But usually less dramatic than some other options.

In all of these cases, I would recommend supporting the skin with:

1. At home skincare focussed on collagen building.

2. Collagen supplement – to give your skin the building blocks to make new proteins.

3. Consider using Emepelle which will make the skin cells work more efficiently and therefore produce more collagen and elastin.