Scarring is part of the skin’s wound-healing response and can follow acne, surgery, trauma, burns or inflammatory skin disease. In aesthetic practice, the most relevant first step is to identify the type and maturity of the scar, whether active disease is still present and whether the concern is textural scarring, colour change or both.
No single treatment suits every scar. Atrophic acne scars, hypertrophic scars and keloids behave differently, and some scars require medical or surgical management rather than routine aesthetic treatment.
How Scars Form
When the dermis is injured, the body lays down collagen as part of repair. The amount, organisation and remodelling of this collagen influence the final appearance of the scar. Some scars flatten and fade with time, while others remain depressed, raised, symptomatic or more pigmented than surrounding skin.
Scar appearance is influenced by depth of injury, inflammation, genetics, anatomical site, skin tension, infection, wound care and individual tendency towards hypertrophic or keloid scarring.
Common Scar Presentations
Atrophic scars
Depressed scars caused by loss of tissue, commonly after inflammatory acne. Acne scarring may present as ice-pick, boxcar or rolling patterns, and mixed patterns are common.
Hypertrophic scars
Raised scars that remain within the boundaries of the original injury. They may be red, firm, itchy or uncomfortable, particularly while active.
Keloid scars
Raised scars that extend beyond the original wound boundaries and can continue to grow. Keloid tendency is more common in darker skin types and in certain anatomical sites.
Flat or pigment-altered scars
Some scars become flat but remain lighter, darker or redder than surrounding skin. This colour change may need a different plan from structural scar correction.
Contracture scars
Scars following deeper burns or trauma can restrict movement. These sit outside routine cosmetic scar management and may require specialist medical or surgical input.
Practitioner Considerations
-
Identify the scar type, location, age and whether it is still changing
-
Check whether active acne or inflammation is still present before treating acne scars
-
Separate textural scarring from post-inflammatory erythema or hyperpigmentation
-
Ask about previous keloid or hypertrophic scar formation before creating new controlled injury with needling, peels or energy devices
-
Assess Fitzpatrick phototype and PIH risk when planning resurfacing procedures
-
Refer scars that are painful, rapidly growing, restricting movement, diagnostically uncertain or outside the practitioner’s treatment scope
Professional Approaches to Scar Concerns
Scar management often uses combinations rather than a single modality. The appropriate route depends on whether the primary issue is depth, tethering, surface texture, vascularity, pigmentation or excessive collagen formation.
-
Professional resurfacing or peel programmes for selected superficial texture and pigment concerns
-
Microneedling or RF microneedling for appropriate atrophic scar patterns and skin-quality goals
-
Medical or surgical pathways for deep tethered scars, significant keloids or contractures
-
Pigmentation-focused skincare where colour change is more prominent than structural scarring
-
Photoprotection and barrier support around procedures to reduce avoidable inflammation and PIH risk
-
Realistic treatment plans that focus on improvement rather than complete scar removal
Healthxchange Portfolio Options for Scars
Scar management should be driven by scar type, maturity, colour change, tissue behaviour and the client’s risk of post-inflammatory pigmentation. Healthxchange’s portfolio allows practitioners to consider skincare, recovery support, camouflage, assessment and device-led pathways according to the individual presentation.
Skincare, recovery and camouflage
Epicutis can support hydration and barrier-focused care around more intensive skin programmes. Clinisept may be considered within appropriate procedural skin-hygiene protocols. Obagi and Medik8 can support practitioner-led approaches to texture, pigmentation and resurfacing where appropriate, while Jane Iredale may be useful when clients need cosmetic camouflage or complexion support during the management journey.
Assessment and device-led pathways
OBSERV can help document colour, texture and post-inflammatory changes. Potenza may form part of a practitioner-led pathway for selected texture and acne-scar concerns, while MediLUX and UltraLUX can sit within wider skin-quality or recovery pathways where appropriate to the device indication and the client’s treatment plan.
Hypertrophic, keloid, contracture or diagnostically uncertain scars should not be approached as routine cosmetic texture concerns. Referral and medical management may be more appropriate depending on the presentation.