The NHS does not cater for acne scarring. Treatments for pigmentation as a consequence of acne are also limited.

Azelaic acid 20% (Skinoren®) is helpful in treating individuals with active acne and post-inflammatory hyperpigmentation which is a particular issue in skin of colour. Your GP may be willing to prescribe this for you. At the time of writing there do not appear to be treatments in the NHS for acne scarring.

For example clients with complex concerns such as pitting combined with dark pigmentation— a layered approach can be taken:

Release: Subcision/polynucleotides to reduce the appearance of the tethered scars.
Repair: Polynucleotides to thicken and heal the skin.
Resurface: VI Peel or Obagi Blue Peel to erase the reduce pigmentation.
Refine: ZO Skin Health products at home to maintain the results.

What is acne scarring?

The term ‘scarring’ refers to a fibrous process in which new collagen is laid down to heal a full thickness injury. It is thought to affect 30% of those with moderate or severe acne vulgaris. The approach taken to soften the appearance of acne scarring will depend on your overall skin condition, what type of scars are present and other factors specific to the treatment. Scarring can be described as rolling, ice-pick or boxcar.

What treatments for acne scarring and pigmentation after acne are available at this clinic?

The use of Polynucleotide injections just under the surface of the skin is encouraged at the beginning of the process as this will help to improve the skin quality and to get better results from the other procedures that follow and targeted skin care. The process of subcision can sometimes be used to help to break up the scar. There is some evidence of benefits for people with acne scarring (atrophic). This can be used near the scar or in the scar.

Some of the Chemical Peels, such as the Vi Peel Purify Precision Plus (used in skin of colour for acne, acne scarring and hyperpigmentation), Neostrata Prosystem Peels should have a period of preparation with skin care first. Other peels such as the Retinol Peel, Obagi Blue Peel Radiance and ZO Skin Health peels can help with mild acne and acne scarring.

If texture issues rather than acne are the main issue then Dermaroller XCellaris Pro Twist microneedling can be considered. A series of treatments is recommended. Bio-Spicules is the preferred opion in skin of colour as the microneedling treatment.

The treatment selected will be based primarily on safety profile.

Treatment	Best For…	The “Pros”	The “Cons”
Subcision	Deep, “tethered” rolling scars.	Permanent structural release of scar tissue.	Potential for temporary bruising/swelling.
Polynucleotides	Regenerating thin, scarred skin.	Heals from within; “bio-remodels” the skin.	Results take a few weeks to develop.
VI Peel Purify Precision Plus	Serious pigmentation & active acne.	Deeply transformative for dark spots (PIH).	Visible “sheet peeling” for 3–5 days.
Obagi Blue Peel Radiance	Congestion & dullness.	Instant brightening; zero downtime.	Multiple sessions needed for long-term change.
Cleopatra Skin Treatments	Luxury rejuvenation & glow.	Ultra-premium feel; calms and hydrates.	Focused on radiance over deep scar repair.
Xcellaris Pro Twist	Textural pitting & pores.	High-precision collagen induction.	Skin remains red for 24–48 hours.
Bio Spicules	Speeding up skin turnover.	Needle-free; rapid 7-day renewal cycle.	Skin feels “prickly” for 2 days.
WOW fusion (Microneedling)	Shallow scarring & large pores.	Bespoke “cocktail” of acids/toxin for surface refinement.	Minor redness; requires a course for best results.
PRP (Platelet-Rich Plasma)	Natural healing of atrophic scars.	Uses your own growth factors; 100% natural and biocompatible.	Requires a blood draw; mild swelling post-treatment.
WOW fusion + PRP (Combined)	The Ultimate Scar Reset.	Synergistic effect; microneedling creates channels for deep PRP delivery.	Longest recovery time of the three (48 hours of redness).

Are there any professional skin care products specifically for the after effects of acne?

NeoStrata® Post-Acne Mark Correcting Serum

If your primary concern is the “stained” appearance of your skin following a flare-up, this targeted serum is an essential addition to your home care foundation. It is specifically formulated for those with sensitive or oily skin who need to clear marks without causing further irritation.

The Power of Tranexamic Acid: This serum features a potent concentration of Tranexamic Acid, a hero ingredient that specifically targets the “biological triggers” of pigment. It works by interrupting the inflammatory process that tells your skin to produce excess melanin, effectively fading dark spots and preventing them from returning.
10% AHA/PHA Blend: This gentle yet effective acid concentration dissolves the bonds of discolored skin cells, gradually “lightening” red and brown marks.
Niacinamide (Vitamin B3): A hero ingredient for acne sufferers, it calms the redness (Post-Inflammatory Erythema) and strengthens the skin barrier.
Oil-Free Clarity: This serum is ultra-lightweight and non-comedogenic, ensuring your journey to even skin tone doesn’t cause a rebound in oiliness.

ZO® Skin Health: Retinol Control + Blemish Complex

For patients dealing with active congestion alongside stubborn post-acne scarring, this is a dual-action powerhouse. Unlike basic blemish creams, this medical-grade complex is designed to clear current breakouts while simultaneously aggressively targeting the texture and pigment left behind by old ones.

Advanced Retinol: High-potency retinol speeds up cell turnover, forcing the skin to shed scarred and pigmented cells faster to reveal smoother, healthy skin underneath.
Pigment Control: It works to inhibit the overproduction of melanin, helping to fade those dark “shadows” that often remain after a blemish has healed.
Dual-Action: While it refines the skin’s surface to reduce the appearance of pitted scars, it also keeps pores clear to ensure no new acne takes its place.

This option is only for those whose skin is tolerant as there are significant anticipated reactions.

Neostrata Resurface products

There are several products in the Neostrata Resurface skincare range which would help to reduce the appearance of uneven texture of the skin as a result of acne. In addition, products from this segment of the Neostrata Portfolio are recommended as preparation for a series of Neostrata Pro System Peels. In lighter skins, at least 2 weeks of use is recommended. In darker skin types at least 4 weeks of preparation with products are needed.

Sunscreen alert! Sunscreen must be used when using this product and for one week afterwards (regardless of skin type)

The Non-Negotiable: Why Medical-Grade SPF is Your "Insurance Policy"

When advanced treatments are carried out, your skin is essentially being tricked into a state of intensive repair. In peels and microneedling, this process involves removing the damaged outer layers and stimulating fresh, vulnerable new cells. These “baby” cells are incredibly sensitive to UV light; without the protection of a medical-grade SPF, even a few minutes of incidental sun exposure can trigger Post-Inflammatory Hyperpigmentation (PIH). This means your skin could produce more melanin as a defence mechanism, darkening your scars and undoing your progress.

Unlike standard high-street sunscreens, medical-grade SPF (such as those in the ZO Skin Health range) provides a “triple-spectrum” defence. It protects not only against UVA and UVB but also against HEV (Blue Light) from your phone and IR-A (Infrared) heat, both of which are known to worsen acne scarring and pigmentation. Think of your SPF not just as sun protection, but as the essential “healing shield” that allows your clinical results to flourish.

Clinic treatments

Polynucleotides

If you have struggled with the long-term aftermath of acne—such as thinned skin, “pitting,” or loss of elasticity—Polynucleotides offer a revolutionary way to heal. Unlike traditional dermal fillers that simply “mask” indentations, Polynucleotides (such as the industry-leading Plinest) work at a cellular level to repair and renew the skin’s architecture.

What are Polynucleotides?

Polynucleotides are natural DNA fractions derived from salmon DNA. When injected into the skin, they act as “biostimulators.” They don’t just hydrate; they communicate with your cells to switch on repair mode.

Why they are ideal for Acne Scars

Acne scarring occurs when the skin’s collagen structure is damaged or “tethered” during the inflammatory process. Polynucleotides treat this by:

Boosting Fibroblast Activity: They stimulate the production of Type I collagen and elastin, effectively “filling” atrophic (pitted) scars from the inside out.
Reducing Inflammation: They have a profound anti-inflammatory effect, helping to calm the persistent redness often seen in scarred tissue.
Improving Vascularization: By improving blood flow to the scarred area, the skin receives more nutrients, leading to a healthier, more vibrant complexion.

Polynucleotides also act as a preparatory treatment. Before moving on to more aggressive resurfacing—such as the Xcellaris Pro Twist microneedling or deep VI Peels—it is vital that the skin is resilient enough to respond. Polynucleotides act as the ultimate skin “primer” because they:

Strengthen the Skin Barrier: Ensuring your skin can handle active treatments without excessive downtime.
Hydrate from Within: Creating a “juicy,” hydrated environment that allows needles and peels to work more effectively.
Optimize Healing: By boosting your skin’s regenerative capacity before a procedure, your recovery time is faster and your final results are significantly enhanced.

The Plinest brand of polynucleotides is used due to its high concentration of purified polynucleotides. It is a highly biocompatible, injectable gel that is particularly effective for the delicate skin of the face and neck where acne marks are most prominent.

Bio-Spicules

Bio-Spicule Therapy, a revolutionary “liquid microneedling” treatment derived from hydrolyzed marine sponges. This treatment is a game-changer for those seeking deep skin renewal, acne clearance, and scar revision without the downtime of traditional invasive procedures.

How Bio-Spicules Work

Bio-spicules are microscopic, needle-like structures that are massaged into the skin. Unlike a chemical peel that dissolves cells with acids, Bio-Spicules work mechanically and biologically:

72-Hour Stimulation: Once massaged into the skin, the spicules remain active for up to 72 hours, continuously stimulating the dermis and triggering a powerful wound-healing response.
Accelerated Turnover: A standard skin cell cycle takes about 28 days; Bio-Spicule therapy compresses this into just 7 days, forcing the skin to rapidly shed impurities and damaged scar tissue.
Deep Ingredient Delivery: The “channels” created by the spicules allow Dr. Wilson to infuse potent anti-acne and skin-brightening actives deeper into the skin than topical application alone.

Why Bio-Spicules are Ideal for Acne & Scarring

Purges Congestion: By accelerating the skin cycle, Bio-Spicules push deep-seated “plugs” and blackheads to the surface, clearing the skin faster than traditional facials.
Resurfaces Pitting: The intense stimulation of collagen and elastin helps to level out uneven skin texture and shallow acne pits.
Fades Pigmentation: The rapid exfoliation helps to lift Post-Inflammatory Hyperpigmentation (PIH) and redness, leaving a more uniform skin tone.
Antibacterial: The natural composition of the spicules helps to neutralize acne-causing bacteria within the pores.

The “Prep” Power of Bio-Spicules

Much like Polynucleotides, Bio-Spicules are an excellent way to prepare the skin for high-intensity medical treatments. By “waking up” the skin’s regenerative processes and removing the barrier of dead skin cells, they ensure that subsequent treatments like the Obagi Blue Peel or WOW fusion can penetrate more effectively and deliver superior results.

Vi Peel Purify Precision Plus

If you are struggling with “angry” cystic acne and the dark, long-lasting marks that remain once the spots have healed, the VI Peel Purify Precision Plus is our premier clinical choice. This is not a standard facial; it is a deep, transformative resurfacing treatment that “resets” the skin’s health in a single week. However a series of treatments are likely to be needed

The Science of Dual-Action Repair

This professional peel utilizes a synergistic blend of high-potency ingredients, each targeting a specific layer of the acne cycle:

For Active Acne: A combination of Salicylic Acid, Benzoyl Peroxide, and Resorcinol works to neutralize P. acnes bacteria, dissolve excess sebum, and clear out the “plugs” within the follicles.
For Scarring & Pigment: The “Precision Plus” booster adds Kojic Acid, Hydroquinone, and TCA. These ingredients aggressively target the melanin-producing cells to shatter existing dark spots and prevent new ones from forming as the skin heals.
For Skin Strength: Vitamin C and Phenol stimulate collagen production and provide a mild numbing effect, ensuring the treatment is as comfortable as it is effective.

The 7-Day Transformation

Unlike “lunchtime” peels, the VI Peel involves a structured 7-day process.

Application: The peel is applied in-clinic by Dr. Wilson.
The “Shed”: Around day 3, your skin will begin to peel (often in visible “sheets”). This is the damaged, pigmented skin being shed to make way for new tissue.
The Reveal: By day 7, the peeling is complete, revealing a significantly clearer, smoother, and more even complexion.

⚠️ Clinic Policy: The Foundation Requirement

At Crewe Hair and Skin Clinic, patient safety and result-integrity are our primary concerns. Because the VI Peel is a powerful medical-grade treatment, we require all patients to be on an active, clinic-prescribed skincare programme for at least 2–4 weeks prior to the peel.

Why is this mandatory?

Reducing PIH Risk: High-intensity peels can “startle” pigment-producing cells. By using active home care first, we “suppress” these cells, drastically reducing the risk of Post-Inflammatory Hyperpigmentation (PIH)—especially in darker skin tones.
Skin Resilience: Active ingredients strengthen the skin barrier, ensuring your skin heals faster and more evenly during the 7-day peeling process.
Maintaining the “Reveal”: A peel “clears the canvas,” but your home care keeps it that way. Without the right daily actives, oil and bacteria will quickly return to the pores.

The ESK Advantage

For our acne and pigment patients, we most commonly prescribe the ESK (Evidence Skincare) range. ESK is formulated with high concentrations of evidence-based ingredients like Retinal (Vitamin A) and Niacinamide (Vitamin B3).

Using the ESK protocol alongside your VI Peel ensures that while the peel removes the damage, the ESK products prevent new damage from occurring, maintaining your smooth, clear results long-term.

Neostrata Skin Peels

A series of peels are needed to get results across all the ranges. Some peels will carry a greater risk of post inflammatory hyperpigmentation, particularly in skin of colour. Sunscreen purchased from this clinic is a non-negotiable to reduce the risk.

NeoStrata®, the pioneers of Alpha Hydroxy Acid (AHA) technology, offer a tiered approach to skin clearing. Whether you need a gentle “reset” for oily skin or a high-powered transformation for scarring, there is an option that can be tailored

1. NeoStrata® Pro System Peel (The “Lunchtime” Clarifier)

This is a highly flexible, customizable treatment that uses a blend of Glycolic and Mandelic Acids. It is the gold standard for patients who want clear skin without the “peeling” phase.

Targeting Oily Skin: Mandelic Acid is “lipophilic,” meaning it loves oil. It dives deep into the follicles to dissolve congestion and kill the bacteria that cause acne.
Refining Texture: The Glycolic Acid works to smooth out the microscopic “hills and valleys” of the skin surface, making pores appear smaller and the skin more reflective.
Preparation Power: This peel is the perfect “entry-level” treatment to prepare your skin for more intensive needling. It ensures the skin is free of dead-cell buildup, allowing other microneedling treatments to work more effectively.

2. NeoStrata® Retinol Peel (The Texture Transformer)

For patients ready to take their scar-clearing journey to the next level, the NeoStrata® Retinol Peel offers a deeper, more intensive renewal.

Collagen Induction: High-potency Retinol (3%) works at a cellular level to speed up cell turnover. This is essential for “lifting” shallow acne pits and smoothing out textural scarring.
Pigment Erasing: It is exceptionally powerful at “shattering” the clusters of melanin that cause deep post-acne dark spots (PIH).
The “Step-Up” Prep: We often use a course of Pro System Peels to strengthen the skin before “stepping up” to the Retinol Peel. This ensures your skin is conditioned to achieve the best possible results with minimal sensitivity.

The Vi Peel range of peels has a long track history of use across all different skin types.

The Vi Peel purify precision plus peel has been particularly useful for those with darker skins experiencing acne, post acne hyperpigmentation and reducing the appearance of scarring.

There will be peeling in the week after the procedure and specific products need to be used at specific times of day in the week after the peel.

There is an iphone App to help guide you through the process

Dermaroller Xcellaris ProTwist - Medical Grade Microneedling for acne scarring

If your skin has been left with indentations (atrophic scars) or a “bumpy” texture following years of breakouts, the Xcellaris Pro Twist is the ultimate tool for structural remodelling. It doesn’t just treat the surface; it forces the skin to rebuild itself from within. It cannot be used where there is active acne.

How the Pro Twist Works

The device uses ultra-fine, medical-grade needles to create thousands of controlled “micro-injuries” in the dermis.

Collagen Induction: These micro-injuries trigger the body’s natural wound-healing response. This leads to the production of fresh Type III Collagen, which eventually matures into Type I Collagen, effectively “lifting” the floor of indented scars.
Vertical Precision: Unlike traditional dermarollers that enter the skin at an angle (causing unnecessary trauma), the Pro Twist needles enter and exit vertically. This means more precision, less discomfort, and faster healing times.

The treatment can be used for up to 90 minutes so can be used for other cosmetic concerns such as stretch marks.

Why it is Ideal for Acne After-Effects

Smooths Pitting: By remodeling the scar tissue, it softens the edges of “boxcar” and “rolling” scars, making them significantly less visible.
Refines Large Pores: The boost in collagen tightens the skin’s framework, which physically pulls pores tighter and smoother.
Fades Pigment: The rapid cell turnover helps to break up clusters of melanin, clearing stubborn post-acne marks with the appropriate home care products

⚠️ Clinic Policy: Pre-Treatment Conditioning

Because the Xcellaris Pro Twist creates a controlled injury to the skin, Crewe Hair and Skin Clinic policy requires all patients to be established on a clinic-prescribed skincare programme (typically ESK) for 2–4 weeks prior to treatment.

The Importance of “Priming” your Skin:

Healthy Healing: For your skin to produce high-quality collagen, it needs the right nutrients (like Vitamin A and C found in the ESK range). If your skin is “starved” of these actives, your results will be limited.
Reducing Downtime: Well-hydrated, conditioned skin heals up to 40% faster than “unprepared” skin.
Active Acne Control: We cannot perform microneedling on skin with active, inflamed acne as it risks spreading bacteria. Your home-care programme ensures the skin is calm and “clear” before we begin structural work.

WOW fusion microneedling treatment for acne scarring

The treatment for acne scarring involves the use of the 1mm WOW fusion device with Botulinum Toxin in the first time plus either the HA Factor, RVit or Age Complex, depending on your skin assessment.

Treatment is repeated without toxin every month and then with toxin every 3 months until the skin improves.

The WOW facial range has peels for acne.

Platelet Rich Plasma treatment

For acne scarring microneedling and PRP should be done every 2 weeks for a total of 3-6 sessions.

The literature indicates that more improvement is seen in boxcar and ice pick scars than with rolling scars.

Acne scarring and pigmentation