Phase one — settle the acne
Most people arrive having already tried three or four things. The first appointment is largely about working out which of them failed because they were the wrong treatment, and which failed because nobody explained how long they take.
Depending on severity and scarring risk, that means topical retinoids, oral antibiotics with a defined stop date, hormonal treatment, or isotretinoin with proper monitoring. We do not start scar work while acne is still active.
- Prescription topical and oral therapy, reviewed at six weeks
- Isotretinoin under monthly bloods and consultant supervision
- Hormonal assessment where the pattern suggests it
- Chemical peels for congestion and post-inflammatory pigmentation
Phase two — revise the scars
Scar type dictates the tool. Rolling scars respond to subcision and radiofrequency microneedling; boxcar scars usually need focal resurfacing; ice-pick scars often need TCA cross. Most people have a mixture, which is why a single-technique clinic tends to disappoint.
- Radiofrequency microneedling — 3 to 4 sessions, six weeks apart
- Subcision for tethered rolling scars
- TCA cross for ice-pick scarring
- Fractional resurfacing where texture is the dominant problem
What it costs and how long it takes
Honest expectations
Scar revision improves scars. It does not erase them. A realistic target is a sixty to seventy per cent improvement in appearance over four sessions, and the difference is most obvious in raking light rather than in a mirror straight on.
“They refused to start my scar treatment for four months while we got the acne under control. I was frustrated at the time. It was completely the right call.”
Downtime
Peels: two to four days of flaking. RF microneedling: two days of redness and swelling, similar to sunburn. Subcision: bruising for seven to ten days. We will tell you the number before you book, not after.