Overview
Scarring is a natural part of the skin’s healing process, occurring when the deeper layers of the skin are affected and collagen is produced to repair the area.
Depending on how the skin heals, scars can take different forms. Some scars develop where there is a loss of tissue, creating indentations in the skin, while others form due to excess collagen, leading to raised or thickened areas.
Because of this variation, scarring is not a single condition. It is a group of different scar types, each requiring a different approach.
How we approach scarring
At Mirabel, scarring is approached by first identifying the type and depth of the scar, as this determines what will be most effective.
The aim is to:
• Improve skin texture and smoothness
• Stimulate collagen to support more even skin structure
• Soften the appearance of both indented and raised scars where appropriate
• Create gradual, natural-looking improvement over time
Treatment is carefully selected based on the specific characteristics of the scarring, often combining different approaches to achieve the best outcome.
A measured, layered approach is essential, as meaningful improvement in scarring takes time and consistency rather than a single treatment.
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What you may notice
Scarring can present in a number of different ways:
• Indentations or “pitting” in the skin
• Raised or thickened areas of scar tissue
• Uneven skin texture or surface irregularity
• Marks left after acne or skin injury
• Skin that feels uneven when touched
The appearance of scarring can vary depending on its cause and how the skin has healed.
Types of scarring
Scars are generally grouped into a few main types:
• Atrophic (indented) scars – caused by a loss of collagen, creating depressions in the skin
• Hypertrophic scars – raised scars that remain within the original area of injury
• Keloid scars – raised scars that extend beyond the original wound boundary
• Post-inflammatory marks – flat areas of pigmentation that are often mistaken for true scars
Atrophic acne scars are the most common and can be further divided into:
• Ice pick scars – deep, narrow pits
• Boxcar scars – wider depressions with defined edges
• Rolling scars – broader, uneven depressions
Each type behaves differently and responds to different treatment approaches.
What is happening in the skin
Scarring develops as part of the skin’s repair process after injury or inflammation.
This can involve:
• Loss of collagen, leading to indented or sunken scars
• Excess collagen production, leading to raised or thickened scars
• Changes in how collagen fibres are organised within the skin
• Disruption of normal skin structure and texture
The balance between collagen breakdown and production during healing determines how a scar will form and how it appears over time.
What can influence scarring
Several factors influence how scarring develops:
• Severity and depth of the original skin damage
• Inflammation, particularly in conditions such as acne
• Genetics and individual healing response
• Skin type and location on the body
• Delayed or disrupted healing
For example, deeper or more inflamed acne is more likely to lead to visible scarring, particularly if the skin’s healing process is affected.
When to seek advice
If scarring is affecting the appearance or texture of your skin, a more tailored approach can help to identify what type of scarring is present and how it can be improved.
Seeking advice can help to:
• Accurately identify the type of scarring
• Avoid ineffective or inappropriate treatments
• Understand what level of improvement is realistic
• Create a structured, long-term treatment plan
Early guidance can be particularly helpful in preventing scarring from becoming more established.