When you’ve spent years managing your acne, at times feeling as though your skin has it in for you, the resulting scarring can feel like a cruel joke. Not to be confused with hyperpigmentation or skin staining, which can be treated over time, acne scarring permanently alters the texture of your skin, leaving 'dents' where there were once spots.
According to Dr Anjali Mahto, consultant dermatologist and author of The Skincare Bible: Your No-Nonsense Guide To Great Skin, inflammatory acne can damage the collagen fibres within the deeper layers of our skin. "New collagen is formed as a repair response but may not be as even as before, resulting in atrophic scarring. However, scarring is also more likely to occur if you squeeze or pick at your spots too." This is a habit I have been guilty of over the years.
Most of my acne scarring resided in the centre of my face, resembling oversized pores, and although I’m passionate about skin positivity, these scars chipped away at my confidence. On down days, scrolling through social media made me feel even worse. It’s hard not to take those 'perfect skin' pictures you see on Instagram at face value and feel as though everyone except you has baby bottom skin.
I get filler injected to plump out a few of the expression lines around my mouth (the ones my foundation would always collect in) and at the clinic, I had a lightbulb moment. Could filler be injected into my scars to plump them up in the same way it does my lines? According to Dr Mahto, yes. "Dermal fillers can be used for indented scars and the treatment can be offered by a good, practising cosmetic dermatologist. However, depending on the type of filler used, the treatment will need to be repeated at regular intervals (typically every six months) to maintain the outward results. Indented scars often require multiple modalities of treatment to get the best result and fillers can be combined with other treatments such as microneedling or laser."
Aesthetic doctor and plastic surgeon, Maryam Zamani seconds this, touting hyaluronic acid-based fillers as a good option for treating pitted skin. "They are especially useful if scarring is isolated rather than widespread. Injecting underneath an atrophic scar plumps and lifts the area resulting in a more even finish, semi-permanently reversing the damage caused by inflammatory acne. Plus, natural collagen development often occurs as a healing response post-injection, which can further improve the appearance of the skin." It pays to take the shape and size of the scar into consideration, too. "Broad, rolling scars are round in shape and respond best, while boxcar scars (more square-looking) and deep triangular 'ice pick' scars can be trickier to treat," adds Zamani.
I couldn’t wait to try this and as someone who is no longer squeamish when it comes to needles, I looked to Dr Zamani for my procedure. Dr Zamani strongly recommends booking in for a consultation (this should be common practice) and scheduling the procedure for a later date, especially if you aren't au fait with injectables. This gives you time to consider all your options and make an informed decision rather than a spontaneous one.
The filler was injected underneath my scars, however, some were too small to treat and an acid-based peel was suggested at a later date. Around 0.5ml of filler was injected into the viable scarring in my cheeks and it was all over in a matter of minutes with virtually no pain. All I felt was a slight prick as the needle entered my skin and then a pressure as the filler was pushed underneath my scars.
Across the UK, prices for non-permanent hyaluronic acid-based fillers such as Juvederm and Restylane range from £150 to £850 for 1ml of dermal filler. The cost of my treatment was £750 and I opted to use the other 0.5ml on my lines. I wondered why most aestheticians only use non-permanent filler for this procedure, as I imagined that this type of treatment would benefit from permanent fillers, and frankly I wanted a long-term fix. "I personally don’t advocate permanent filler for any treatment," Dr Zamani explained. "The results will gradually wear off after around 6-18 months and need repeating. However, in my experience, scars rarely return to their previous state. Also, as we age, the positioning of our skin and bones changes, too. Permanent fillers don’t accommodate these changes which can result in an unnatural look."
To me, the change was pretty much instant and improved further around two weeks later. Friends and family couldn’t tell the difference and thought I was a little mad, but I was incredibly happy with the results. Sure, the transformation was subtler than I would have liked, but Zamani had forewarned me that I would not have baby smooth skin, so my expectations were far more realistic by the time she began injecting me. What I have noticed is that my foundation hugs my skin better as does my blusher, and I’ve even started wearing cream blush, something I never did before.