Understanding the difference between active acne, post-acne marks and scarring and, how professional microneedling with SkinPen may support healthier-looking, more resilient skin.
THE HAUS NOTES · SKIN EDITION · 10 MIN READ
Acne is often spoken about as though it is one skin concern. In reality, it can involve several different changes within the skin, each requiring a different approach. For some, acne is an ongoing cycle of congestion, inflammation and breakouts. For others, the breakouts have settled, but the redness, pigmentation or uneven texture they leave behind can remain long after the blemish itself has disappeared. And then there is acne scarring. Where the skin's underlying structure has changed, leaving depressions or raised areas that can be more persistent.
This is a topic that is particularly personal to me.
As a teenager, I struggled with cystic acne or years. I remember how frustrating and disheartening it was to continually seek help, only to be turned away from certain treatments or told that I could only have selected procedures because my skin was considered too problematic or unsuitable. At the time, there was far less understanding of how to approach acne-prone skin through different stages of inflammation, healing and scarring. I often felt that the focus was on what couldn't be done, rather than understanding what was happening within my skin and how it could be managed effectively.
That experience has stayed with me throughout my career.
It has shaped the way I look at acne today. Not as a reason to automatically exclude someone from treatment, but as a reason to look more closely, understand the skin and consider what may be appropriate. Because active acne, post-acne marks and established scarring are not necessarily the same concern, and they should not automatically receive the same treatment approach.
At Lau-vei Haus, our approach begins with understanding what is happening within your skin, its history and what it needs before deciding which treatment may be appropriate. I know firsthand how much acne can affect your confidence. I also understand how important it is to feel that someone is genuinely listening, rather than simply being told what you cannot have.
My goal is to approach acne-prone skin with curiosity, clinical judgement and a willingness to look beyond the obvious. Because having acne should never mean your skin concerns are dismissed.
UNDERSTANDING ACNE: MORE THAN JUST BREAKOUTS
Acne is a chronic inflammatory condition involving the pilosebaceous unit, the hair follicle and its associated oil gland.
It develops through a combination of factors, including:
Follicular congestion: Dead skin cells accumulate and contribute to blocked pores.
Excess sebum: Overactive sebaceous glands produce more oil, contributing to congestion.
Bacterial activity: Cutibacterium acnes (C. acnes) is involved in the inflammatory process.
Inflammation: The body's inflammatory response contributes to the development of red, swollen and sometimes painful lesions.
Internal and lifestyle influences: Hormonal changes, stress, sleep and other individual factors can influence acne activity.
Acne can present in several ways, including:
Comedones: Open blackheads and closed whiteheads.
Papules: Small, inflamed red bumps.
Pustules: Inflamed lesions containing pus.
Nodules and cysts: Deeper, more inflammatory lesions that can be painful and carry a greater risk of scarring.
Acne is not simply a result of poor hygiene or not cleansing your skin properly. In fact, excessive cleansing, over-exfoliation and using too many active ingredients can compromise the skin barrier and contribute to irritation. Long-term acne management requires more than an occasional in-clinic treatment. A consistent home skincare routine, appropriate active ingredients, sun protection and, where indicated, medical management all have a role to play.
CAN MICRONEEDLING BE USED FOR ACTIVE ACNE?
This is an area of microneedling that deserves a closer look.
Microneedling is commonly associated with collagen induction and the improvement of acne scarring. However, over 14 years of treating skin, alongside ongoing clinical research and evolving treatment approaches, I have developed a deeper appreciation for the potential role of microneedling in managing certain presentations of active acne.
The rationale centres on the skin's wound-healing response and the different characteristics of inflammatory and non-inflammatory lesions. There is also emerging discussion around how controlled micro-injuries may influence the follicular environment, including the relationship between oxygen availability and C. acnes.
Microneedling is not appropriate for every acne presentation, particularly where there is significant active inflammation, infection or compromised skin integrity. Careful assessment, appropriate patient selection and an individualised treatment approach remain essential.
POST ACNE MARKS: WHEN THE BREAKOUT HAS GONE, BUT THE MARK REMAINS
One of the most common frustrations after acne is the appearance of marks that remain once the blemish itself has healed. These are not necessarily scars. In many cases, they are changes in skin colour rather than changes to the underlying skin structure. There are two common types.
Post-inflammatory erythema (PIE)
PIE appears as pink, red or sometimes purplish marks following inflammation. These marks are associated with changes in superficial blood vessels and can be more noticeable in lighter skin tones, although they can occur across all skin types.
Post-inflammatory hyperpigmentation (PIH)
PIH presents as flat brown, tan or greyish marks caused by increased pigment production following inflammation. It can be more persistent in deeper skin tones and may become more noticeable following irritation, picking or aggressive treatments.
Why the distinction matters
PIE and PIH are not the same as atrophic acne scars. They involve changes in colour rather than a loss of skin structure.
Their management may involve a combination of appropriate skincare, sun protection and selected professional treatments, depending on the individual's skin and the nature of the pigmentation or redness. For pigmentation in particular, controlling inflammation and protecting the skin from UV exposure are important considerations.
ACNE SCARRING: WHEN THE SKIN’S STRUCTURE CHANGES
Acne scarring occurs when inflammation affects the deeper structures of the skin and the normal healing process results in a change to its architecture. Unlike post-acne marks, these changes are structural. There are two broad categories of acne scarring.
Atrophic acne scars
These are depressed scars caused by a loss or disruption of collagen and dermal tissue during the healing process.
There are three commonly recognised types:
Ice pick scars: Small, narrow and deeper indentations.
Boxcar scars: Wider depressions with more defined edges and a relatively flat base.
Rolling scars: Broader, shallow depressions that create an uneven or undulating skin surface.
Hypertrophic acne scars
These are raised scars caused by an overproduction of collagen during the wound-healing process. They remain within the boundaries of the original lesion, unlike keloid scars, which can extend beyond the original wound. Different scar types respond differently to treatment. Some may benefit from microneedling, while others may require a combination approach or referral for alternative procedures.
WHY THE DEVICE AND THE PRACTITIONER MATTER
Not all microneedling is the same.
There is a difference between professional microneedling performed with a purpose-designed device and at-home devices or cosmetic rollers. When treating acne-prone skin, the device, practitioner and treatment plan all matter.
The device
At Lau-vei Haus, we use SkinPen Precision, a professional microneedling device designed to create controlled, consistent microchannels. It uses a sterile, single-use needle cartridge for each treatment. This is an important consideration when maintaining appropriate infection prevention and treatment standards. The design of the device, consistency of needle movement and ability to tailor treatment to the individual are all relevant considerations.
The practitioner
A device does not assess your skin. The practitioner does.
With over 14 years of clinical experience in skin health and advanced dermal therapies, Lauren Chandler’s approach to microneedling is informed by a detailed understanding of skin anatomy, wound healing, inflammatory responses, pigmentation pathways and scar morphology.
Knowing how to operate a device is only one part of the treatment. Understanding how different skin types respond, recognising when the skin is not suitable for treatment, and knowing how to adapt treatment depth, intensity and preparation are equally important. This is particularly relevant for individuals with a history of post-inflammatory hyperpigmentation, deeper skin tones, impaired skin barriers or varying degrees of acne scarring.
At Lau-vei Haus, treatment decisions are never based on a device or a protocol alone. They are guided by clinical assessment, experience, individual skin characteristics and an understanding of what the skin actually needs.
The treatment plan
A considered treatment plan is not simply about choosing a device and performing a treatment.
It involves understanding:
Whether acne is currently active and the type of lesions present.
The severity of inflammation and skin sensitivity.
Whether the skin barrier is compromised.
The type of post-acne marks or scarring.
Your Fitzpatrick skin type and history of pigmentation.
Previous treatments and response to skin injury.
Current skincare, medications and relevant contraindications.
Whether medical assessment or another treatment would be more appropriate.
THE IMPORTANCE OF HOME CARE
One of the most important parts of managing acne-prone skin happens outside the treatment room. In-clinic treatments can support the skin, but they cannot address every factor contributing to acne. A consistent home skincare routine helps support the skin between appointments and maintain the progress made through professional treatments.
The right products and ingredients depend on the individual. More active ingredients do not necessarily mean better results. Following microneedling, your regular skincare routine may need to be temporarily adjusted while the skin recovers.
A CONSIDERED APPROACH AT LAU-VEI HAUS
One of the most important things to understand about acne is that the skin you are left with after a breakout may need a very different approach from the skin experiencing active acne. A person with ongoing inflammatory breakouts, someone with persistent pigmentation and someone with established atrophic scarring may all describe their concern as 'acne', but their treatment pathways can be quite different.
With more than 14 years of experience in aesthetics and advanced skin treatments, my approach has always been to look beyond the concern someone initially presents with. I want to understand the skin, its history, what has already been tried and what the individual is hoping to achieve. That means not automatically recommending a treatment because it is popular, and not assuming that more intensive treatment will deliver a better result.
At Lau-vei Haus, SkinPen microneedling is considered as part of an individualised skin health plan. Whether we are addressing acne-prone skin, post-acne marks or established scarring, the starting point is always a thorough assessment.
The device matters. The technique matters. But clinical judgement matters just as much.
READY TO UNDERSTAND YOUR SKIN?
If acne, post-acne marks or scarring are something you have been navigating, a considered skin consultation is a good place to start. At Lau-vei Haus we assess your skin, discuss your concerns and determine whether SkinPen microneedling or another approach may be suitable.
Lauren Chandler
Registered Nurse · Advanced Dermal Clinician · Aesthetic Clinical Trainer
Founder, Lau-vei Haus
Ascot, Brisbane
Personalised aesthetic medicine, skin health and regenerative care.
This article is intended for general educational purposes and does not replace medical diagnosis or treatment. Acne, Acne Scarring and Post acne marks should be appropriately assessed before treatment.
FREQUENTLY ASKED QUESTIONS
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Suitability depends on the type and severity of acne, skin condition, medical history and practitioner assessment. It is not appropriate for every individual or every type of acne. A consultation prior to treatment is necessary to discuss suitable options.
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Professional microneedling with SkinPen may improve the appearance of selected atrophic acne scars by stimulating a wound-healing response and supporting collagen remodelling. Some scar types may require additional or alternative treatments.
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Post-inflammatory hyperpigmentation and post-inflammatory erythema are different concerns. Selected professional treatments may form part of an individualised plan, but the approach needs to account for skin tone, pigmentation history and the risk of further inflammation.
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No treatment can guarantee complete removal of acne scars. The aim is to improve the appearance of scarring, skin texture and overall skin quality. Results vary between individuals.
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Suitability depends on your individual skin, medical history, pigmentation history and current concerns. People with higher Fitzpatrick score may be suitable, but careful assessment and appropriate preparation are particularly important to reduce the risk of post-inflammatory pigmentation.
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Some changes in skin texture may become noticeable within a few weeks. However, collagen remodelling is a gradual process. A course of treatments may be recommended to achieve optimal results, with improvements continuing to develop over several months. Maintenance treatments may also be recommended to support ongoing skin health and maintain results over time.
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Potentially, yes. However, the timing and combination of treatments need to be carefully planned. Some treatments are better performed separately, and active acne or irritation may need to be managed first.