Acne scarring treatment in Marylebone, London. CO2, UltraClear, SkinPen and PicoSure, matched to your scar types.
Dr Joney De Souza Clinic treats acne scarring for people who won the battle years ago and are still paying for it. When inflamed breakouts heal, the skin sometimes rebuilds its collagen imperfectly: too little leaves a depression, disordered repair leaves texture, and the result is the pitted, shadowed surface that no amount of skincare smooths. Unlike the marks acne leaves behind, true scars are structural, which is why they persist long after the last breakout.
Scars come in recognisable shapes, and the shapes matter. Rolling scars are soft, wave like dips that shadow in side light. Boxcar scars are sharper edged depressions, and ice pick scars are narrow, deep points. Most scarred skin carries a mix, often alongside flat red or brown marks that are not scars at all but pigment, and telling those apart changes the entire plan.
The good news is genuine: scarring responds to modern resurfacing and collagen induction better than almost any long standing skin concern, and improvement compounds across a course. Our clinic maps your scar types first and treats to the map, because that diagnosis, more than any device, is what decides the result.
Most scarred skin carries a mix of these patterns, and each responds to a different hand. Find the ones that sound like your skin, then follow them through. Your practitioner maps the full picture at consultation.
Soft dips that shadow in side light
Wave like depressions with soft edges, most visible under side lighting. Because the skin surface is intact, collagen induction works beautifully: microneedling triggers repair beneath the dips so they gradually rise toward level over a course.
Sharp edged and deep
Sharper edged depressions and narrow deep points are the stubborn end of scarring, and they want the strongest tool. Ablative CO2 resurfacing renews the surface and drives deep collagen repair, softening edges and depth with real, visible effect.
Scars plus uneven colour
Where scarring travels with dullness and uneven tone, UltraClear’s cold fibre resurfacing refines texture and evens colour in the same course, with less downtime than fully ablative treatment. The gradual, balanced route.
Flat marks where spots were
Flat marks that colour where spots used to be are post inflammatory pigmentation, not scarring, and they fade with a completely different toolkit. It is the most common mix up we see, and our pigmentation page covers it properly.
Method matters more
Deeper tones scar and mark more readily, and aggressive resurfacing risks pigment change, so method matters. Microneedling suits all tones, laser choices are assessed individually, and a patch test comes first as standard rather than exception.
The order matters
Scar treatment on skin that is still breaking out is money spent in the wrong order, because active acne keeps writing new damage. Calming the acne comes first, sometimes via your GP or dermatologist, and we will say so honestly before selling you anything.
Real results from our Marylebone clinic, photographed under consistent lighting. Collagen repair builds for months after each session, so treat these as an honest illustration of what is achievable rather than a promise of your own outcome.
CO2 laser resurfacing
SkinPen microneedling
Ultraclear Laser
5 months post 1 treatment
| Compare | CO2 LaserDeepest resurfacing | UltraClear LaserTexture and tone together | SkinPenCollagen induction | PicoSureScar texture, small areas |
|---|---|---|---|---|
 |  |  |  | |
| Best for | CO2 Laser Deep boxcar and ice pick scarring | UltraClear Laser Scarred texture with uneven tone | SkinPen Rolling scars, all skin tones | PicoSure Texture refinement in defined areas |
| Typical course | CO2 Laser Usually a single session | UltraClear Laser 1 to 3 sessions | SkinPen A course of 3 | PicoSure 1 to 3 sessions |
| Downtime | CO2 Laser Around a week of healing | UltraClear Laser Several days of redness and flaking | SkinPen A day or two of redness | PicoSure Minimal, brief redness |
| Skin tones | CO2 Laser Lighter tones, assessed individually | UltraClear Laser Most tones, assessed individually | SkinPen All tones | PicoSure All tones, settings matched |
| Price from | CO2 Laser £850 | UltraClear Laser £850 | SkinPen £450 face, scars from £250 | PicoSure £250 small area |
| View CO2 laser | View UltraClear | View SkinPen | View PicoSure |
Short clips from the treatment room at our Marylebone clinic, from CO2 and UltraClear to SkinPen and PicoSure.
Four routes to smoother skin, chosen by scar type and skin tone rather than fashion. Around them sit the supporting players: Enerpeel chemical peels for surface refinement, 1540nm fractional laser as a further resurfacing option, and doctor performed PRP and PRF to accelerate repair alongside microneedling.
Ablative resurfacing
The strongest tool in the box: fractional ablative resurfacing renews the damaged surface and drives deep collagen repair beneath boxcar and ice pick scars.
Usually one session, with about a week of healing.
Cold fibre laser
Refines scarred texture and evens tone in the same course, with less downtime than fully ablative resurfacing. The balanced route for texture plus colour.
One to three sessions.
Collagen induction
Thousands of controlled micro channels trigger collagen repair beneath rolling scars, gradually lifting the dips toward level. Safe across all skin tones.
A course of three is standard.
Picosecond laser
Picosecond energy remodels scar texture in defined areas with minimal downtime, and earns its keep where scarring and post acne pigment overlap.
One to three sessions.
Every plan at Dr Joney De Souza Clinic starts with a proper scar map. Your practitioner examines the skin under directional light, identifies which of the marks are rolling, boxcar or ice pick scars and which are flat pigment marks in disguise, and assesses your skin tone on the Fitzpatrick scale, because tone changes which tools are safe. Anything still breaking out gets addressed before scar work begins.
The plan then matches tool to scar type, often combining approaches across a course, and you will hear an honest ceiling before you commit, because scars soften convincingly but rarely vanish outright.
“My ‘less is more’ approach has become the mainstay of my practice and clients appreciate that they will have natural looking results.”
Dr Joney De Souza, speaking to The Sybarite
Here is what happens before, during and after treatment at our Marylebone clinic.
Your consultation maps the scar types, confirms your skin is clear enough to treat and sets the sequence. For laser treatments you will be asked to avoid sun exposure and self tan for two weeks beforehand, and a patch test comes first where tone calls for it.
Sessions run forty five to ninety minutes including numbing time, because topical anaesthetic goes on before microneedling and resurfacing. Expect warmth and prickling rather than pain, with your practitioner talking you through each pass.
Microneedling brings a day or two of redness, UltraClear several days of flaking, and CO2 about a week of healing with diligent aftercare. The real result arrives over the following two to three months as collagen rebuilds, and daily SPF is non negotiable while skin renews.
The honest split: marks yes, scars no. The flat red and brown marks acne leaves behind fade genuinely with retinoids, vitamin C and daily SPF, and that routine, built properly with ZO Skin Health prescription skincare, is worth doing regardless. Dermarollers and acid peels at home, though, cannot reach the depth where true scars live, and aggressive home experiments on scarred skin usually add irritation to injury.
Structural scarring needs energy and depth delivered precisely, which is what the in clinic tools are for. The best results pair a treatment course with a home routine that supports healing between sessions.
What treatment will not do. We would rather say this plainly. Deep scarring softens convincingly, often dramatically, but rarely vanishes to nothing, and anyone promising scar free skin is overpromising. Results build over months, vary between people and scar types, and active acne must be calmed before scar work begins.
You may also want to read about related concerns we treat alongside acne scarring, including pigmentation and open pores.
The questions our Marylebone team hears most often about acne scarring, from which scars respond best to what treatment involves and costs. If yours is not here, message us on WhatsApp and a practitioner will answer properly.
It follows the scar type. Rolling scars respond beautifully to SkinPen microneedling, deep boxcar and ice pick scars want CO2 resurfacing, and texture with uneven tone suits UltraClear. Most faces mix scar types, so most good plans mix tools.
Honestly, no, and it is worth hearing before you spend. What modern treatment achieves is substantial softening: shallower dips, softer edges, smoother texture that makeup sits well on and side light no longer exaggerates. Most people find that result transformative; nobody should be promised perfection.
Possibly not. Flat red or brown marks where spots used to be are post inflammatory pigmentation, which fades with skincare and gentle treatment rather than resurfacing. True scars change the skin’s texture, catching shadow in side light. The distinction changes the whole plan, and we check it first.
On rolling scars, genuinely well. Thousands of controlled micro channels trigger fresh collagen beneath the dips, lifting them gradually toward level across a course of three sessions. It is also the safest option across all skin tones, which is why it anchors so many of our plans.
When scarring is deep and sharp edged, because nothing else matches its depth of repair. One session achieves what gentler tools need several for, at the cost of about a week of healing. It suits lighter skin tones best, and we assess suitability honestly rather than defaulting to the biggest tool.
Yes, chosen correctly. Deeper tones risk pigment change with aggressive resurfacing, so microneedling leads, laser choices are assessed individually and a patch test comes first as standard. Treating tone safely is a method question, not a reason to go untreated.
SkinPen runs as a course of three, UltraClear and PicoSure one to three sessions, and CO2 usually one. Combination plans sequence tools across several months, and you will get an honest number at consultation once your scars are mapped rather than a guess over the phone.
Collagen rebuilds on its own schedule: expect visible change from six weeks, with improvement compounding for three to six months after each session. Scar treatment rewards patience, which is why we photograph at baseline and review under the same light rather than trusting the bathroom mirror.
A day or two of redness after microneedling, several days of flaking after UltraClear, minimal redness after PicoSure, and about a week of healing after CO2. All of it is manageable with good aftercare, and daily SPF through recovery protects the result.
No, and we will say so even though it delays a sale. Active acne keeps writing new damage, so scar work on breaking out skin is money spent in the wrong order. Calm the acne first, sometimes with your GP or dermatologist, then repair the scars properly.
As supporting players. Peels refine surface texture and help the pigment marks that travel with scarring, and they slot neatly between deeper treatments. What they cannot do alone is rebuild collagen under a true scar, which is the structural half of the job.
At our clinic, PicoSure scar work starts from £250 for a small area, SkinPen from £450 for the face, and CO2 and UltraClear resurfacing from £850. Courses are priced at consultation, and our full price list has the detail.
Verified Google reviews from patients treated for acne scarring and texture at Dr Joney De Souza Clinic in Marylebone.
I have been getting the Picosure laser facial and it has completely changed my skin! My acne scars have faded, texture is gone and my skin is glowing! Roma performs the treatment and she is so knowledgeable and kind, I highly recommend this clinic!
Had CO2 facial done about a month ago, my skin continues to look healthier, younger and less textured. The laser faded and continues to fade more stubborn acne scars.
Roma has tailored my treatments to fit in with my skin and pays a lot of attention to make sure you get the best possible results. So talented, knowledgeable and kind. I have had such amazing results with her for my facial pigmentation and my skin looks so much brighter and more even.
