Mr. Onur Gilleard
Qualifications & Experience
Mr Onur Gilleard is a distinguished consultant plastic surgeon on the GMC specialist register. He previously held an NHS consultant post at St Bartholomew’s Hospital in London, specialising in skin cancer and microsurgical reconstruction. In 2021, Mr Gilleard transitioned from the NHS to dedicate himself fully to private practice, allowing him to focus exclusively on providing personalised, high-quality care to his patients. He is recognised as an expert in laser treatments, having conducted research and developed advanced treatment protocols using cutting-edge laser technology to optimise both clinical outcomes and cosmetic results.
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There’s no single “best” acne scar treatment — the right one depends on the type of scar. For atrophic (sunken) scars such as boxcar and rolling scars, CO2 laser resurfacing gives the most significant improvement; tethered rolling scars often also need subcision. Microneedling and chemical peels help milder, shallower scarring and texture. Pigment marks left after acne (post-inflammatory hyperpigmentation) are a colour problem, not a contour one, and are treated differently again. The best results usually come from a tailored, often combined plan — chosen by an expert, and adjusted carefully for your skin tone. This guide matches the treatment to the scar.
Know Your Scar Type First
- Atrophic (sunken) scars — the commonest acne scars: ice-pick (narrow, deep), boxcar (wider, sharp-edged), and rolling (broad, wavy, often tethered below).
- Hypertrophic / keloid scars — raised, firm scars, more common on the jaw, chest and back.
- Post-inflammatory hyperpigmentation (PIH) — flat brown or red marks left after a spot; a pigment issue, not a true scar.
The Treatments Compared
| Treatment | How it works | Best for | Downtime |
|---|---|---|---|
| CO2 laser resurfacing | Removes micro-columns of skin and stimulates collagen remodelling. | Atrophic — boxcar, rolling, some ice-pick. | Several days to ~1–2 weeks. |
| Microneedling | Fine needles trigger collagen via controlled injury. | Milder, shallower scars and texture. | 1–3 days. |
| Chemical peels | Controlled exfoliation of the surface layers. | Superficial scarring and PIH. | Variable; deeper peels longer. |
| Subcision | A needle releases the fibrous tethers under a rolling scar. | Tethered rolling scars (often with laser). | Bruising for a few days. |
For the CO2 option in depth, see our CO2 laser for acne scars guide and ablative vs non-ablative lasers.
Matching Treatment to Scar
- Boxcar & rolling (atrophic): CO2 laser resurfacing is the workhorse; rolling scars often need subcision first — see CO2 for rolling scars.
- Ice-pick: very narrow deep scars may need focused techniques alongside laser.
- Mild/shallow scarring: microneedling or peels can be enough.
- PIH: treated with pigment-focused care and sun protection, not resurfacing.
Most people with significant scarring do best with a combined plan; honest expectations matter, so read realistic improvement percentages.
A Note on Skin Tone
In richer skin tones (Fitzpatrick IV–VI), aggressive resurfacing carries a higher risk of post-inflammatory hyperpigmentation, so laser settings and combinations are chosen carefully and conservatively. An expert who treats all skin tones — and is honest about the trade-offs — is essential. London Skin Clinic’s CO2 laser resurfacing is consultant-led for this reason. Book a scar assessment.
Frequently Asked Questions
- What’s the best treatment for acne scars?
- It depends on the scar type. CO2 laser resurfacing gives the biggest improvement for atrophic boxcar and rolling scars; microneedling and peels suit milder texture; tethered rolling scars often need subcision; and pigment marks (PIH) are treated separately. A tailored, often combined plan works best.
- Is laser better than microneedling for acne scars?
- For deeper atrophic scars, CO2 laser resurfacing generally achieves more than microneedling, which suits milder, shallower scarring. Microneedling has shorter downtime, so the choice balances scar depth against recovery time — an assessment decides which fits you.
- Can treatments be combined?
- Yes, and they often are. Subcision plus CO2 laser is a common combination for rolling scars, and resurfacing may be staged with pigment care. Combining treatments to match your specific mix of scars usually gives the best overall result.
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