Five Questions to Ask Before Booking Laser Treatment for Acne Scarring – by Dr Anjali Mahto, London Dermatologist
Acne scarring is one of the most emotionally and physically challenging consequences of acne, and one of the most misunderstood. Many patients, desperate for smoother skin, book laser treatments without being fully explained the nuances of the technology or the expertise required to achieve results safely; misinformation on social media does not help. But not all clinics, devices, or practitioners are created equal.
At Self London, we see patients every week who have had suboptimal outcomes elsewhere: minimal results after multiple sessions, unexpected pigmentation changes, or simply confusion about what their treatment involved. In most cases, these patients were never given a clear diagnosis, a structured treatment plan, or any real explanation of what to expect.
If you are considering laser treatment for acne scarring, these five questions can help you navigate your options with confidence, and ensure you choose a clinic that will treat your skin with the respect and expertise it deserves.
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Have I received an accurate diagnosis of my scars and do I understand which types I have?
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Acne scarring is not one condition, it is an umbrella term for a spectrum of scar types, each requiring different management. The most common include:
✔ Atrophic scars (such as boxcar, ice pick, and rolling scars)
✔ Hypertrophic or keloid scars
✔ Post-inflammatory erythema (redness) or hyperpigmentation (dark marks)
Each of these responds differently to treatment. For instance, ice pick scars often require deeper, targeted procedures such as punch excision, TCA CROSS or laser coring. Rolling scars benefit from subcision and polynucleotides followed by fractional or full-field resurfacing. Surface pigment or redness may respond to different wavelengths altogether and none of these concerns are improved by “laser facials” alone if there is indentation in the skin.
An expert will examine your skin clinically and, ideally, take diagnostic imaging (e.g. VISIA) to assess scar depth, skin type, and associated conditions before treatment. At Self London, we believe this is the most important part of the process: if your scars are not properly classified, your treatment cannot be appropriately planned.
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What kind of laser or device is being used and is it appropriate for my skin and scars?
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“Laser” is often used as a catch-all term, but there are profound differences between devices. Key distinctions include:
✔ Ablative vs. non-ablative: Ablative lasers (e.g. CO₂ or Er:YAG) remove layers of skin and are often most effective for deeper scarring. Non-ablative devices penetrate the skin without removing its top layer and can stimulate collagen with less downtime.
✔ Fractional vs. full-field: Fractional lasers create microscopic zones of injury, allowing faster healing and reduced risk. Full-field lasers treat the entire surface and require greater care.
✔ Wavelength and pulse duration: This relates to how deep the laser is penetrating in the skin and for how long, and can be adjusted depending on the skin type, condition of concern and its extent and severity.
Not all lasers are suitable for every skin type. For example, darker skin types (Fitzpatrick IV–VI) require careful selection to avoid pigmentary complications. At Self London, we routinely treat all skin types and tailor every protocol to minimise risk, but many clinics lack the equipment or experience to do so.
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Is this treatment part of a comprehensive plan, or a one-off recommendation?
Acne scar treatment is rarely solved in one session. It typically requires a personalised plan combining multiple approaches — laser resurfacing, polynucleotides, subcision, needling, prescription skincare, and more. Skilful layering of techniques over time, with appropriate recovery, is key to achieving natural, meaningful results.
Many clinics offer standalone laser sessions with little or no context. But scarring should never be approached piecemeal. Just as a sculptor works in stages, great scar revision relies on sequence, timing, and anatomical understanding.
At Self London, every treatment plan begins with a medical diagnosis and an in-depth consultation. Prescription skincare and evidence-based topical actives may be used to prime the skin beforehand. Post-laser protocols are carefully managed. And as the plan progresses, we adjust based on your results, not a pre-set number of sessions.
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Who is performing my treatment, and what experience do they have?
This is perhaps the most important and most overlooked question.
Laser treatment is a medical procedure. It requires in-depth understanding of laser physics, tissue interaction, skin anatomy, and risk management. Yet in many settings, lasers are delegated to inexperienced practitioners with minimal training. Devices are powerful and in untrained hands, complications can and do occur.
At Self London, all laser-based treatment plans are overseen by our founder, Dr Anjali Mahto — a consultant dermatologist with over a decade of laser experience and a global reputation in acne care. Our therapists are trained under her direct supervision and protocols are built from real-world evidence and clinical outcomes. Our devices are not generic machines; they are chosen like surgical instruments — specific tools for specific indications.
This level of care is rare and it shows in our results.
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What are the risks, and how does this clinic manage them?
Laser treatment, when performed correctly, is safe and effective. But like any medical procedure, it carries potential risks: temporary redness, swelling, temporary pigmentation change, infection, or rarely, scarring. These are more likely when the wrong device is used, when protocols are too aggressive, or when post-treatment care is poorly managed.
An expert-led clinic will not over-promise. They will tell you what is realistic, prepare your skin appropriately, give you time to reflect before booking you in for treatment, adequate time to consent, and then follow up closely. They will also have a plan in place to manage any issues should they arise and take responsibility for your outcome.
We often hear of patients who are told their results are “normal” when they intuitively know something is wrong. At Self London, we believe in transparency, medical accountability, and honest follow-up because your trust is not something we take lightly.
Why do laser results vary so widely between clinics?
Because every element of treatment matters: diagnosis, device selection, protocol, skin type, practitioner experience, and post-care. The laser itself is only one part of the equation. Just as two pianists can produce very different sounds from the same Steinway, the same device in different hands and different clinics can deliver entirely different outcomes.
This is especially true when the goal is scar improvement, not just skin refreshment. Subtle changes in technique, pulse stacking, energy levels, and even treatment intervals make a difference. At Self London, we are obsessive about these details because our patients trust us to do more than just “run the laser.” They trust us to restore their confidence.
A note on pricing and perceived value
It is understandable that patients may seek out lower-cost providers for laser. But laser treatment is where expertise, not just equipment, truly matters. Saving £200 on a session is a false economy if the treatment is ineffective, or worse, damaging.
We know this can be hard to navigate. We often act as second opinion for patients unsure of where to begin. Our advice is always the same: choose the clinic where you feel seen, understood, and cared for. Where your plan is explained. Where your results are taken seriously.
Final thoughts
Laser treatment for acne scarring is not a one-size-fits-all solution. It is a journey that requires trust, skill, and long-term thinking. If you are ready to take that step, ask the right questions — and choose a clinic that is prepared to answer them thoroughly, without pressure or gimmicks.
At Self London, we combine medical expertise with cutting-edge technology and we take pride in crafting plans that are as individual as your skin. Whether you are looking to treat longstanding scars or simply want to understand your options, we are here to guide you with intelligence, care, and honesty.
Book a consultation with us to start your journey.
