The author provides a detailed discussion of acne scarring, underpinned by statistics, reflecting the current prevalence. The pathogenesis of acne scarring, different types of scars and severe psychological impact are explored with emphasis on providing evidence-based treatments in aesthetic practice. The three stages of wound healing are comprehensively described, with supporting clinical images of keloid, atrophic and ice-pick scars, as well as post-inflammatory hyperpigmentation. Emphasis is placed upon the importance of assessing the emotional and social impact of acne scarring and the aesthetic clinician is advised to utilise screening tools when treating all aspects of acne. Referenced clinical recommendations for treatment are made for each type of scarring with discussion around the challenges of treating keloid and hypertrophic scarring. A brief overview of treatment modalities available in aesthetic practice to treat scars is described with some discussion on topical treatments. Aesthetic clinicians are advised to remain mindful of treatment limitations and the potential risks of worsening the appearance of scars. A greater emphasis could have been placed on specialist referral where complex presentations may arise in aesthetic practice.