You photograph your acne scars every month, yet still can't tell if they're improving: how to track progress accurately

Taking monthly photos of acne scars makes it hard to recognise progress if you change the angle or lighting, or photograph while the skin is still swollen. For more accurate tracking, keep the photo conditions fixed and have an in-person examination with your doctor.

Quick summary:

• Keeping the device, distance, angle and light source consistent helps limit discrepancies when comparing images.
• Swelling, discolouration or bruising after a procedure can make scar depth hard to judge by eye.
• Self-taken photos cannot replace a clinical assessment by a doctor and should not be used to calculate your own percentage of improvement.

Keep lighting, angle and device consistent

According to clinical photography standards published in medical literature, comparing results over time is more reliable only when you keep the camera or capture device, distance, viewing angle, background, framing and lighting fixed. When photographing at home, if you stand just a few steps off or the light source shifts from front-facing to one side, the shadows cast by the scar edges change immediately. A rolling scar can look deeper or shallower simply because of the shadowing effect of the room light.

There is currently no mandatory fixed standard for the distance of photos taken at home, nor a strict rule on how often to photograph each month. However, trying to repeat the same standing position, the same room and the same camera angle each time you record your progress will help reduce misleading impressions caused by changes in the surrounding environment.

Avoid smoothing effects and post-editing

Clinical photography standards state clearly that post-processing techniques must not be used to enhance the appearance of the actual result. Many mobile devices now automatically turn on beauty mode, skin smoothing or shadow brightening when taking portraits. These features can artificially flatten the scar surface in the photo, creating the impression that the skin surface has visibly filled in.

Conversely, when you turn these filters off for the next photo, the image may make your skin seem to have worsened, even though the actual scar tissue structure has not changed. Therefore, turning off all software-based features and keeping the original, unedited photos is important so that you do not make inaccurate judgements about your own progress.

Wait for swelling and redness to settle before comparing

According to the American Academy of Dermatology (AAD), swelling or skin discolouration after a procedure can distort initial visual comparisons. BonBoz guidance also notes that after some scar procedures such as TCA CROSS, CO2 laser or subcision, swelling or bruising may appear, and small scabs may flake off after about 4 to 7 days.

Specific recovery varies depending on the procedure and the individual, so aftercare should follow the instructions of your treating doctor. When the skin is still swollen, bruised or discoloured, early photos can make comparison unreliable. Take follow-up photos at the times your treating doctor advises, rather than picking the same interval yourself for every procedure.

Photos cannot replace a professional examination

According to the AAD, planning acne scar treatment requires considering many factors: scar type, number, location, age, skin tone, desired goals and other related factors. Scar types such as ice pick scars and rolling scars may need different approaches. For atrophic scars, people may need more than one procedure, including methods such as chemical peels, dermal fillers, laser resurfacing, microneedling, platelet-rich plasma (PRP), radiofrequency, scar surgery or dermabrasion. Among these, scar surgery can help lift the scar away from the underlying tissue.

In particular, if acne is still flaring up, treatment usually begins with acne control to reduce inflammation and prevent new scars from forming. Phone photos do not replace a doctor directly examining the type, number and location of scars or assessing active acne. Instead of scoring your own percentage of improvement on a screen, you should bring a consistent set of photos to your consultation about acne scar treatment.

References

• AAD - Acne scars: Consultation and treatment
• AAD - Acne scars: How to care for your skin after treatment
• PMC - Clinical photography standards
• PubMed - Standards in dermatological photography

Frequently asked questions

Is it suitable to use the phone's front camera to track scars?

There is no general rule requiring the front or rear camera. What matters is keeping the same device, distance, angle and lighting across shots, while turning off beauty or smoothing filters.

How often should I take photos to track scars?

Standard medical literature currently does not specify a fixed monthly frequency for photos taken at home. Instead of photographing too often, which can cause psychological pressure, you should take photos before the procedure and at follow-up visits as directed by your treating doctor.

Why do scars look different in photos taken on the same day?

Small changes in the direction of natural light, the tilt of the face relative to the camera or changes in the room lighting all create different shadows along the scar edges, making the depth of the scar look noticeably different in photos even when taken on the same day.

How do skin-smoothing photo apps affect tracking?

Skin-smoothing apps blur scar edges and the contrast of the tissue surface, masking the true condition of the skin. This leads to misconceptions about results and makes it harder to assess treatment progress objectively.

This content was written by the BonBoz Clinic Editorial Team and cross-checked against the medical sources cited in the article.

This content is for reference only and does not replace an in-person examination and consultation with a doctor.