Acne Scars Treatment Overview

By RealSelf
There are lots of ways to treat acne scarring—finding the right treatment depends on the nature of the scars. Popular options include laser resurfacing, dermabrasion, and chemical peels. Some acne scars are more superficial and appear in the form of small areas of hypopigmentation on the skin. Other acne scars are more severe, appearing as deep divots or large, raised scars that significantly affect skin texture.
Types of acne scars include:
  • Icepick acne scars
  • Rolling acne scars
  • Boxcar acne scars
  • Raised acne scars (Keloid or hypertrophic scars

Acne scar causes

The inflammation caused by acne can often leave wounds in the skin. As acne wounds heal, an abundance of collagen can get left behind, forming acne scars that make the skin appear uneven. Acne can also cause post-inflammatory hyperpigmentation (PIH), a skin discoloration left behind after an inflamed acne wound has caused over-production of melanin in the skin. PIH is not true acne scarring, however, and will typically fade over time.

Acne scar removal

The first step in treating acne scars is to stop the formation of new acne. From there, acne scar treatments should be customized depending on the characteristics of your skin and scars.
  • For a few small, shallow acne scars, less aggressive treatment that involves concealing your acne scars with an injectable filler may be in order.
  • A large number of deep acne scars is more likely to require surgical excision combined with a series of dermabrasion treatments or aggressive laser peels.
Acne scars before and after laser treatment
Patient of New Orleans Dermatologist Mary Lupo, MD before and after acne scars
Before deciding on an acne scar treatment, consult a board certified doctor to determine what's best for your specific situation and set realistic expectations for what you can achieve. In many cases, acne scars cannot be completely removed, only improved.

How to get rid of acne scars

  • CO2 laser - Includes Fraxel Repair Laser, Active FX and Deep FX, Juvia and others; usually requires one treatment with significant downtime
  • Erbium laser - Includes Fraxel Restore Laser, ProFractional Laser and others; usually performed in a series with minimal downtime
  • Dermabrasion for acne scars - Small, rapidly spinning wheel with a roughened surface similar to fine-grained sandpaper is used to remove the upper layers of your skin
  • Subcision - Used for rolling acne scars, to break up fibrous bands of tissue under the skin
  • Punch excision - Small, sharp punch instrument is used to cut out severe boxcar or icepick acne scars; surrounding skin is sutured together
  • Punch graft - Same as punch excision, but instead of suturing surrounding skin together after the acne scar is excised, skin is taken from another body area and grafted to the former location of the scar
  • TCA chemical peel - Performed at a variety of depths depending on acne scar severity
  • Salicylic chemical peel - Sometimes treatments combine with microdermabrasion treatment, e.g. SilkPeel
Injectable fillers are also used to fill in acne scar depressions:

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