Acne Scars Treatment Overview

With a RealSelf Worth It Rating in the 90s, finding a treatment for acne scars should be fairly straightforward with the help of a board certified doctor. 

Acne scar treatments depend on the severity of your case. Some acne scars are more superficial and appear in small areas of hypopigmentation, or loss of skin color. Other acne scars are more severe, appearing as deep divots or large, raised scars that can significantly affect skin texture. Laser resurfacingdermabrasion, and chemical peels are all popular options. 


Types of acne scars include:

  • Ice pick acne scars: Tiny dots, or deeper, narrow scars.
  • Rolling acne scars: These look like small waves in the skin.
  • Boxcar acne scars: Broader scars with deep, defined edges (like a box).
  • Keloid or hypertrophic (raised) scars: Scarred tissue is raised above healthy tissue.


Acne scar causes

Acne inflammation can often wound the skin. As acne wounds heal, an abundance of collagen can be 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 usually fade over time.


Acne scar removal

The first step in treating acne scars is to stop new acne from forming. From there, acne scar treatments should be customized based on your skin and scars. 

For small, shallow scars, dermal fillers work well. Deep acne scarring is more likely to require surgical excision combined with a series of dermabrasion treatments or aggressive laser peels.

Always consult with a board certified doctor to determine the best treatment for you and set realistic expectations. In many cases, acne scars can only be improved and not completely removed. 


Acne scars before and after laser treatment

PHotos: DR. MARY LUPO


Acne scar treatments:

  • CO2 laserIncludes Fraxel Repair Laser, Active FX, and Deep FX, Juvia, and others. These types of lasers usually require one treatment with significant downtime.
  • Erbium laser: Includes Fraxel Restore Laser and ProFractional Laser. These are usually performed in a series with minimal downtime.
  • Dermabrasion: A small, rapidly spinning wheel with a surface similar to fine-grained sandpaper removes the upper layers of your skin.
  • Subcision: Used for rolling acne scars, to break up fibrous bands of tissue under the skin.
  • Punch excision: A small, sharp punch instrument is used to cut out severe boxcar or ice pick acne scars. The surrounding skin is then sutured together.
  • Punch graft: Follows the same process as a punch excision, but instead of sutures, skin from another body area is grafted to the scar.
  • TCA chemical peel: This trichloroacetic acid peel can be customized by strength to treat the severity of scarring. 
  • Salicylic chemical peel: These acne-fighting treatments can be combined with microdermabrasion, aka a SilkPeel.


Dermal fillers for acne scars:

Dermal fillers can also be effective treatments to help reduce the visibility of acne scarring. The most popular dermal fillers for this include those made with hyaluronic acid, like Restylane and Juvederm, a naturally occurring substance in the skin. Fat transfer is also an effective way to fill acne scars.

*Treatment results may vary

Dr. Michele Green explains why a combination of treatments may be needed to treat acne scars.

Explore more:

Read reviews on acne scar treatments.

Read doctor Q&As about acne scar treatments.

See before and after pictures.

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