Acne scarring treatment advice – best options for my skin? (Photos)

Question

I’m looking for advice on treating acne scars. I’ve attached photos for reference. I’ve had acne in the past, and while it has mostly cleared, I’m left with visible scarring. Any advice would be appreciated.

Anna Chacon, MD, FAAD · Answer

Thank you for sharing this, and I completely understand how lingering acne scars can feel frustrating even after the breakouts themselves have improved. The good news is that acne scarring is very treatable, but the best results almost always come from a combination approach, rather than a single treatment.

From what you’re describing, post-acne scarring typically falls into a few categories—textural changes (like shallow or deeper indentations), discoloration (red or brown marks), and uneven skin surface. Each of these responds to different types of treatments.

1. For texture and indented scars

If there are areas that look like shallow dents or uneven skin, we usually focus on stimulating collagen and remodeling the skin:

Microneedling (with or without RF) – very helpful for overall texture improvement and gradual collagen rebuilding
Fractional laser resurfacing (CO2 or erbium) – more intensive, but can significantly improve surface irregularities
Subcision – used when scars are tethered or “pulled down” under the skin
In some cases, very small amounts of filler can be used to lift deeper individual scars
2. For redness or brown marks (post-inflammatory pigmentation)

These are often just as noticeable as texture and usually respond very well to:

Medical-grade skincare (retinoids, azelaic acid, vitamin C)
Chemical peels (light to medium depth)
Laser treatments targeting pigment or redness
Most importantly, consistent broad-spectrum SPF 50+, because sun exposure can prolong discoloration
3. For overall skin quality

Even when scars are mild, improving overall skin quality can make a big difference in appearance:

Collagen-stimulating treatments (microneedling or RF)
Gentle resurfacing procedures
A consistent topical regimen to maintain long-term results

The most important thing to know is that acne scarring is not usually corrected with one treatment. The best outcomes come from layering treatments over time—addressing texture first, then pigmentation, and then refining the skin surface.

While scars may not disappear completely, they can often be significantly softened so that they are much less noticeable in everyday lighting and photos.

Nelson Lee Novick, MD · Answer

The title to this answer says it all:  Subcision, which I have been performing for over thirty years has a proven track record for both safety and efficacy for elevating and smoothing atrophic (indented) boxcar and rolling scars.  TCA CROSS, which I have been performing for over a quarter of century has a proven track record for safety and efficacy for improving ice pick scars and dilated pores. 
By contrast, the use of the expensive light and energy-based gizmos being hawked so much out there these days and promoted by heavy marketing hype and social media buzz, unfortunately, to date, lacks the rigorous hard science backing to support all the hype. 
You would be wise to consult an experienced, board certified cosmetic dermatologist scar treatment specialist and to exercise a whole lot of ?buyer beware" caution if hawked the expensive device treatments, rather than Subcision and TCA CROSS that have stood the test of decades of time. 
Hope this helps and best of luck.

Acne scarring treatment advice – best options for my skin? (Photos)

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