Chemical peel Vs laser for mild to moderate acne scarring - which one is better? (Photo)

Question

Overall which is better for mild to moderate acne scarring? I have some box car scars, some rolling scars. I’ve had Fraxel restore laser done and also Skin pen micro needling and saw zero difference. Im not expecting a miracle from anything, just at least something noticable. Do chemical peels offer more results? Sometimes I feel like these lasers are a scam.

Anil R. Shah, MD · Answer

My name is Ranen and I am an aesthetic nurse at Aesthetic Skin in Chicago.  Thank you for sharing your photos with us.  I would actually recommend doing a combination of modalities including Cross TCA in individual scars and full face Co2.  It would be multiple treatments.  If you have further questions please feel free to contact me 312-944-0117.

Nelson Lee Novick, MD · Answer

If you're looking for acne scar treatments that have stood the test of time for both safety and efficacy, consider subcision for elevating and smoothing Indented boxcar and rolling scars. I have personally been performing subcisions for these kinds of scars (as well as for Indented post-surgical, post-traumatic and post-infectious scars--like chickenpox scars-- for over thirty years with gratifying results.
For ice pick scars and dilated pores (as well as btw unwanted piercing holes), I have been employing TCA CROSS with gratifying results for nearly a quarter of a century. 
And for treating any residual, superficial skin color or textural Irregularities, I have been using manual microneedling (no need for the added expense and risks of RF microneedling) for better blending of the treated scars with the surrounding normal skin. On average a 60-80% overall improvement can be anticipated after an average of about three to four treatment sessions for each of the aforementioned treatment modalities. 
I commend you on a healthy skepticism of the expensive, fancy-named light and energy-based gizmos being hawked out there ,since the hard science to support their use unfortunately lags well behind the heavy marketing hype and social media buzz to promote them. My regular readers are well aware that I have been urging "buyer beware" for years when it comes to these often here-today-gone-tomorrow "bells and whistles" gizmos I am truly sorry that you had to learn this the hard way.  
You would be wise to consult with an experienced, board certified cosmetic dermatologist acne scar treatment specialist. Hope this helps and best of luck going forward.

Anna Chacon, MD, FAAD · Answer

Thank you for sharing your concerns and being so clear about your expectations. For mild to moderate acne scarring, especially when you have a mix of boxcar and rolling scars, the approach really depends on your skin type, scar depth, and how your skin responds to treatments.

Lasers like Fraxel and microneedling can help, but they often require multiple sessions and sometimes the results are subtle, especially for scars that are deeper or more textured. It’s not uncommon to feel like they “don’t work,” particularly if the scarring is more complex or if the skin’s natural healing response is slower.

Chemical peels, on the other hand, work differently—they resurface the skin more superficially or moderately depending on the type of peel. Medium-depth peels, for example, can smooth out texture irregularities and improve overall skin tone, which may make rolling scars appear less noticeable. However, peels typically are more effective on surface-level irregularities rather than deep boxcar scars.

Honestly, for mild to moderate acne scarring, sometimes a combination approach works best—targeting deeper scars with subcision or filler, and improving overall texture with peels, microneedling, or fractional lasers. The key is realistic expectations: you likely won’t get a “perfect” result, but with the right tailored approach, you can achieve noticeable improvement.

I understand your frustration—some laser treatments can feel overhyped—but when matched to the right scar type and skin condition, both lasers and peels do have value. It’s about finding the best fit for your specific scars.

Chemical peel Vs laser for mild to moderate acne scarring - which one is better? (Photo)

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