Skin Health Acne Professional Procedures What You Can Do About Acne Scars The Best Acne Scar Treatments and Procedures By Angela Palmer Angela Palmer Facebook Angela Palmer is a licensed esthetician specializing in acne treatment. Learn about our editorial process Updated on February 22, 2022 Medically reviewed Verywell Health articles are reviewed by board-certified physicians and healthcare professionals. These medical reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Leah Ansell, MD Medically reviewed by Leah Ansell, MD LinkedIn Leah Ansell, MD, is a board-certified dermatologist and an assistant professor of dermatology at Columbia University. Learn about our Medical Expert Board Print Table of Contents View All Table of Contents Types of Scarring What to Do First Topical Retinoids Microneedling Chemical Peels Laser Treatments Punch Techniques Subcutaneous Incision Dermabrasion Microdermabrasion Dermal Fillers Steroid Treatments Frequently Asked Questions Acne will eventually go away on its own. Acne scars, on the other hand, can be harder to deal with. The good news is that scar treatment has come a long way. Today, there are many things you can do to reduce the appearance of acne scars. This article looks at some of the types of acne scars, and what you can do about them. Verywell / Alexandra Gordon Types of Acne Scarring Acne scars form when skin tissue is damaged. Picking at and popping pimples can damage your skin and cause scars. Even if you're really careful with your skin, scars can still form. Severe blemishes and those that are very red and inflamed are more likely to scar. If you're very prone to scarring, even minor blemishes can leave scars. Different treatments are effective for different types of acne scars. Some common types of acne scars include: Ice pick scars are deep pits in the skin. They are also sometimes called pockmarks. Boxcar scars are round or oval-shaped depressions. Rolling scars happen when bands of scar tissue form under the skin. They give the skin an uneven appearance. Atrophic scars are indented but tend to be thinner and flatter than boxcar and rolling scars. Hypertrophic scars have a raised appearance. Keloid scars are thick and irregular with a lumpy appearance. What to Do First There are a few things you can do about your acne scars. First, your acne needs to be controlled. See a dermatologist if you haven't already. Don't waste time on over-the-counter products. If you have acne scars, get a prescription acne treatment right away. This will help minimize scarring overall. If you're already seeing a dermatologist, follow their directions exactly. Let them know if you have any concerns. Once your skin is fairly clear, you can decide how to treat your scars. Topical Retinoids Topical retinoids can help clear acne. They're also prescribed to treat the dark marks that blemishes leave behind. These spots are called post-inflammatory hyperpigmentation and are usually brown, red, or purple. They're common, and nearly everyone with acne gets them to some extent. These dark spots aren't true acne scars. In some cases, they even fade away without treatment. Topical retinoids help speed the process and can help fade away even stubborn marks. Topical retinoids only work on dark marks. Pitted or depressed scars need more than just topical creams. How Effective Are Retinoids in Treating Acne? Microneedling During this procedure, a device is used to create small pricks on the skin. This process stimulates healing, which can reduce some acne scars for some people. Microneedling is usually done in a dermatologist's office. It can be done with or without radiofrequency, which is sometimes used to enhance the effects of the treatment. You can also buy at-home devices for self-administered microneedling. Keep in mind that it can be risky to do this at home. You can cause serious skin damage that doesn't fix your scars. It may even produce more scarring. The risk will be higher if the device is used incorrectly. Chemical Peels During this procedure, a doctor applies a chemical to exfoliate the top layer of skin. Different chemical peels can be used for different reasons. For example, trichloroacetic acid (TCA) cross-hatching is good for ice pick scars. Other chemical peels may be more helpful for hyperpigmentation. Light chemical peels are also sometimes used to treat severe acne. Recap Microneedling helps stimulate healing, which can reduce the appearance of scars. Chemical peels may also be helpful for different types of scars. Laser Treatments Laser treatments come in two forms: Ablative Non-ablative Ablative lasers resurface the skin by removing outer layers. Non-ablative lasers create changes in the dermis, the second layer of skin. They do this without damaging the skin's surface. Ablative Lasers The most common ablative lasers used to treat acne scars are: Carbon dioxide lasersErbium-YAG lasers These lasers burn skin tissue in a controlled manner to a specific depth. This can help: Encourage smoother new skin cells to grow Reduce the depth of atrophic scars Soften the overall look of scarring It usually takes two weeks for your skin to heal after this procedure. Your skin may remain red for a while afterward. The redness fades over the course of several weeks to several months. Non-Ablative Lasers Non-ablative lasers tighten the skin and stimulate new collagen formation. They are often called lunchtime lasers because they can be done quickly. Unlike ablative lasers, there is little to no downtime. These lasers are most beneficial for mild acne scarring and pigmentation problems. They don't tend to work as well for deep, pitted scars. Raised scars and keloids are sometimes treated with a form of non-ablative laser called pulsed dye lasers. Side Effects Hypopigmentation is the loss of skin color. This is a possible side effect of laser treatment, especially in darker skin tones. Your dermatologist can tell you if you're a good candidate for laser treatment. Types of Cosmetic Laser Procedures Recap It may take a few weeks or months to recover from an ablative laser treatment. A non-ablative laser treatment is much faster, but works best on milder scarring. Punch Techniques Punch techniques include: Punch excisionPunch elevationPunch grafting These treatments can be used for ice pick scars and other depressed scars. The scar is cut from the skin with a small punch tool resembling a tiny, circular cookie cutter. After the scar is cut out, the skin is sewed closed. Ice pick acne scars. DermNet / CC BY-NC-ND A small scar may remain after this treatment. It is usually less obvious than the original one. The new scar may grow fainter with time, and it can be more easily resurfaced with techniques like microdermabrasion or laser treatment. After a scar is removed, a skin graft can be used to fill the void. The graft is usually taken from the skin behind the ear. Punch elevation may be used for deep boxcar scars with normal-looking skin at the base. During punch elevation, only the base of the scar is cut away. The dermatologist then elevates the base to the skin's surface and attaches it with sutures, steri-strips, or skin glue. After this procedure, the skin will have the same tone and texture as the surrounding tissue. Punch Graft Technique for Deep Acne Scars Subcutaneous Incision Subcutaneous incision is also known as subcision. It is used to treat rolling acne scars and some depressed acne scars. Subcision is a simple surgical procedure performed under local anesthesia. A needle or small scalpel is inserted parallel to the skin's surface. The instrument cuts the bands of tissue that tether the skin to deeper structures. The skin visibly lifts once these bands have been released. This creates a smoother appearance. Recap Surgical procedures for treating scars include punch techniques and subcutaneous incision. These techniques physically cut out the scar or detach the tissue that causes an uneven appearance. Dermabrasion Dermabrasion is performed under local anesthesia at your dermatologist's office. A rapidly rotating wire brush abrades the top layers of the skin. After healing, the scars look softer, and pitted scars aren't as deep. Dermabrasion is used to treat depressed boxcar scarring. This procedure may make ice-pick scars look more prominent. This is because ice pick scars are narrow at the skin's surface but often widen near the base. Dermabrasion was once considered the gold standard in acne scar treatment, but today it's used less often in favor of laser resurfacing. Dermabrasion may cause pigmentation changes in darker skin tones. Microdermabrasion Microdermabrasion is a cosmetic procedure performed at day spas as well as by dermatologists. It should not be confused with dermabrasion. During this treatment, a machine sprays ultra-fine aluminum oxide crystals onto the skin. The crystals are then vacuumed away. These treatments usually need to be done more than once. Microdermabrasion only removes the surface skin cells. This is why it works best on hyperpigmentation. It won't do anything for pitted or depressed scarring. What to Expect With Microdermabrasion Dermal Fillers Dermal fillers are another treatment for depressed acne scars. A filler substance is injected into the scar. This elevates the base of the scar so it is more even with the skin's surface. The results are not permanent, so it needs to be repeated after several months. Different fillers can be used, including: Human and bovine collagenHyaluronic acidFat transferred from the patient's body Your dermatologist will help you decide which filler will be best for you. What to Expect With Dermal Fillers Recap Dermal fillers can even out the surface of a scar, making skin look smoother. The effects of this procedure are not permanent. Steroid Treatments Steroid treatments are often used for raised hypertrophic and keloid scars. Steroids may be injected directly into the scar tissue. This causes the tissue to shrink or flatten, softening the scar and improving the overall appearance. Corticosteroid creams and impregnated tapes may also be used to treat these types of scars. Impregnated tapes are infused with a corticosteroid, applied over the scar, and left on for several hours at a time. This photo contains content that some people may find graphic or disturbing. See Photo Hypertrophic acne scars. DermNet / CC BY-NC-ND Summary Acne scars can form when you pick at your skin or pop pimples. Severe blemishes are also more likely to scar. Before seeking treatment for acne scars, see a dermatologist for help getting your acne under control. Once your acne has improved, there are a few different treatments available to help reduce the appearance of scars. These include microneedling and laser treatments, chemical peels, and treatments that cut out the scar. The method used often depends on the type of scarring you have. Your dermatologist can help you choose the right one. A Word from Verywell It's important to be realistic and understand that most scars can't be completely erased. But much improvement can be achieved with the right treatment or combination of treatments. Your dermatologist can recommend the best scar treatments for you. Many people choose to not treat their scars, and that's OK too. Remember, the scars are much more obvious to you than they are to anyone else. Frequently Asked Questions How can you tell if a pimple will become a scar? If you have cystic or nodular acne, it may be more likely to scar. That's because the blemishes form deep under your skin. Picking or squeezing pimples may also cause scarring, so it's best to avoid popping them so they'll heal correctly. Can aloe vera get rid of acne scars? It probably can't get rid of them, but it may be able to make them lighter. A 2018 review found that aloesin, a component in aloe vera, is effective in reducing hyperpigmentation. This includes the dark marks left behind by acne. Was this page helpful? Thanks for your feedback! Dealing with acne can be frustrating. Our free guide provides expert tips to help you take control. Sign up and get yours today. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit 8 Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Saint-jean M, Khammari A, Jasson F, Nguyen JM, Dréno B. Different cutaneous innate immunity profiles in acne patients with and without atrophic scars. Eur J Dermatol. 2016;26(1):68-74. doi:10.1684/ejd.2015.2713 Woolery-lloyd H, Kammer JN. Treatment of hyperpigmentation. Semin Cutan Med Surg. 2011;30(3):171-5. doi:10.1016/j.sder.2011.06.004 Hedelund L, Haak CS, Togsverd-bo K, Bogh MK, Bjerring P, Haedersdal M. Fractional CO2 laser resurfacing for atrophic acne scars: a randomized controlled trial with blinded response evaluation. Lasers Surg Med. 2012;44(6):447-52. doi:10.1002/lsm.22048 Hedelund L, Moreau KE, Beyer DM, Nymann P, Haedersdal M. Fractional nonablative 1,540-nm laser resurfacing of atrophic acne scars. A randomized controlled trial with blinded response evaluation. Lasers Med Sci. 2010;25(5):749-54. doi:10.1007/s10103-010-0801-1 Kim EK, Hovsepian RV, Mathew P, Paul MD. Dermabrasion. Clin Plast Surg. 2011;38(3):391-5, v-vi. doi:10.1016/j.cps.2011.05.001 Wollina U, Goldman A. Fillers for the improvement in acne scars. Clin Cosmet Investig Dermatol. 2015;8:493-9. doi:10.2147/CCID.S86478 Fabbrocini G, Annunziata MC, D'arco V, et al. Acne scars: pathogenesis, classification and treatment. Dermatol Res Pract. 2010;2010:893080. doi:10.1155/2010/893080 Hollinger JC, Angra K, Halder RM. Are natural ingredients effective in the management of hyperpigmentation? A systematic review. J Clin Aesthet Dermatol. 2018;11(2):28-37. Additional Reading Alexiades M. Laser and light-based treatments of acne and acne scarring. Clin Dermatol. 2017;35(2):183-189. doi:10.1016/j.clindermatol.2016.10.012 Fife D. Evaluation of acne scars: how to assess them and what to tell the patient. Dermatol Clin. 2016;34(2):207-13. doi:10.1016/j.det.2015.11.009 Werschler WP, Few JW, Jacob CI, Joseph JH, Spencer JM, Taub AF. Advancing the care of post-acne scarring: expert insights into new treatment options. J Drugs Dermatol. 2016;15(5):518-25. Zaleski-Larsen LA, Fabi SG, McGraw T, Taylor M. Acne scar treatment: a multimodality approach tailored to scar type. Dermatol Surg. 2016;42(Suppl 2):S139-49. doi:10.1097/DSS.0000000000000746 Zouboulis CC, Bettoli V. Management of severe acne. Br J Dermatol. 2015;172(Suppl 1):27-36. doi:10.1111/bjd.13639