Punch Graft Acne Scar Treatment

The punch graft technique is a treatment used to improve the appearance of depressed acne scars.

Acne scar removal treatment
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How Does the Punch Graft Technique Work?

First, you'll meet with the dermatologist or plastic surgeon who will be doing your procedure. There are many different ways to treat acne scars. Together, you'll decide which scars will be treated with the procedure. 

Your healthcare provider will numb the entire area with a local anesthetic before the treatment, so you shouldn't feel any pain during the procedure besides the anesthetic needle stick. 

During the procedure:

  • A small punch tool that resembles a tiny cookie cutter is used to cut out the scar. 
  • A small plug of skin, usually taken from behind your ear, is carefully placed in this void.
  • The graft is held in place with sutures, steri-strips, or special surgical skin glue.

Punch grafting is an outpatient procedure, so you don't need a hospital stay. And most people drive themselves home after the treatment is done. 

Over the next few days. the recovery is nearly painless. Typically, it takes about a week for the new skin plug to heal. You'll need to keep a dressing on for about five to seven days. The dermatologist performing your procedure will explain how to take care of your dressing. 

For some scars, a graft might not be needed. Instead, the scar is removed and a tiny opening is sutured closed. This procedure without grafting is called punch excision.

Types of Acne Scars the Punch Graft Technique Treats

The punch graft technique works only for deep ice pick or boxcar scars, or acne scars that are very deep and depressed. As the scar is removed and the skin is replaced, the depressed area is raised to the same height as the surrounding skin. The goal of the treatment is to make your skin look smoother and more even.

Although punch grafting can make a big difference in your skin's appearance, it isn't the right treatment for every type of acne scar, and there can be some drawbacks.

Things to consider about the punch graft technique:

  • It only improves the individual scars that are treated. So, if you have many scars that need addressing, it can be a long, meticulous procedure. 
  • Punch grafting can't be used to treat raised scars (called hypertrophic scars) or uneven skin tone.
  • The procedure can leave a slight scar. This scar should be smaller than the original scar. Instead of a depressed or pitted area, you'll notice a small line. 
  • The skin graft may have a different color or texture than the surrounding skin because the skin behind your ear is slightly different than the skin on your face. 

Your healthcare provider can tell you if punch grafting is a good treatment option for your acne scars.

Punch Grafting Can Be Combined With Other Acne Scar Treatments

In general, the skin should look smoother than it did prior to treatment. There can be some unevenness in the skin's appearance due to other scars that can't be treated by the procedure or as a result of the procedure. This can usually be faded using microdermabrasion or chemical peels after the skin has healed.

Since most people have several different types of acne scars, you'll probably need a few different acne treatment procedures to get the results you're looking for.

2 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.
  1. Gozali MV, Zhou B. Effective treatments of atrophic acne scars. J Clin Aesthet Dermatol. 2015 May;8(5):33-40. PMID: 26029333

  2. Lanoue J, Goldenberg G. Acne scarring: a review of cosmetic therapies. Cutis. 2015 May;95(5):276-81. PMID: 26057505

Additional Reading
  • Fabbrocini G, Annuziata MC, D'Arco V, et. al.  "Acne scars: pathogenesis, classification and treatment."  Dermatol Res Pract.   2010;2010:893080.

By Angela Palmer
Angela Palmer is a licensed esthetician specializing in acne treatment.