What's the Best Treatment for Acne Scars?

Treatments for acne scars include resurfacing procedures, fillers, skin tightening, collagen induction therapy, electrodesiccation, injections, surgery, laser therapy, cryosurgery, and scar creams/gels/silicone dressings.

Acne (acne vulgaris) is a common skin condition characterized by chronic or recurrent development of pimples, papules, pustules, or nodules on the skin. Acne can result in permanent scarring of the skin after the lesions have healed.

Different types of acne scars include: 

• Ice pick: small, deep pits
• Rolling: wide and shallow  
• Boxcar: sharp angles and edges; may be deep or shallow 
• Keloid and hypertrophic: raised scar 
• Skin discoloration: dark spots that appear red to purple in color
• Perifollicular elastolysis (PFE): flesh-colored or yellow lesions (uncommon)

Over time, the appearance of mild acne scars may diminish on their own. 

The best way to ensure that acne doesn’t scar is to treat it properly so it heals without scarring, however, there are a number of dermatological treatments available to get rid of acne scars or reduce their appearance. The best treatment for acne scars depends on the type of scarring. 

Treatments for acne scars include:

• Resurfacing procedures
  • The best treatment for scars that are nearly flat (not very deep)
  • Removes layers of skin allowing for the production of new skin cells
    • Laser skin resurfacing
    • Chemical peels 
    • Dermabrasion 
    • Microdermabrasion (not the same as home microdermabrasion kits)
• Fillers
  • The best treatment for a few depressed scars, but not icepick scars
  • Some are temporary, lasting between 6 to 18 months, and some are permanent
  • Fillers may include: 
    • Collagen
    • The patient’s own fat
    • Other substances
• Skin tightening
  • The best treatment for depressed acne scars; may sometimes effectively treat deep icepick and boxcar scars 
  • Radiofrequency to tighten the skin and make depressed acne scars less noticeable
  • Requires repeat appointments and some home care 
• Collagen-induction therapy
  • The best treatment for widespread depressed acne scars; not used for raised acne scars
  • Also called “needling” or “micro-needling” 
  • A sterile, handheld needle-studded roller is moved across depressed acne scars to puncture the skin
  • Encourages the body to produce more collagen as it heals
  • Usually requires between three and six treatments done every two to six weeks 
  • It may take several treatments and up to nine months to see results
• Electrodesiccation
  • Best treatment as part of a treatment plan to shape or reduce the edges of boxcar scars, and diminish raised scars
  • Uses electric probes to heat the tissue, which causes the tissue to die
• Injections
  • The best treatment for painful raised scars
  • Medicine may be injected directly into the scars to soften and flatten raised, thick scars
  • Usually requires repeat visits, once every few weeks
  • The skin may be injected with: 
    • Corticosteroids
    • Chemotherapy medicine called fluorouracil (5-FU) 
    • Interferons also used to treat cancer
• Acne scar surgery 
  • The best treatment for a few depressed scars
  • A minor procedure used for very noticeable acne scars
  • A dermatologist lifts the scar or breaks up the scar tissue to create a less-noticeable scar
• Acne scar surgery, followed by injections or radiation
  • The best treatment for raised scars that need stronger treatment than injections alone can provide
• Laser therapy
  • Effective for most types of acne scars
  • Pulsed dye laser (PDL) can diminish color and flatten a raised scar
  • Intense pulsed light (IPL) also may be a treatment option for people with lighter skin
• Cryosurgery
  • The best treatment to diminish raised scars in people who have lighter skin, but not recommended for people who have the skin of color
  • Freezes scar tissue, causing it to die and gradually fall off
  • Often combined with corticosteroid injections
• Scar creams, gels, and silicone dressings
  • Can help reduce scar size and discomfort but are unlikely to eliminate a raised scar?
  • May be available without a prescription
  • Can be used at home to shrink, flatten, and fade raised scars
  • Often helps reduce itch and discomfort
  • Products must be used continuously to be effective