Treatment for Acne Scars matched to their type and your skin—there’s no single cure-all. For most people, a combination of dermatologist-proven procedures (like lasers, microneedling, chemical peels, or fillers) and targeted at-home topicals delivers the fastest, most noticeable improvement.
You’ll learn which procedures target pitted scars versus dark spots, how at-home acids and retinoids fit into a plan, and what to expect from recovery and results. This article breaks down the evidence-based options and helps you choose the safest, most effective path for your skin.
Evidence-Based Treatments for Acne Scars
Best Treatment for Acne Scars target texture, pigment, and volume. Expect procedures that remodel collagen, resurface skin, or replace lost tissue; many people need a combination for best results.
Laser Therapy Options
Laser treatments fall into two main categories: ablative and non-ablative. Ablative lasers (e.g., fractional CO2, erbium) remove microscopic layers of skin and stimulate robust collagen remodeling; they yield the largest improvement for deep icepick or boxcar scars but require several days to weeks of healing and carry higher risk of temporary redness or pigment changes.
Non-ablative lasers (e.g., fractional 1550 nm) heat deeper dermal layers without significant epidermal removal. You’ll see gradual improvement across multiple sessions with less downtime and lower risk.
Consider skin type, scar depth, and downtime tolerance when choosing a laser. Darker skin tones need careful parameter selection or test spots to reduce post-inflammatory hyperpigmentation. Ask your provider about expected session count, pain control, and postprocedure sun protection.
Microneedling Procedures
Microneedling creates controlled micro-injuries to trigger collagen and elastin production. You can choose between manual dermarollers, automated pen devices, and radiofrequency microneedling (RF microneedling), which adds thermal energy to boost tightening and deeper remodeling.
Standard microneedling suits rolling and boxcar scars; RF microneedling often gives better results for tethered or deep scars by releasing fibrous bands and stimulating volumetric lift.
Expect 3–6 treatments spaced 4–8 weeks apart. Side effects are usually mild: transient redness, pinpoint bleeding, and brief swelling. Avoid aggressive microneedling on active acne, and follow wound-care and sunscreen guidance to reduce infection and pigment risks.
Chemical Peels for Scar Reduction
Chemical peels remove injured surface layers and promote epidermal turnover and dermal remodeling. Superficial peels (glycolic, salicylic) improve pigmentation and mild texture irregularities with minimal downtime. Medium-depth peels (trichloroacetic acid 20–35%) can soften shallow boxcar scars and visible textural unevenness but require healing time and careful pre- and post-care.
Deep peels deliver pronounced resurfacing but carry higher complication rates and longer recovery; they’re rarely first-line for acne scarring because lasers or combined approaches can be safer and more predictable.
Match peel strength to scar type and skin phototype. Providers often combine peels with other treatments to target both pigment and texture while minimizing repeated trauma to the skin.
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Dermal Fillers and Injectable Solutions
Fillers offer immediate correction of atrophic (depressed) scars by replacing lost volume. Hyaluronic acid fillers provide reversible, adjustable lift and are useful for rolling and some boxcar scars. Polymethylmethacrylate (PMMA) microsphere injections and collagen stimulators (e.g., poly-L-lactic acid) produce longer-lasting volumization by inducing collagen formation.
Subcision often pairs with fillers: a needle releases tethered scar bands, then filler prevents reattachment and smooths contour. Expect minimal downtime and predictable short-term results with injectables, but maintenance treatments may be needed depending on filler type.
Discuss risks like bruising, infection, and overcorrection with your clinician. Your practitioner should evaluate scar depth, skin quality, and aesthetic goals to recommend the appropriate filler and treatment interval.
Choosing the Best Treatment for Your Skin
Match treatment to scar type, skin tone, and healing capacity. Prioritize options that address the depth of damage, minimize pigment risks, and fit your recovery timeline.
Assessing Scar Types and Skin Tone
Identify your scar shapes: rolling scars respond well to subcision and fillers, boxcar scars often improve with resurfacing (laser or TCA CROSS), and icepick scars may need punch excision or deep chemical approaches. Track how many scars are shallow versus deep to guide whether you need surface treatments, structural repair, or both.
Note your skin tone. Darker skin (Fitzpatrick IV–VI) has higher risk of post-inflammatory hyperpigmentation from aggressive lasers or deep peels. You’ll often need lower-fluence lasers, non-ablative modalities, conservative peel depths, and pre- and post-procedure pigment control (topical hydroquinone alternatives, retinoids, strict sunscreen).
Get a professional assessment. A dermatologist or experienced aesthetic provider can map scar types, test treatment responses on a small area, and suggest devices and energy settings tailored to your tone and risk profile.
Combining Treatments for Optimal Results
Combine approaches to treat different layers: use deep collagen-stimulating procedures (microneedling, fractional RF, subcision, fillers) for structural volume loss, plus superficial resurfacing (low-fluence laser, superficial peels, retinoids) for texture and pigment. Stagger sessions to let collagen remodel—typically 4–12 weeks between major procedures.
Sequence matters. Do structural work (subcision, fillers) first if you have tethered scars, then perform resurfacing once tissues settle. For pigment-prone skin, add topical lightening agents and photoprotection before lasers to reduce pigment flares.
Set realistic expectations. Multiple sessions over months yield the best improvement. Track progress with photos, and avoid combining multiple aggressive procedures in one visit to lower complication risk.
Aftercare and Long-Term Skin Health
Follow wound-care directions precisely: keep treated areas clean, apply prescribed ointments, and avoid picking. Use broad-spectrum SPF 30+ daily; UV exposure worsens scars and pigment.
Support collagen remodeling with topical retinoids and peptides once healing allows—typically several weeks post-procedure. Consider maintenance microneedling or low-energy treatments every 6–12 months to sustain improvement.
Watch for complications. Persistent redness, new hyperpigmentation, or nodules warrant prompt follow-up. Communicate medication use (isotretinoin, blood thinners) and medical history before procedures to reduce risks.
