Acne Scar Treatment Guide

Acne scars are what a breakout leaves behind in the skin, and the right treatment depends on the kind of scar, the timing and what else is happening with your skin. The American Society for Dermatologic Surgery says acne scars are usually the result of inflamed blemishes caused by skin pores engorged with excess oil, dead skin cells and bacteria. It adds that the skin repairs deep lesions by forming new collagen fibers, and that these repairs usually are not as smooth and flawless as the original skin. Timing runs through every option: when to start, and what each one asks of the weeks around it.

Scar types and what comes first

The American Society for Dermatologic Surgery separates scars into hypertrophic or keloid scars, which form when the body produces too much collagen as acne wounds heal, and atrophic scars, which are depressed and develop when there is a loss of tissue. Two common kinds of atrophic scar are icepick scars, which are small yet obvious holes in the skin, and boxcar scars, which are round or oval depressions with steeply angled sides. The American Academy of Dermatology adds that raised scars develop when the body produces too much collagen, so they require different treatment.

Order matters too. The American Academy of Dermatology says that if you have acne breakouts, your plan will likely begin with acne treatment, because stopping breakouts can reduce inflammation and prevent new acne scars.

For depressed scars, the American Academy of Dermatology says a chemical peel helps the body produce more collagen and elastin, and when the skin has more of both, depressed acne scars tend to be less noticeable. The dermatologic surgery society explains chemical peels for acne scars on its own page. The American Academy of Dermatology also describes microneedling, in which puncturing the skin causes the body to produce new collagen and elastin, and says the new collagen helps diminish acne scars.

The American Society for Dermatologic Surgery says pain and recovery time with laser therapy are minimal, the procedure is non-invasive, and it works best in combination with other acne treatments. The American Society for Dermatologic Surgery also describes dermabrasion as the surgical sanding or planing of the outer layer of skin on acne scars, after which the treated area typically appears smoother and refreshed.

Two scar guides: peels and lasers

Two guides take the most common options one at a time.

• Peels That Soften Acne Scarring: how chemical peels are described as working on depressed scars, and what to ask about them before you book.
• Laser Therapy for Pitted Acne Scars: how laser treatment is described for pitted scars, and which recovery questions to bring to a consultation.

For the dermatologic surgery society's own overview, read its page on laser therapy for acne scars. Researchers have also compared combinations, such as a prospective comparative study of platelet-rich plasma injections with and without microneedling for atrophic facial acne scars. Treat it as a reading suggestion, not a verdict on what suits your skin.

Questions for the consultation

Ask which scar type you have, since raised and depressed scars call for different treatment. Ask whether your acne is under control and what that means for when to start. Ask how many visits to plan for, what the weeks after each visit look like, and whether the month you start matters for your schedule. A licensed clinician can answer these for your skin.

Treat everything above as general information, not medical advice.