How to Finally Treat Acne Scars (Without Wasting Time or Money)

WebMD

23-06-2025

Acne may fade, but the scars it leaves behind can linger for years – both on the skin and emotionally. For many, acne scars affect self-esteem and confidence, long after the last breakout has healed.
The good news: Today's acne scar treatments are more effective, personalized, and safer than ever. The key is knowing what type of scars you have and how to match them with the most appropriate therapy.
Understanding Your Acne Scars
Not all acne scars are the same. Each type responds differently to treatment, so accurate identification is an important first step.
Ice pick scars: Deep, narrow scars that resemble small puncture marks. Often considered one of the most challenging types to treat. Think V-shaped.
Boxcar scars: Broad, well-defined depressions with sharp edges, commonly seen on the cheeks and temples. Think U-shaped.
Rolling scars: Shallow, wave-like indentations caused by bands of scar tissue pulling down the skin.
Hypertrophic or keloid scars: Raised, thickened scars often found on the chest, shoulders, or jawline.
Post-inflammatory hyperpigmentation (PIH) or erythema (PIE): Red or dark discoloration that remains after acne resolves, especially common in skin of color. While technically not a true scar, they can feel like it!
Accurate diagnosis leads to more successful outcomes and avoids the trial and error that can waste both time and money.
There Is No Universal 'Fix'
Despite online claims, no single product or procedure treats every type of acne scar. Treatment needs to be customized based on scar type, skin tone, and individual goals. Be cautious of 'miracle' solutions or overly aggressive procedures that promise dramatic results overnight.
Evidence-Based Treatments That Work
Here are some of the most effective, dermatologist-approved methods:
Subcision and Laser-Assisted Subcision
Ideal for rolling scars, subcision involves releasing the fibrous bands beneath the skin that cause depressions. When combined with laser therapy, it also stimulates collagen for smoother skin.
Microneedling With Radiofrequency
This combines fine needles with thermal energy to remodel skin and improve texture. It is a preferred option for moderate scarring and has minimal downtime.
TCA CROSS (Chemical Reconstruction of Skin Scars)
This technique uses a high-strength acid like TCA or phenol, applied directly into ice pick scars to stimulate collagen production. It's highly targeted and effective for deep, narrow scars.
Laser Resurfacing
Ablative lasers like CO2 or erbium can improve skin texture and depth of scarring. Caution is advised for people with darker skin tones to reduce the risk of pigmentation issues.
Topical Treatments for Pigmentation
When scars leave behind discoloration, the following options can be effective:
Broad-spectrum sunscreen used daily
Tretinoin to increase skin turnover and collagen boosting
Brightening agents such as vitamin C, niacinamide, azelaic acid, and tranexamic acid
Lasers and chemical peels may also be used as a second step, once inflammation has resolved.
Don't Overlook Fillers and Biostimulatory Treatments
For certain types of depressed acne scars – like rolling or boxcar scars – injectables can offer fast and visible improvement. These are especially helpful when used alongside other treatments like subcision or microneedling.
Here's how they work:
Hyaluronic acid fillers: Add immediate volume to lift indented scars and smooth the skin's surface. Results are visible right away and can last six to 12 months.
Biostimulatory injectables (like Sculptra or Radiesse): They do more than just fill. These stimulate your skin's natural collagen production for gradual, longer-lasting improvement, and they're especially useful in combination treatments.
Combination therapy: This is often used after subcision to hold the skin up and prevent the scar from tethering down again.
While not a permanent fix, fillers can be a powerful tool in your acne scar treatment plan, especially if you're looking for quicker wins while working on long-term skin texture.
Address Active Acne First
Scar treatments are only effective when active acne is controlled. Initiating scar therapy while breakouts continue can undermine results and increase the risk of complications. Begin by managing active acne to set the foundation for long-term skin health.
Set Realistic Expectations
While complete scar removal is unlikely, significant improvement – often 30% to 50% – is achievable. These changes can make a major difference in how the skin looks and feels, contributing to greater self-confidence and comfort.
Navigating the world of acne scar treatments can be overwhelming. With an accurate diagnosis, evidence-based therapies, and a personalized approach, real and lasting improvement is possible.
Rather than chasing quick fixes, focus on progress. The skin has an impressive ability to heal with the right support – and your path to smoother, more confident skin may be closer than you think.