Acne Scars

Medically Reviewed by Poonam Sachdev on March 10, 2024
9 min read

Acne scars are marks left behind after the acne itself has gone away. It’s really common. About 1 in 5 people have acne scars on their face, chest, or back.

If your goal is to make your scars less noticeable, a dermatologist (skin doctor) can help. They can look at your skin and suggest a treatment that can help.

Acne can leave seven different kinds of scars. It's common to have more than one type. If your skin is prone to breaking out, you might notice:

Ice pick acne scars. This type of scar looks like an ice pick was used to make it. It has a wide hole at the top that gets smaller as it gets deeper. You're more likely to get ice pick scars on your forehead or upper cheeks because the skin there is naturally thinner.

Boxcar acne scars. These may look like a square or circle was pressed into your skin. Often, boxcar scars show up on your jawline or lower cheeks.

Rolling acne scars. If your skin looks wavy and uneven, you have what's called a rolling scar. It's caused by damage under your skin's surface. This type of scarring is often seen on the lower half of your cheeks or the skin around your jaw.

Hypertrophic acne scars. Some scars indent your skin. Other types, such as hypertrophic scars, create a flat or raised scar tissue over where your acne was. It happens when too much collagen in your skin grows over the area. You might see this type of acne scar on your chest, back, shoulders, or face.

Keloid acne scars. These raised bumps may be darker than your skin. They may also be bigger than the patch of acne that you once had. Like hypertrophic scars, keloid scars can sometimes be itchy or painful.

Dark spots or staining and acne scars. You might see a dark spot appear once a pimple clears, especially if you have medium to dark skin. That's because acne can accidentally trigger more melanin (pigment) in your skin.

Perifollicular elastolysis. These round or oval little bumps may match the color of your skin. Also called papular scars, they can appear on your arms, chest, back, or shoulders, as well as on your face.

Your skin can scar after acne for a few different reasons:

Deep skin damage. Any type of acne can leave a lasting mark. But scarring is more likely if your acne goes deep into your skin. For instance, nodules, which feel like hard lumps under your skin, and cysts, which are full of pus and can be painful to the touch, are both likely to leave scarring.

Picking at pimples. It's common to want to pick at or squeeze a pimple. But irritating it won't make it go away faster; it only inflames your skin more, increasing the chances of a scar.

Your body's healing process. For instance, if your body makes too much collagen (a key component of your skin) to heal the area, raised scars can be the result. This is more likely to happen if you have dark skin. On the other hand, too little collagen can cause sunken acne scars.

Your genes. If a close family member had acne scarring, you too may be prone to it. Having dark skin also makes scars more likely.

Along with general symptoms, such as raised or sunken spots on your skin, your scar may itch or be painful. Acne scars often get more noticeable with age.

If you're thinking about getting rid of your scars, you can go see a dermatologist. They have special training in skin issues and know about many treatments that can help fade, shrink, or smooth out acne scars. But before a dermatologist can decide which option may work best for you, they'll need to examine your skin.

During a consultation, a dermatologist will figure out the type of scars you have and how severe they are, based on this scale:

  • A red, flat scar. This is the mildest type of scar.
  • Mild acne scar. It can be easily covered up, for instance, with makeup or a mustache or beard.
  • Moderate acne scar. This can be seen by others who are close by.
  • Severe acne scar. It can't be covered up and can be seen from at least 50 centimeters away.

This information, as well as where the scars are on your body, will help your dermatologist figure out the next steps.

 

You may need more than one kind of treatment to smooth your skin. Some can be done at home. Others are performed in your doctor's office or as a same-day procedure at a hospital.

After looking at your acne scarring, your dermatologist could suggest:

Acne scar removal and skin resurfacing

The goal is to remove damaged layers of your skin so that new, healthy skin appears. This can be done by:

  • Laser. It creates a more even skin surface.
  • Dermabrasion. A rapidly spinning wheel with a rough surface removes damaged skin.
  • Chemical peel. A special type of acid removes the top layer of your skin. This can help with deeper scars.
  • Microdermabrasion. Tiny crystals sprayed onto your skin can scrub it smooth. While this usually doesn't get rid of acne scars, it can improve your results from other treatments.

New skin will begin to form about 7-10 days after resurfacing. But the area may stay pink for several weeks to several months.

Treating acne scars with fillers

Your doctor puts a filler (collagen or fat) into the damaged area with a needle. This puffs up the skin under the scar to help smooth it out. Because your body slowly absorbs the filler, this process needs to be repeated from time to time.

Microneedling for acne scars

A device covered in tiny needles is rolled over your skin. It’s a safe way to stimulate the tissue under it to grow. You may have to do it several times. Sometimes, doctors call this collagen induction therapy.

Skin tightening for acne scars

If your scarring is mild, a type of energy called radiofrequency can be used to produce more collagen and subtly tone your skin.

Injections for acne scars

Different types of medicine ranging from Botox to a corticosteroid to a chemotherapy drug can be injected into your skin. This is typically done in a series of treatments. Your doctor can tell you how often you will need to have it done.

Acne scar electrodesiccation

This treatment uses an electric probe to heat and kill skin tissue. It's especially helpful with boxcar scars.

Surgery for acne scars

Some people need an operation to remove severe acne scars or cysts. Your doctor cuts away or loosens the scars. Then, the area is repaired with stitches or a skin graft (skin from another part of your body).

Acne scar cryosurgery

Treatment freezes your skin to help raised scars fall off.

Platelet-rich plasma for acne scars

Platelet-rich plasma is taken from your own blood and injected into scars once a month for 4 months. This may help other treatments work better.

It's important to know that acne scars can't be treated if you still have active acne. That's because many acne treatments interfere with medicines and procedures used to fade scars. If your skin is broken out, a dermatologist will first help you get that under control.

Make a list of questions and bring it to your dermatology consultation. You may want to ask:

  • What treatment do you suggest, and why?
  • What results can I expect?
  • Will it hurt?
  • What are the risks?
  • How long before I see a change?
  • Will I need to have the treatment more than once?
  • What can I do after the procedure to help my skin heal?
  • What should I avoid?
  • How much does this treatment cost?
  • What will my insurance cover?

You may be able to take steps to help with acne scars at home. Talk to your doctor about:

Treatments for future acne breakouts. Doing so can prevent more scars from forming.

Skin creams. For instance, an ingredient such as azelaic acid, a natural acid found in yeast, could help reduce redness or dark spots.

Over-the-counter scar treatments. Scar creams, gels, or silicone dressings could help scars fade.

Makeup. Your doctor can suggest a brand that offers special coverage for acne and acne scars.

Over-the-counter bleaching products. These can help lighten scarring that's darker than your usual skin tone.

Sunscreen. You'll need to wear it regularly to keep your scarring from getting darker. Ask your dermatologist to suggest the best type for your skin.

To lower your chance of scarring, follow these tips:

Don’t pick, pop, or squeeze your acne. This not only increases your chances of skin damage but also delays the healing process, so pimples take longer to go away.

Keep your hands away from your face. Dirt and bacteria on your hands and fingernails can lead to pimples or cause existing acne to flare.

Use gentle cleansers. Don’t scrub.

Quit smoking. Tobacco increases the chances that your skin will scar.

Avoid tanning. Natural sunlight and tanning beds can worsen acne. When you're outside, wear a broad-spectrum sunscreen with SPF 30 or higher. Look for one that says "noncomedogenic" on the label. This means it won't clog your pores and cause acne.

Watch your diet. Some studies show that foods that quickly raise your blood sugar such as white bread, white potatoes, and cornflakes, can make acne worse. More research is needed, but avoiding such foods could benefit your skin.

Treat breakouts as soon as they happen. Clearing up your skin is the best way to prevent acne scars.

Scarring from acne is common. If you're unhappy with how your skin looks, a variety of treatments can make your scars less noticeable. Talk to a dermatologist to find out your options.

Are acne scars permanent? In some cases, they can be. But different treatments can still help them look less noticeable.

How long does it take for acne scars to fade? Everyone is different, so there's no exact timeline. But after examining your skin, your dermatologist will explain when you can hope to see a change.

Does retinol help with acne scars? Retinol is a form of vitamin A. When it's put on your skin, it can help unclog pores, speed up the shedding of skin cells, and increase collagen. Some studies show that retinol can not only clear up acne but also improve acne scars. Some retinol products are sold over the counter, but your dermatologist could prescribe a stronger cream.

Does tretinoin help with acne scars? A very strong type of retinol is called tretinoin. You need a prescription to get it as a gel, cream, or lotion. Research shows that tretinoin can reduce acne scars, even if you've had them for a while and even if they're severe. Your doctor may use tretinoin in some in-office treatments.

Does niacinamide help with acne scars? A type of vitamin B3, niacinamide can soothe redness, lighten dark spots, and help your skin heal from damage. If your doctor thinks niacinamide could improve your scars, they'll probably suggest you use it along with another type of skin care cream, such as retinol.

Does vitamin C help with acne scars? A powerful antioxidant, Vitamin C can help turn over your skin cells faster, reduce inflammation and redness, and promote wound healing. Your dermatologist might use vitamin C in some in-office procedures, such as microneedling, to help fade your acne scars.