Acne Scars

Guide to Acne Scars and Treatments

Acne scars can be embarrassing and troublesome. They are a constant reminder of the pain an individual went through when they had active acne. Acne scars are the result of an inflamed cyst, papule or skin lesion. The pore becomes large with dead skin cells, bacteria and oil, and swells, which then causes a break in the follicle wall. If there is a deep break in the wall, the healthy skin tissue around the break will be destroyed. New collagen will be formed. In some individuals, too much new collagen is formed. This will create a raised tissue on the skin’s surface. This creates one type of acne scarring- Keloid or hypertrophic scarring. In other cases, atrophic or depressed scars will form. These develop when there is a loss of tissue and are more common than Keloid scarring. Under atrophic scarring, there are a few forms. Ice pick scarring leaves a small hole in the skin that looks like it has been stabbed by an icepick. These are commonly found on the cheeks. Boxcar scarring are depressed scars that are round or oval shaped, and look much like chicken pox scars. Rolling scars are scars under the skin’s surface that give a wave like appearance. They are common and tend to be wide and very shallow.


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Acne Scar Treatment

The good news about acne scars is there are many treatments available that can help minimise the scarring. An individual can meet with their skin specialist to find the best treatment for their skin. Possible treatments for acne scarring include:

  • CO2 Laser acne scar treatment- This treatment is done for icepick, boxcar and rolling scars. A laser is used to remove skin. The laser will be moved over the skin one to three times. It can take a few minutes to complete if the area is small or more than an hour if areas are larger. Local anesthesia will be used. Healing time takes ten to twenty one days, and the skin will remain pink for up to three months. A dressing will be applied to the skin, which will need to stay on for three days. Side effects do include milia, crusting and oozing of the skin, prolonged redness and either hypopigmentation or hyperpigmentation.
  • Chemical Peels- Light or superficial chemical peels is a treatment done to help with acne scarring. The results are not permanent, so therefore should be done only on mild acne cases. A solution of BHA or AHA will be applied to the skin with a cotton ball and then will be neutralised. The process will remove the surface layer of skin, exfoliating the skin. Sunblock must be used after the process as the skin is very sensitive to the sun after this treatment. Possible side effects include peeling skin, redness of skin for a few days, itching, and hyperpigmentation (extremely rare).
  • Skin needling- Skin needling is used to puncture the skin, which will give trauma to the skin. New Collagen will then be rebuilt in the skin, which will heal the existing acne scars. Recovery time is very short and no damage is done to the epidermis. There is redness of the skin and there could be possible bruising. Results can be seen in one or two sessions. It can take up to twelve months for the results to fully appear due to the collagen slowly rebuilding itself.
  • Fractional Laser Treatment– This non-invasive procedure treats a fraction of the skin at a time. It is a great solution to acne scars. It can be used on any part of the body, and will target both the epidermis and the dermis. This process has a very fast healing time. Numbing cream will be applied to the area being treated. Once the numbing cream has numbed the skin, it is wiped off and a gliding gel is applied to the skin. The Fractional laser will be allowed to glide over the skin, and a cooling machine will be used to ease any discomfort. A full face will usually take about half an hour to complete. Skin will be pink for three to five days, with swelling being minimal, usually only lasting two to three days. A mild sunburn sensation will be felt for about an hour after the procedure is done.
  • Dermabrasion- Superficial and deeper acne scars can be removed with dermabrasion. During the dermbrasion process, a high speed diamond or wire wheel brush or sandpaper will remove the surface of the skin. It is a heavy exfoliation of the skin. After the treatment, a dressing will need to be applied with petroleum jelly every day for two to four days.  A wind burnt or red face can often be seen for up to nine months after the treatment is done.  Repeat treatments may be needed.  A crust forms on the skin after the procedure, and takes up to fourteen days to flake off. Side effects of dermabrasion include some pain, sun sensitivity, and hyperpigmentation or hypopigmentation. Dermabrasion can be used for boxcar, icepick and rolling scars.
  • Subcision- Subscision is used for rolling scars. The scar will be cut away from the skin, and the blood will fill underneath the area cut and fill it in. The blood clot will help form connective tissue under the scar. This will then create a level surface. Bruising and swelling can be seen for up to two weeks, and multiple treatments are often needed, usually up to three. This process is often combined with laser resurfacing or dermabrasion.
  • Dermal fillers– Dermal fillers are very effective for rolling scars, as well as some boxcar scars that are not as defined. Dermal fillers fill in depressed scars, with the dose varying due to where the scarring is, how big the scarring is, and what results an individual wants. Results can be seen immediately. Skin will be cleansed, then the face is iced. The skin specialist will then inject the solution chosen into the skin with a very fine needle. Dermal fillers only have a temporary effect, from a few months to a year or more. For twenty four hours, the patient will be asked to limit facial motion.

These are just many of the acne scar treatments that a skin specialist can offer. Many of the treatments described above work well by themselves, but can be paired up with different methods for an even greater effect. An example of this would be having fractional laser done on the acne scars and filling them in with dermal fillers. Using the two in combination will provide for smoother skin in which the dermal fillers will generally last longer.

To prevent acne scars, never pick or squeeze the acne. This may seem like a good idea to get the pus or bacteria out of the pimple, however, it could force the debris deeper into the skin, causing more inflammation and further damage to the skin. Picking the scab off acne will increases the chance of scarring due to the fact that the scab is the skin’s way of naturally bandaging the skin. Removing a scab that is not ready to fall off will prolong the healing process.

Another way to prevent acne scars is taking care of the skin to prevent future breakouts and inflammation of the skin. Should you have bad acne, you may wish to consult a skin specialist to find a treatment to get acne under control.


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9 replies
  1. Vanessa
    Vanessa says:

    I have suffered from really bad acne when I was younger and now my skin is paying the price. I feel like it is all pitted out. I was wondering if these treatments would work on acne scars that are older? Is there a time frame that one needs to have the procedures done or can they be done years and years later, after the damage has been done to the skin?

  2. Surgery for scars
    Surgery for scars says:

    I have had acne scarring surgery. Sounds horrendous I know but really it is not that bad. It is a minor skin surgery in my eyes. It repairs the scars to make them less noticeable. I had the surgery done about three years or so ago. The scars have faded over time, and has left me with more gorgeous skin and quite a bit more confidence. My scars were lifted from my face to make it less noticeable. I did not feel any pain with it. I was awake during the surgery but the area was numbed very well. I was nervous about having the treatment done because you are awake, but honestly, if I can do it, anyone can! It was one of the best decisions I have made for my acne scars, and I have a better social life because of it. I want to go out now and meet new people. When I had these acne scars, I never wanted to leave my house. I do want to note that this is best used for only a few depressed scars.

  3. Samantha J.
    Samantha J. says:

    I would like to know if microdermabrasion is good for acne scars? I see that it is not listed on the list above, while dermabrasion is. Is dermabrasion the same as microdermabrasion, just more powerful? I have had one microdermabrasion session done a few weeks ago, and was wondering if that will eventually help a few of the acne scars that I have. I am confused as one site I was on said that microdermabrasion is not for acne scarring but yet another site said that it was a treatment for it. Anyone care to weigh in on this one?

  4. Mother's advice?
    Mother's advice? says:

    My mother has always offered me some good advice about the skin. I have never had an acne scar and just wanted to share with everyone what she always told me about my face. Keep the skin clean and cleanse a few times a day. Never pop a pimple and keep the hands away from the face so you are not tempted to do so. Use products that were made for the face, and use them gently. Avoid any harsh skin care lines.

  5. Dermabrasion??
    Dermabrasion?? says:

    I am interested in dermabrasion. I have never had it done but would like to see if it can improve the appearance of my acne scars, as well as a few of the wrinkles that I have. I am thinking of going with this treatment as I know that it can help my acne scarring and the wrinkles and it is permanent. I have read up on it, and think that the pain is pretty manageable for me. I want something that will make my skin look healthy again. Dermabrasion can be a great tool for this and I look forward to speaking with my dermatologist about it.

  6. Koraline
    Koraline says:

    I have had needling done on my skin for my acne scars. A needle studded roller was moved over my face across my acne scars that were depressed. The needles puncture the skin, and then new collagen is formed as the skin heals. I had six treatments done about a month apart. I had some swelling on my face and a few bruises but that was about all. It is a safe treatment to do for any skin type and I really benefited from it. I had acne all over my face, thus many scars. My dermatologist said that this was a great treatment for wide spread acne and I fully agree.

  7. Glad to do it
    Glad to do it says:

    I have had fractional laser done on my acne scars before. It is not really all that bad. The cooling fan does help to keep the skin cool. A mild sun burnt feeling was felt after the treatment, but it helped to make my scarring look better, so that mild pain was fine. I had very little swelling and my face was only red for about two days. The numbing cream did an excellent job at numbing my face, and I have never felt better about myself. I do recommend that if you have acne scarring you have fractional laser treatments done on it. You will be glad that you did!

  8. Haylie
    Haylie says:

    I have read that cryotherapy can be used for acne scars. I have done a bit of research and it is for people who have light skin, like myself. Has anyone on here had this type of treatment done for their raised acne scars? The scar tissue is frozen, then the tissue dies, and then eventually falls off.

  9. My Acne Story
    My Acne Story says:

    It is bad enough that acne plagued me when I was in my late teens and early twenties. But to have the scars to say that I lived through acne is embarrassing. I am not really sure which one is worse…having to battle with the acne or trying to cover up the scars. I never picked at my face as my aunt always told me this would lead to scarring. However, looking back on my attempts to get rid of the acne, it is no wonder I have the scars for it. I used way too many products that were causing my skin to take a beating. Harsh scrubs that were really abrasive, rubbing alcohol to dry out the face and pimples, washing four or five times a day with the hottest water I could get. I feel sorry for the skin on my face and I am sure that the acne scars were a way to repay me back. I am interested in having some sort of professional treatment done on my face. I now know that I need to be gentle with the cleansers and products that I use and am ready to get a treatment done to improve the scars that I have. Which one is the best treatment does everyone feel? I really would like to not do dermabrasion, but am interested in possible the fractional laser. Is this a procedure that a 27 year old could do? Seems like this is the one that I am leaning towards. I am going to consult with a dermatologist soon and see if he or she thinks that I am a candidate for this kind of procedure. I would be fine with having a pink face for a few days and some swelling. After all, nothing in my eyes can look worse than the scarring that is there now. Even if I wear makeup, it seems to just settle into my face, making my face look pitted. I want smooth skin. I have not had a breakout in a few years, so my skin has been rather clear. It is just the acne scarring that makes my face look terrible.


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