Acne is stubborn and tough to get rid of, and you may feel victorious after you've finally managed to get your acne under control!
Acne scars can be tough to deal with, but don't worry, there are several options for treating acne scars including some tips from board certified dermatologists Dr. Davin Lim practicing in Brisbane and Dr. Abby Waldman practicing at Brigham and Women's Hospital.
What Are Acne Scars?
Acne scars can appear due to the damage in collagen caused by acne. Acne scars are the texture changes, and discoloration that can happen after having acne.
Types Of Acne Scars
Dealing with acne is only half the battle as an inflamed pimple will stretch collagen fibers over time. This can lead to long term damage on our skin’s surface.
The common types of acne scars are
- Rolling scars
- Ice pick scars
- Boxcar scars
- Hyperpigmentation
Out of the above acne scar types, hyperpigmentation is the one easiest to reduce and some hyperpigmentation can fade on their own even without treatment.
According to dermatologist Dr. Davin Lim, hyperpigmentation and erythema are grade 1 scars - which are flat scars that leave a dark or red mark and are easiest to treat.
Other types of acne scars:
- Boxcar scars are shallow with a strong straight and defined edge.
- Rolling scars are depressed scars with less of a defined edge or ridge.
- Ice pick scars are deep and narrow which are more difficult to treat.
If you have keloid scars, it's best to see a professional to help treat keloids as many typical acne scarring treatments will be contraindicated to treating keloids.
Top Ways To Get Rid of Acne Scars
Microneedling
Type of scar: rolling scars, boxcar, ice pick scars, and hyperpigmentation.
Microneedling is an acne scar treatment that uses very fine needles to prick the skin to create a controlled injury. This is considered one of the most effective at home method to help with indented acne scarring.
According to dermatologist Dr. Abby Waldman: "Microneedling creates tiny holes in the skin to turn on the mechanisms in the skin to make new skin cells, turn over old cells, stimulates collagen and that helps with acne scars"
The great thing about microneedling is that it less invasive compared to laser acne scars treatments and the results are long lasting.
Microneedling can help with minor indented or pitted acne scars as well as hyperpigmentation.
Microneedling promotes the absorption of topical product so it can enhance other skincare ingredients meant for acne scarring like Vitamin C.
For an at-home microneedling treatment, use shorter needle sizes at 0.5mm and pick a stamp design tool versus a roller so it creates the least amount of skin trauma.
Different forms of microneedling can be done in office too with deeper needles.
Recommended tool: Banisher 3.0 at home microneedling kit
Alpha Hydroxy Acids
Type of scars: hyperpigmentation, discoloration
Glycolic acid is an AHA which stands for alpha hydroxy acid. This AHA is one of the most effective AHAs and a very popular ingredient for fading acne scars. Glycolic Acid can also get rid of hyperpigmentation, acne, and discoloration.
Glycolic acid is a naturally occurring substance that offers many benefits to the skin such as rejuvenation and exfoliation. Glycolic acid can be found in chemical peels and it is an ingredient in consumer skincare products that most people can tolerate.
Recommended product: Pumpkin Enzyme Masque
Vitamin C
Type of scars: hyperpigmentation and dark spots, minor texture.
Vitamin C is one good source when it comes to getting rid of acne scars for its wound healing, collagen production, and brightening properties.
Regarding Vitamin C, dermatologist Dr. Emma of House Of Medics shares that “it helps combat the visible signs of aging like fine lines and wrinkles, and most exciting for me it helps combat dark spots.”
Vitamin C is great for treating acne scars as it is responsible for our skin’s elasticity, collagen synthesis, and it prevents excess melanin production.
Try to look for vitamin c in the form of l-ascorbic acid, or ascorbic acid. It's best for discoloration and the most studied form of vitamin c, but it tends to oxidize quickly.
Products with L-ascorbic acid include the Banish Vitamin C Serum.
Retinoids
Type of scars: hyperpigmentation, minor textured scars
Retinoids such as retinol, adapalene, tretinoin, or Vitamin A products have been considered a go-to ingredient for both acne scars and acne.
Retinols promote cell turnover or shedding of dead skin cells and encourage the development of collagen.
Retinol is not as strong as prescription-strength retinoids so retinol or derivatives of it are what you find in drugstore skincare products.
A word of warning is that retinoids and its derivatives may cause purging for the first couple of weeks and they can cause irritation to the skin so best to start off slow and use a moisturizer.
Niacinamide
Type of scars: Dark spots and hyperpigmentation.
Also known as nicotinamide, niacinamide is a form of Vitamin B-3 which is an essential nutrient when it comes to treating acne scars. Niacinamide works by lightening dark marks, reducing inflammation, and improving tissue regeneration.
While niacinamide may help with dark marks, it may not help with textured or deep acne scars.
Niacinimide is commonly found in many skincare products, even if the products are not directly targeted for acne scarring.
Subscision
Best for: boxcar scars, rolling scars
Subscision is a type of surgery where your doctor will break down the fibers adhering the acne scar down to the deeper layers of skin which is causing the pitted acne scar.
This type of treatment will require an in person assessment by a dermatologist to check if your scars are tethered down and if it would benefit you.
Fillers
Best For: A small amount of boxcar or rolling acne scars
Fillers are a type of injection that go under the skin to fill in acne scars. Only go to a certified practitioner to get fillers done. When done well, fillers can smooth out the appearance of acne scars.
Depending on the filler, you may need injections every 3 to 18 months depending on the result you want to maintain. Most fillers are temporary but there are also fillers that are permanant. Both would require follow up visits to touch up.
Chemical Peels
Type of scars: Ice pick, boxcar
Your dermatologist may recommend deeper chemical peels that contain acids with higher concentrations to address moderate scars.
These peels work in the same way as the kinds you use at home to dissolve the uppermost layers of skin, only that they penetrate the skin on a much deeper level.
Deeper peels such as TCA peels should be done by a professional and can improve moderate to severe acne scars with the proper aftercare and with the supervision of a professional.
You can use skincare products that are made with more gentle acids or lower concentration of exfoliating acids for light acne scarring and discoloration. Look for ingredients like glycolic acid, lactic acid, mandelic acid, and salicylic acid.
Radiofrequency
This a procedure that uses radiofrequency waves that heat up the skin and stimulates the skin to produce more collagen and could reduce acne scars over time.
Radiofrequency may also be combined with microneedling in some cases and it may also feel hot or warm.
PRP Microneedling
PRP microneedling is a procedure in the office with a device that injects your own plasma into your skin for the healing properties to heal acne scars. Plasm Its a combination treatment of PRP which stands for plasma rich platelets and microneedling.
Plasma Rich Platelets contain growth factors that can help renew the skin.
Laser Treatments
Type of scars: ice pick, boxcar, rolling, dark spots
Most laser treatments work by sending pulses of light that create heat energy to damage the top layer of skin. These lasers can induce the wound healing response, so that new skin and collagen can form in its place.
Certain types of ablative laser such as co2 laser may not be suitable for darker skin tones as they could increase the risk of hyperpigmentation since darker skin tones contain more melanin.
There are different intensity and types of lasers available, so discuss with a dermatologist that works with your skin tone to see what treatment plan would for if you go the laser route.
Dermabrasion
This acne scar treatment uses a device that physically takes off the upper level of skin to treat acne scars. It may not be very effective for indented acne scars, but can help lighten hyperpigmentation.
Treating Raised Scars
Raised scars need a different type of treatment because the issue is usually an overgrowth of collagen, while indented scars are from lack of collagen. Raised scars are also known as hypertrophic scars.
Some treatments for raised scars include:
- Steroid Shots
- Surgical Removal
- Silicone Gel Sheets
Natural Remedies For Acne Scars
If you want to stick with home remedies, these could give mixed results and usually aren't effective alone for deep and pitted acne scars.
If your acne scars are limited to mild hyperpigmentation or discoloration, these home remedies could work for you or you may want to use them in combination with other acne scarring treatments.
ALOE VERA
Aloe is one of the best household products anyone can use to treat their hyperpigmentation.
Aloe contains aloesin which has some evidence of destroying melanated cells, and in preventing hyperpigmentation caused by UV radiation.
Aloe improves wound healing by strengthening collagen structure. Aloe Vera has been a popular plant remedy or solution for many skin problems such as acne, so if you are still dealing with acne, aloe vera is fine to use.
To Use: Purchase Aloe vera gel and apply onto skin daily.
APPLE CIDER VINEGAR
This fermented vinegar has a lot of useful functions, including fading your acne scars by naturally exfoliating and shedding away dead skin cells.
It contains Vitamins A, B2, B6, C, and E along with the natural lactic and malic acids which are responsible for gently exfoliating the skin for a more even-toned complexion. Dilute it with water so it doesn't cause too much stinging and to help lower the acidity.
It takes a lot of patience and consistency to see positive results, no matter what products or options you choose in treating acne scars. Don’t be afraid to try different options should the first one fail. You may even need a combination of treatments if your acne scars are on the moderate to severe side.
Keep the healing up with some emotional treatment as well. Acne does not only leave with deep physical scarring but emotional scarring too.
You’re still beautiful with or without acne.
If you are still struggling with acne scars or need extra guidance, you can contact your local dermatologist or book a teledermatology call with licensed dermatologist Dr. Anna Chacon if you are located in the U.S.
References:
1. Singh S, Gupta A, Gupta B. Scar free healing mediated by the release of aloe vera and manuka honey from dextran bionanocomposite wound dressings. Int J Biol Macromol. 2018 Dec;120(Pt B):1581-1590. doi: 10.1016/j.ijbiomac.2018.09.124. Epub 2018 Sep 21. PMID: 30248422.
2.Erbağci Z, Akçali C. Biweekly serial glycolic acid peels vs. long-term daily use of topical low-strength glycolic acid in the treatment of atrophic acne scars. Int J Dermatol. 2000 Oct;39(10):789-94. doi: 10.1046/j.1365-4362.2000.00076.x. PMID: 11095203.
3. Choi S, Lee SK, Kim JE, Chung MH, Park YI. Aloesin inhibits hyperpigmentation induced by UV radiation. Clin Exp Dermatol. 2002 Sep;27(6):513-5. doi: 10.1046/j.1365-2230.2002.01120.x. PMID: 12372097.
4. Telang PS. Vitamin C in dermatology. Indian Dermatol Online J. 2013 Apr;4(2):143-6. doi: 10.4103/2229-5178.110593. PMID: 23741676; PMCID: PMC3673383.
5. Valerón-Almazán, P. , Gómez-Duaso, A. , Santana-Molina, N. , García-Bello, M. and Carretero, G. (2015) Evolution of Post-Surgical Scars Treated with Pure Rosehip Seed Oil. Journal of Cosmetics, Dermatological Sciences and Applications, 5, 161-167. doi: 10.4236/jcdsa.2015.52019.
3 comments
John Navarro
Appreciate for your valuable content. It is helpful and gives the reader a useful information.
venukumari
Thanks for great information! we are looking forward for more updates. even thanks for specific content for updating our knowledge.
Jolly Potter
Extremely grateful for this guide on treating acne scar treatments. You can find similar services at Skinworks Clinic. Skinworks Clinic offers advanced facial, skin consultation, and expert-tailored treatment to help you reduce the appearance of scars, skin pigmentation, as well as sagging skin. Visit our website now for more details.
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