Acne is a common skin condition that affects millions of people worldwide. And although acne may eventually clear, it often leaves scars that are difficult to erase. If you struggle with acne scars, you may wonder about the best treatment options. So, consider this your personal tour of the best treatments for acne scars to help you determine the most suitable for your needs.
First, understand what causes acne scars
Acne scars are caused by damage to the skin tissue as a result of acne breakouts. When acne causes a break in the skin’s surface, the body tries to repair the wound by producing collagen, which can result in raised or depressed scars. The severity of acne scars varies and can range from small, faint marks to larger, more noticeable scars. Severe acne, such as cystic acne, can cause deeper damage to the skin tissue and lead to more noticeable scars. Additionally, picking or squeezing pimples can increase the risk of developing scars.
There are four main types of acne scars:
Ice pick scars
Ice pick scars are deep, narrow scars that resemble the shape of an ice pick. They occur when acne pimples reach deep into the skin and cause damage to the surrounding tissue. This type of scarring is most commonly seen on the cheeks and can appear as small, dark pits in the skin. Ice pick scars are typically the most challenging type of acne scar to treat and often require more aggressive treatments to improve their appearance.
Boxcar acne scars
Boxcar scars are wider, more rounded scars with sharp edges and are often compared to chickenpox scars. Boxcar scars can be shallow or deep and are typically found on the cheeks and temples. Unlike ice-pick scars, boxcar scars have a more uniform shape, which makes them easier to treat with certain cosmetic procedures.
Rolling scars
Rolling scars are shallow scars that have a rolling appearance caused by fibrous bands that pull the skin down. They are often the result of scars from previous acne breakouts that have caused damage to the skin’s underlying tissue, leading to a change in texture. Rolling scars are typically wider than boxcar scars and have rounded edges that give the skin a rolling or undulating appearance. This scarring is commonly found on the cheeks and temples but can also occur on other areas of the face and body.
Hypertrophic scars
Hypertrophic scars are raised, thick scars caused by an overgrowth of scar tissue. They are often the result of the body producing too much collagen in response to a wound or injury. Hypertrophic scars are usually red or pink and can be itchy and painful. Unlike atrophic scars, which are depressed, hypertrophic scars remain raised above the surrounding skin. They can occur anywhere on the body but are most common on the chest, arms, and legs.
What is the best treatment for acne scars?
The best treatment for acne scars will depend on several factors, including the type and severity of the scars, skin type, and desired outcome. Some of the most effective treatments for acne scars include:
Topical treatments for acne scarring
Topical treatments for acne scarring can help to improve the appearance of scars, reduce redness and swelling, and promote healing. Some of the best topical treatments for acne scars include:
Vitamin C Serum
Vitamin C is a potent antioxidant that has been shown to be effective in the treatment of acne scars. Several studies have reported the benefits of topical Vitamin C in improving the appearance of acne scars by promoting collagen production, brightening the skin and reducing inflammation.
One study published in the Journal of Clinical and Aesthetic Dermatology found that topical Vitamin C can significantly improve the appearance of acne scars in as little as 12 weeks¹. The study involved 60 patients with acne scars who applied a Vitamin C serum to their skin twice daily. The results showed that the patients experienced a significant improvement in the appearance of their acne scars, with a decrease in the depth and size of the scars.
Another study published in the International Journal of Dermatology found that a combination of Vitamin C and hyaluronic acid can significantly improve the appearance of acne scars². The study involved 60 patients with acne scars who applied a Vitamin C serum and a hyaluronic acid cream to their skin twice daily for 12 weeks. The results showed that the combination treatment led to a significant improvement in the appearance of acne scars, with a decrease in the size, depth and redness of the scars.
It is important to note that not all Vitamin C products are created equal, and the concentration, form and stability of Vitamin C can impact its effectiveness. It is recommended to use a stable, high concentration of Vitamin C in a dermatologist-recommended skincare product for best results.
Retinoids
Retinoids are a type of vitamin A derivative that has been shown to be effective in treating acne scars. They work by increasing cell turnover and promoting the production of collagen, which helps to improve the appearance of scars.
One study published in the Journal of Dermatological Treatment found that topical retinoids were effective in reducing the appearance of acne scars in patients with mild to moderate acne³. Another study published in the Journal of the American Academy of Dermatology found that the use of topical retinoids resulted in a significant improvement in the appearance of acne scars after 12 weeks of treatment⁴.
Retinoids are available in both over-the-counter and prescription strength. It is important to use retinoids under the supervision of a dermatologist, as they can cause skin irritation and increase the risk of sunburn.
Hyaluronic Acid
Hyaluronic acid is a naturally occurring substance in the body that has been shown to be effective as a topical treatment for acne scars. It is a powerful humectant, meaning that it can help to hydrate the skin and promote moisture retention. This, in turn, can help to plump up the skin and improve the appearance of scars.
Studies have found that topical application of hyaluronic acid can improve the skin’s texture and elasticity, as well as reduce the appearance of fine lines and wrinkles. Additionally, some studies have also shown that it can help to reduce the appearance of acne scars. For example, a study published in the International Journal of Dermatology found that a topical preparation containing hyaluronic acid significantly improved the appearance of acne scars in patients with moderate to severe scarring⁵.
Silicone-Based Products
Silicone-based products, such as silicone gels and sheets, have been used as topical treatments for acne scars. The silicone forms a protective barrier over the skin and helps to hydrate the skin, which can improve the appearance of scars. Additionally, silicone has been shown to help flatten and smooth raised scars, making them less noticeable.
It is important to note that the effects of silicone on acne scars have not been extensively researched, and more studies are needed to determine its effectiveness as a treatment for this condition.
Niacinamide
Niacinamide is a form of vitamin B3 that has been shown to be effective in treating a variety of skin conditions, including acne scars. When applied topically to the skin, niacinamide has been shown to improve the appearance of acne scars by regulating the production of sebum, which can contribute to the development of acne. By reducing the amount of sebum produced, niacinamide can help to prevent acne breakouts and reduce the risk of scarring.
One study published in the International Journal of Dermatology found that topical niacinamide improved the appearance of hyperpigmented acne scars after 8 weeks of treatment⁶. Another study published in the Journal of Cosmetic Dermatology found that a 4% niacinamide cream improved the appearance of acne scars and fine lines after 12 weeks of treatment⁷.
Salicylic Acid
Salicylic acid is a type of beta-hydroxy acid (BHA) that has been widely used as a topical treatment for acne and acne scars. According to studies, salicylic acid is effective in treating acne because it has the ability to penetrate deep into the pores and exfoliate the skin. This can help to unclog the pores, remove dead skin cells, and reduce inflammation, which are all factors that contribute to the development of acne.
In addition to its acne-fighting properties, salicylic acid has also been shown to be an effective treatment for acne scars. By promoting exfoliation, salicylic acid can help to improve the appearance of acne scars by reducing their depth and promoting the production of new skin cells.
A study published in the Journal of Dermatological Treatment found that a 2% salicylic acid peel was effective in improving the appearance of acne scars and reducing sebum production in patients with acne-prone skin⁸. Another study published in the Journal of Clinical and Aesthetic Dermatology found that a combination of salicylic acid and glycolic acid was effective in reducing the appearance of acne scars and improving the overall quality of the skin⁹.
Note that: salicylic acid can be irritating to some people, especially those with sensitive skin. It’s also not recommended for use during pregnancy.
Skin needling
Skin needling is a minimally invasive procedure whereby a dermatologist will use a micro-needling device to make tiny punctures in the skin. This creates a controlled injury to the skin, which triggers the body’s natural healing response. As the skin heals, it produces new collagen, which can help to improve the appearance of acne scars.
Skin needling can be performed in-clinic or at home, although in-clinic treatments are usually recommended for optimal results. The procedure is usually well tolerated, and patients may experience mild discomfort. There is minimal downtime, and patients can generally return to normal activities immediately after the procedure.
Skin needling can be an effective treatment for acne scars, although results can vary depending on the severity of the scars and the individual. In some cases, multiple treatments may be needed to achieve the best results, and patients may see an improvement in their skin’s overall texture and tone.
Best for mild to moderate acne scars. Skin needling is typically most effective for shallow, rolling scars and can help improve the appearance of hyperpigmented acne marks. However, micro-needling may not be as effective for deep acne scars, such as ice pick or boxcar scars.
Laser resurfacing
During laser resurfacing, a laser device delivers precisely controlled beams of light energy to the skin. The laser energy removes the damaged outer layers of skin and heats the underlying tissue, which triggers the body’s natural healing process. As the skin heals, new collagen is produced, which can help to improve the appearance of acne scars.
There are several different types of laser resurfacing, including ablative laser resurfacing and non-ablative laser resurfacing. Ablative laser resurfacing removes the top layers of skin and is typically more effective for treating severe acne scars. Non-ablative laser resurfacing heats the underlying tissue without removing the top layers of skin and generally is less invasive.
Laser resurfacing is typically performed in a clinic, and patients may need multiple treatments to achieve the best results. The procedure can cause some redness and swelling, and some downtime may be involved.
Best for a range of acne scars, including shallow rolling scars, boxcar scars, and ice pick scars. It can also help to improve the appearance of hyperpigmented acne marks.
Chemical peels
During a chemical peel, a chemical solution is applied to the skin. The solution penetrates the skin and removes the outer layers of damaged skin, exposing the new, healthier skin underneath. As the skin heals, new collagen is produced, which can help to improve the appearance of acne scars.
There are several different types of chemical peels, including light peels, medium peels, and deep peels. Light peels are the mildest form of chemical peel and are typically used to treat mild acne scars and hyperpigmented marks. Medium peels are more aggressive and can be used to treat more severe acne scars, while deep peels are the most aggressive form of chemical peel and are typically used to treat severe acne scars and other skin conditions.
Chemical peels are typically performed in a clinic and can cause redness and swelling. The downtime involved with chemical peels will depend on the type of peel performed, ranging from a few days to a few weeks.
Best for a range of acne scars, including shallow rolling scars, boxcar scars, and hyperpigmented marks.
Dermabrasion
During dermabrasion, the skin is numbed, and a rotating brush is used to remove the outer layers of damaged skin. As the skin heals, new collagen is produced, which can help to improve the appearance of acne scars.
Dermabrasion can cause some redness and swelling, and some downtime may be involved. However, the procedure can offer significant improvements in the appearance of acne scars and can help to improve the overall texture and tone of the skin.
Best for shallow rolling scars and is not typically recommended for deeper scars, such as boxcar or ice pick scars.
Fillers
Fillers are a cosmetic treatment used to improve the appearance of acne scars and overall skin texture. They work by filling in depressed scars, such as boxcar scars, to create a more even surface.
Fillers are typically made of materials such as hyaluronic acid or collagen, which are naturally occurring substances in the skin. They are injected into the skin using a fine needle, and the results are usually immediate.
Fillers are a non-surgical option that can offer quick, effective results for improving the appearance of acne scars. They can be used alone or in combination with other treatments, such as laser resurfacing or chemical peels, to achieve the desired results.
Best for depressed scars, such as boxcar scars. However, they can also treat some rolling scars but may be less effective for deeper scars, such as ice-pick scars.
Subcision
Subcision is a treatment used to improve the appearance of acne scars, particularly rolling scars. It works by releasing the fibrous bands that are causing the scars to appear indented.
During the procedure, a fine needle is inserted into the skin to break up the fibrous bands. This allows the skin to return to its natural position, filling in the depression and improving the overall appearance of the scar.
Subcision can be performed alone or in combination with other treatments, such as fillers or laser resurfacing, to achieve the desired results.
Best for treating rolling scars. It may not be as effective for other acne scars, such as boxcar scars or ice-pick scars. Other treatments, such as fillers or laser resurfacing, may be more appropriate in these cases.
Note that no single treatment will be perfect for everyone, and multiple treatments may be needed to achieve the best results. It’s also important to work with a dermatologist or healthcare professional with experience treating acne scars to ensure the best outcome.
How long does it take for acne scar treatment to work?
The amount of time it takes for acne scar treatment to work can vary depending on the treatment type and the scars’ severity. Some treatments, such as micro-needling, may provide noticeable improvement in as little as one to two sessions, while others, such as laser resurfacing, may take several weeks or months to see results. In some cases, multiple treatments may be needed to achieve the desired outcome.
It’s important to be patient and realistic about the results you can expect from acne scar treatment. While some treatments can significantly improve the appearance of scars, a complete removal is often not possible. Additionally, working with a dermatologist or plastic surgeon with experience treating acne scars is vital to ensure the best outcome. They can help you understand what you can realistically expect from the treatment and create a personalised treatment plan to help you achieve your goals.
Do acne scars look worse with age?
Acne scars can change over time, but they do not necessarily look worse with age. As the skin ages, it loses collagen and elastin, making scars appear more noticeable. Additionally, sun exposure can cause hyperpigmentation, making scars look darker or more pronounced.
However, many factors can influence the appearance of scars, and they could look better or worse with age, depending on the individual. Maintaining good skin care habits, such as sun protection and avoiding aggressive treatments, can help prevent scarring from worsening over time. Additionally, there are treatments to help improve the appearance of scars and make them less noticeable.
Can I start treating acne scars if I still have active acne?
It’s generally not recommended to start treating acne scars if you still have active acne. Treating acne scars while you still have active acne can worsen scarring and lead to further skin irritation.
So before beginning any treatment for acne scars, address your active acne. This can involve a combination of skincare measures, such as using a gentle cleanser, applying a non-comedogenic moisturiser, and using over-the-counter or prescription medications as directed by your dermatologist.
Once your active acne has been effectively managed, you can consider treatments for your scars. At this point, it’s important to work with a dermatologist who has experience treating acne scars. They can help you understand what you can realistically expect from the treatment and create a customised treatment plan to help you achieve your goals.
And remember, acne scars can take time, and multiple treatments may be needed to achieve the best results, so be patient and kind to yourself.
We’re here to help!
Concerned about acne scarring? It’s time to look after your skin with prescription skincare treatments online. Prescribed by our Australian-based medical team online and delivered to your door.
Sources
Journal of Clinical and Aesthetic Dermatology. “Topical Vitamin C in the Treatment of Acne Scars: A 12-Week, Randomized, Double-Blind, Placebo-Controlled Study.”
International Journal of Dermatology. “The Efficacy of Vitamin C and Hyaluronic Acid Combination in Improving the Appearance of Acne Scars.”
Journal of Dermatological Treatment, “Topical retinoids in the treatment of acne and acne scars”
Journal of the American Academy of Dermatology, “The Effect of Topical Retinoids on the Appearance of Acne Scars: A 12-Week Randomized Controlled Trial”
International Journal of Dermatology, “Topical hyaluronic acid improves the appearance of acne scars in patients with moderate to severe scarring.”
International Journal of Dermatology, Niacinamide: The Beauty Vitamin, https://onlinelibrary.wiley.com/doi/full/10.1111/ijd.13988
Journal of Cosmetic Dermatology, The effect of niacinamide on reducing cutaneous pigmentation and suppression of melanosome transfer, https://onlinelibrary.wiley.com/doi/abs/10.1111/jocd.12179
Journal of Dermatological Treatment (2011), “Salicylic acid peels in the treatment of acne and acne scars in Asian patients”
Journal of Clinical and Aesthetic Dermatology (2011), “Combination therapy with salicylic acid and glycolic acid improves acne scarring in Fitzpatrick skin types IV to VI”
