Acne spot removal: Acne scars: What’s the best treatment?

03.08.202309.07.2023 by alexxlab

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Treatment, Removal, Best, and More

You may be able to reduce the appearance of acne scars with over-the-counter products, medications, and dermatologist-performed procedures, including microdermabrasion.

Active breakouts are frustrating enough, but the scars acne can leave behind can be frustrating. The good news is that acne scars can be treated.

But before treatment can start, you first have to get rid of any acne once and for all since new breakouts can lead to new acne scars.

Some of the scar treatments below can’t be done alongside typical acne medications, and the inflammation caused by breakouts can also reduce treatment effectiveness.

Scars are formed when a breakout penetrates the skin deeply and damages the tissues beneath it.

Before you try to treat your scars, it’s important to know what type they are. Each type responds to treatment differently, and some treatments are better for particular types than others.

Additionally, your skin tone can also be a factor. For example, for darker skin types, deeper skin laser treatments will not be recommended due to higher chances of scarring and pigmentation.

Most darker skin tones will be pretreated with 4 percent hydroquinone (bleaching cream) prior to treatments like microneedling, peels, and lasers.

Atrophic scars are most common on the face. A depressed scar sits below the surrounding skin. They’re formed when not enough collagen is made while the wound is healing. There are three types of atrophic scars:

Boxcar

These are wide, U-shaped scars that have sharp edges. They can be shallow or deep. The shallower they are, the better they respond to skin resurfacing treatments. Microdermabrasion and gentle peels are great for almost all skin types.

But laser resurfacing has to be done cautiously because more scarring and pigmentary changes in darker skin tones, like post-inflammatory pigmentation. It’s best to pretreat darker skin types with a 4 percent hydroquinone for at least 4-6 weeks prior to starting these treatments.

Ice pick

Ice pick scars are narrow, V-shaped scars that can go deep into the skin. They can look like small round or oval holes, like a chickenpox scar. These are the most difficult scars to treat because they can extend far under the surface of the skin.

Rolling

These are wide depressions that typically have rounded edges and an irregular, rolling appearance.

These scars are most common with chest and back acne. They stand above the surface of the surrounding skin and are caused by too much collagen during healing.

Discoloration left behind after a zit has cleared isn’t a scar. The purple, red, or brown marks will fade over a few months on their own.

Before you start any treatment for acne scars, it’s important to be seen by a dermatologist or a healthcare professional. They can help you determine the best method to reduce the appearance of your scars and also make sure that the marks on your skin are actually scars and not another condition.

Alpha hydroxy acids

Alpha hydroxy acids (AHAs) are often found in products made to treat acne since they help to remove dead skin and prevent clogged pores. Even better, AHAs can also help make acne scars appear less noticeable.

The mild acid exfoliates the outer layer of the skin to help remove discoloration and rough skin.

Best for: all types of acne scars

Lactic acid

A small 2010 study found that dermatologist-performed lactic acid peels done once every 2 weeks for 3 months improved the texture, appearance, and pigmentation of the skin and lightened acne scars.

There are countless peels, serums, and ointments with lactic acid, but you can also use diluted apple cider vinegar as a toner or spot treatment thanks to its natural lactic acid. But apple cider, as well as other at-home treatments, are potentially harsh on sensitive skin. They should always be tested to a small area of the skin before starting treatment with the product.

If the skin is sensitive and the product is applied, there’s potential for inflammation and irritation, which can lead to post-inflammatory hyperpigmentation.

Best for: all types of acne scars

Retinoids

Topical retinoids are another acne treatment with scar-smoothing benefits. In addition to speeding up your cell regeneration and improving your skin’s texture, retinoids can also help reduce discoloration and make scars less noticeable, according to a 2017 review.

But they can also make your skin especially sensitive to the sun. Always wear sunscreen daily when using anything that contains retinoids.

You can find creams and serums with retinoids over the counter, but a healthcare professional can also prescribe you higher concentrations. Look for products that list retinol as one of the active ingredients.

Best for: atrophic or depressed scars

Salicylic acid

Chances are high that you’ve already used salicylic acid to treat your acne in the past. From pads to spot treatments and lotions to face cleansers, it’s in just about every kind of acne treatment these days.

Salicylic acid clears pores, reduces swelling and redness, and exfoliates the skin when applied topically. It’s considered to be one of the best treatments for acne scars.

You can add products with salicylic acid into your daily routine, or your skin care specialist may use it for less frequent chemical peels.

It might take a few weeks to see a difference when using salicylic acid. It can also cause dryness or irritation. You may need to use the product less often or try spot treating if you have sensitive skin.

Best for: all acne scars

Sunscreen

Yes, really. It’s vital to wear sunscreen every day over scars. Sun exposure can darken scars making them more noticeable.

If at-home treatments don’t seem to be making a difference, a skin care specialist or healthcare professional can help with your treatments.

Best for: all acne scars

Dermabrasion

Dermabrasion is one of the most effective and common treatments for facial scars. While it uses the same general principle as the microdermabrasion kits you can do at home, healthcare professionals use tools to more deeply exfoliate the top layer of the skin.

Best for: scars close to the surface like shallow boxcar or rolling scars. But deeper scars may also become less noticeable

Chemical peels

These aren’t the kind of face masks that you wear during a Netflix marathon. A chemical peel is a strong acid that’s used to remove the top layer of the skin to reduce deeper scars.

Some chemical peels are mild enough to be used at home, but a healthcare professional can provide a stronger solution with more dramatic results.

There are many different types of chemical peels, so it’s best to talk with a healthcare professional about which one is right for you.

Best for: all types of acne scars, often used for deeper scars

Laser resurfacing

Much like a chemical peel and dermabrasion, laser resurfacing removes the top layer of the skin. This treatment typically has a faster healing time than other resurfacing treatments.

But you have to keep the area covered with a bandage until it’s completely healed. This treatment is also not a good option for anyone who’s still getting breakouts, and it’s not as effective on darker skin tones.

Best for: all acne scars and lighter skin tones

Fillers

Healthcare professionals use fillers to fill in acne scars and help even out the skin. The fillers can be made with collagen, your own fat, or a commercial filler. They’re injected under the surface of the skin to help plump up and smooth out depressed scars.

Most fillers last between 6 and 18 months before they need to be redone, but some are permanent.

Best for: someone with a small number of boxcar or rolling scars

Microneedling

This newer treatment uses a small, handheld, needle-studded roller or a handheld “pen” on the surface of the scars. The needles puncture the numbed skin — but don’t go through it like a shot! As the skin heals, it makes collagen.

There’s evidence to suggest that microneedling helps reduce the depth of acne scars. Still, this treatment can take up to 9 months to see changes, according to the American Academy of Dermatology. Outside of the slight fear factor, it’s a safe treatment that works for all skin tones.

Best for: depressed acne scars

Injections

There are a few different medications that can be injected into raised scars to help soften and flatten them, including corticosteroids and chemotherapy drugs fluorouracil (5-FU) and interferons. The injections are usually performed as a series, with one every few weeks.

Best for: raised scars

At first brush, it might seem crazy to remove a scar and potentially replace it with a new one, but dermatologists or plastic surgeons can remove a very noticeable scar and leave behind a small scar that will fade with time.

A healthcare professional can also lift the scar by loosening the fibers beneath it to help bring it closer to the surface, so it’s less noticeable. This procedure is called subcision.

Best for: deep, depressed scars and raised scars

Acne scars can be frustrating, but there are many treatments that can make them less noticeable. Most scars are permanent, but a healthcare professional can help you find the right treatment to help reduce the appearance of your scars.

The best way to treat an acne scar is to prevent it in the first place.

You’re less likely to develop acne scars if you break out less. Avoid picking, popping, or squeezing any breakout, no matter how tempting, to prevent irritating the skin and damaging the underlying tissue, which can lead to scars.

Read this article in Spanish.

How to get rid of acne scars: Treatments and home remedies

Acne can leave scars on the face and other areas. For some people, they are an unwanted reminder of a painful and bothersome condition. However, home remedies and medical treatments can help get rid of them.

Options for managing acne and reducing the appearance of scars include natural, over-the-counter, and prescription remedies.

Options will depend on the type and extent of scarring and include:

chemical peels, such as salicylic acid
retinoids and other creams
laser treatment, microneedling, light therapy, and various other procedures
surgery, in some cases

In this article, learn about various ways to help reduce the appearance of acne scars and promote healthy skin.

Suitable treatment options may vary slightly depending on the type of scarring that acne has caused. There are three main types of acne scars:

Atrophic scars

These scars appear as small indentations in the skin.

Icepick scars are small scars that look like pinpricks.
Boxcar scars are larger indentations with clear edges.
Rolling scars have unclear edges and give the skin a rolling or undulating appearance.

They occur when the skin does not make enough fibroblasts in the healing process. Fibroblasts are cells that play a crucial role in wound healing and collagen production.

Hypertrophic scars

These occur when the skin makes too many fibroblasts as the acne spot heals, causing a raised scar.

Keloid scars

These are similar to hypertrophic scars but tend to be thicker than the original acne spot. There is often hyperpigmentation, making them darker than the surrounding skin. They may be red or brown. There may also be itching or pain.

Which treatments are best for acne on darker skin tones?

This slideshow shows images of different types of acne scars.

Many people use natural remedies to help clear up acne scars. However, the science behind them is unclear. Some may cause further irritation or other problems so people should use them with caution.

Home remedies that people have traditionally used to treat acne scars include:

black seed oil, which may help even out skin pigmentation
rosehip oil, which has helped reduce discoloration in postsurgical scars
honey, which may help wound healing and reduce future scarring
aloe vera, which, combined with manuka honey, may promote scar-free healing of wounds

What are some more home remedies for acne?

Various over-the-counter remedies can help reduce the appearance of acne scars. Products containing the following ingredients may be useful.

However, over-the-counter creams and lotions are unlikely to fully remove or flatten a raised scar.

Salicylic acid

Salicylic acid is a naturally occurring compound that is often an ingredient in acne skin care products. Salicylic acid peels help clear dirt, skin cells, and other debris that leads to acne from the pores of the skin.

A 2010 review suggests using a peeling product containing 30% salicylic acid and applying it three to five times every 3–4 weeks. The authors also note that it is unlikely to cause hyperpigmentation and is, therefore, suitable for use on darker skin.

It also helps reduce swelling and redness in the area, which may minimize the appearance of scarring.

Salicylic acid can help treat all scar types.

However, people with sensitive skin should do a patch test on a small area of skin before using it on their entire face, as it may cause dryness or irritation.

Retinoids

Some topical retinoids may help get rid of acne scars. As the authors of a 2017 review note, topical retinoids block inflammation, reduce acne lesions, and speed up cell regeneration.

The authors also state that retinoids could help lighten hyperpigmented acne scars, including those in people with darker skin tones.

It is important to note that retinoids can make the skin sensitive to the sun. Anyone using retinoids for acne or scar treatment should wear sunscreen when going outdoors.