Acne scars can be a frustrating reminder of past breakouts. While acne itself is temporary, the scars it leaves behind can persist for years, affecting not just your skin but also your self-esteem. These marks can contribute to heightened feelings of embarrassment, self-consciousness, and negative self-perceptions, including feelings of unattractiveness. Fortunately, science-backed treatments are available to reduce or even eliminate acne scars. In this guide, we’ll explore the best evidence-based treatments for acne scars, how they work, and who they’re best suited for.

Understanding Acne Scars

Before diving into treatments, it's essential to understand what acne scars are. Scarring is the result of inflammation in the dermis (the deeper layer of skin) caused by severe acne. The skin tries to repair itself by forming new collagen fibers, but the process doesn't always go smoothly.

Types of Acne Scars:

1. Atrophic Scars (most common):

Atrophic scars, the most common type of acne scars, can be further categorized into three distinct forms based on their appearance. Ice pick scars are deep and narrow, giving the impression that the skin has been punctured with a sharp object. These scars extend deep into the dermis and are often difficult to treat. Boxcar scars appear as broad, sunken depressions with sharply defined edges, resembling the shape of a box or crater. Lastly, rolling scars create a wavy or undulating texture on the skin due to bands of fibrous tissue pulling the epidermis from below, giving the skin a less even surface.

2. Hypertrophic/Keloid Scars:

Hypertrophic and keloid scars are raised acne scars caused by excess collagen production during healing. Unlike indented atrophic scars, these scars rise above the skin’s surface. Hypertrophic scars stay within the original wound area and may improve over time, while keloids extend beyond it, often becoming more prominent, firm, and persistent.

Science-Backed Treatments for Acne Scars

1. Microneedling (Collagen Induction Therapy)

Microneedling, also known as collagen induction therapy, involves using a device equipped with tiny needles to create controlled micro-injuries in the skin. These micro-injuries trigger the body’s natural wound-healing process, stimulating the production of collagen and elastin, key components for smoother, firmer skin. This treatment is particularly effective for mild to moderate atrophic acne scars, especially rolling and boxcar scars. One of the major advantages of microneedling is that it requires minimal downtime and can be safely combined with platelet-rich plasma (PRP) for enhanced results. However, it typically takes multiple sessions to see noticeable improvement, and the results develop gradually over time as the skin regenerates

2. Laser Resurfacing (Ablative & Non-Ablative)

Laser resurfacing is a highly effective treatment for reducing the appearance of acne scars, particularly deeper boxcar and rolling scars. There are two main types of laser resurfacing: ablative and non-ablative. Ablative lasers, such as the CO2 laser, work by removing the outer layers of damaged skin, promoting the growth of new, smoother skin. In contrast, non-ablative lasers, like the Fraxel laser, penetrate the skin without removing the surface layer, stimulating collagen production from within. Both types help remodel scar tissue and improve skin texture over time. Scientific evidence supports their effectiveness, a clinical study published reported up to 70% improvement in acne scars using fractional laser treatments. The benefits include long-lasting results and significant improvement in deeper scars. However, laser resurfacing can be costly, and ablative procedures in particular may require downtime and careful aftercare to minimize side effects and ensure proper healing.

3. Chemical Peels

Chemical peels are a non-invasive treatment that uses acidic solutions, such as trichloroacetic acid (TCA) or glycolic acid to exfoliate the top layers of the skin. This controlled removal of damaged skin cells stimulates skin regeneration, resulting in a smoother texture and more even tone. Chemical peels are especially effective for superficial atrophic scars and post-inflammatory hyperpigmentation (PIH), making them a popular choice for individuals looking to reduce mild scarring and discoloration. Many reviews have confirmed that these treatments can be effective in improving skin texture and tone for mild acne scarring, especially when applied with proper technique and caution. Benefits include being more affordable than laser treatments and offering noticeable improvements in skin clarity. However, chemical peels typically require multiple sessions for optimal results and carry a risk of skin irritation, particularly for those with sensitive skin or darker skin tones.

4. Subcision

Subcision is a minor surgical procedure used to treat rolling acne scars that are anchored to deeper layers of tissue. During the procedure, a fine needle is inserted beneath the skin to break up the fibrous bands pulling the skin downward, which helps release the tension and allows the skin to lift and smooth out over time. This technique is especially effective for tethered rolling scars, where the underlying tissue is causing visible indentations. One of the key advantages of subcision is that it may produce immediate visible results, and it can also be combined with other treatments like fillers or microneedling for enhanced outcomes. However, the procedure can lead to temporary bruising and swelling, and for best results and safety, it should be performed by an experienced dermatologist or trained specialist.

5. Dermal Fillers

Dermal fillers are injectable treatments designed to plump and lift depressed acne scars, helping to restore a smoother and more even skin surface. They are particularly effective for atrophic scars, such as boxcar and rolling scars, where volume loss is a concern. Common options include hyaluronic acid (HA)-based fillers like Juvederm and Restylane, which provide temporary results and are well-tolerated by most patients. HA fillers were approved by the U.S. Food and Drug Administration (FDA) in 2003 for cosmetic use and have since become a popular choice for acne scar correction. For longer-lasting results, Bellafill, a collagen-based filler combined with PMMA (polymethylmethacrylate) microspheres offers a semi-permanent solution. The choice of filler depends on the type of scar, desired longevity of results, and individual skin characteristics. The main advantages of fillers are their immediate results and non-invasive nature, making them an attractive option for those seeking quick improvements. However, most fillers require repeat treatments to maintain results, unless a permanent filler like Bellafill is used. As with any injectable, results depend heavily on the skill of the provider.

Conclusion

Choosing the most effective acne scar treatment is only part of the journey, finding a trusted provider is just as crucial. That’s where DigiMEDSPA comes in. Our DigiMEDSPA Directory Listing platform connects you with top-rated Med SPAs that offer science-backed treatments. Each DigiMEDSPA listing offers provider profiles, patient reviews, and details on their expertise with specific scar types whether it’s subcision for rolling scars, lasers for boxcar scars, or TCA CROSS for ice pick scars. You can also find clinics offering advanced options like Bellafill or combination therapies. With DigiMEDSPA, finding the right expert for your skin goals is simpler, smarter, and backed by science.