What Causes Acne Scars?
When acne breakouts penetrate the skin deeply, they damage the skin and the tissue beneath it. As the acne clears, the body tries to repair this damage.
During the healing process, the body produces collagen—a substance that gives the skin support. If the body produces too little or too much collagen, you will see a scar.
The type of scar depends on how much collagen your body makes. If the body produces too little collagen, depressions or pits form as the skin heals. Sometimes the body produces too much collagen as it tries to heal the skin and underlying tissue. When this happens, a person develops a raised acne scar. This type of acne scar is more common in darker skin types.
Who Gets Acne Scars?
Some people are more likely to see scars when their acne clears. The risk increases when a person:
Although we know what increases a person’s risk of developing acne scars, it is not possible to predict who will develop acne scars. Even people who have all the risk factors may not scar.
It is, however, possible to prevent acne scars with effective acne treatment.
What Treatments Are Available for Acne Scars?
Resurfacing removes layers of skin, which allows the body to produce new skin cells.
Dermatologists use the following resurfacing procedures to treat depressed acne scars:
Resurfacing works well for treating acne scars that are nearly flat (not too deep). Even dermabrasion, which removes the top layers of skin and some of the middle layers, cannot effectively treat deep acne scars.
Best for: Depressed acne scars that are not deep. Useful for contouring scar edges to make scars less noticeable. Deep scars often require skin surgery and resurfacing.
Lasers and other light treatments can treat raised scars safely and effectively. Treatment with a pulsed dye laser (PDL) can help reduce the itch and pain, diminish color, and flatten a raised scar. For people with lighter skin, intense pulsed light (IPL) also may be a treatment option.
Best for: All types of acne scars
Microneedling with Radiofrequency
This treatment increases collagen production and tightens the skin, making depressed acne scars less noticeable. Individuals often require a series of 3-4 treatments spaced four weeks apart. This treatment is safe for all skin colors.
Best for: Widespread depressed acne scars. Sometimes, skin tightening effectively treats deep icepick and boxcar scars. Not a treatment for raised acne scars, which form when the body produces too much collagen.
Fillers can be used to safety and effectively plump depressed acne scars. Many fillers give us temporary results, which last between 6 and 18 months. Some fillers are permanent.
Best for: Treating a few depressed scars, but not icepick scars.
A dermatologist may recommend injecting medicine directly into the scars. This can soften and flatten raised, thick scars.
Getting the best results often requires repeat visits. These injections are usually given once every few weeks. How often you will need to return for treatment depends on the scar and many other considerations. You may need to return once every two to six weeks for a while.
Best for: Painful, raised scars
Acne scar surgery
Dermatologists perform acne scar surgery to reduce raised acne scars. This surgery can be performed in a dermatologist’s office.
To obtain the best results, acne scar surgery is often followed by another treatment.