Acne scars can be a persistent reminder of past breakouts, often affecting self-confidence and skin texture long after acne has cleared. These scars form when the skin’s healing process is disrupted, leading to textural changes such as depressions, raised scars, or pigmentation issues.
While home remedies and over-the-counter products may provide some improvement, professional acne scar treatments offer more effective and lasting results. With a variety of treatment options available, from laser therapy and microneedling to chemical peels and surgical techniques, choosing the right method depends on scar type, skin condition, and personal goals.
At City Dermatology Clinic, our dermatologists and surgeons use advanced technologies and tailored approaches to achieve clearer, smoother skin. This guide provides a detailed overview of acne scar removal treatments, offering insightful comparisons to help determine the most suitable method for your specific needs.
Understanding Different Types of Acne Scars
Acne scars vary widely in appearance and severity, and the most effective treatment often depends on the specific type of scar. Identifying the type of acne scar is a crucial step in selecting the right treatment method.
1. Atrophic Scars
Atrophic scars are depressed scars that form when there is a loss of skin tissue during the healing process. These scars are common after severe acne and are often difficult to treat.
- Ice Pick Scars:
- Appearance: Deep, narrow pits that resemble puncture marks.
- Treatment Methods: Microneedling, TCA Cross, Laser Treatments, and Subcision.
- Boxcar Scars:
- Appearance: Broad, rectangular depressions with sharp edges.
- Treatment Methods: Dermal Fillers, Laser Resurfacing, Subcision, and Chemical Peels.
- Rolling Scars:
- Appearance: Wave-like depressions that create an uneven skin surface.
- Treatment Methods: Subcision, Microneedling, and Radiofrequency Treatments.
2. Hypertrophic and Keloid Scars
These are raised scars that form when the skin produces too much collagen during the healing process. They are more common on the back, chest, and shoulders.
- Hypertrophic Scars:
- Appearance: Raised, firm scars that stay within the boundary of the original acne lesion.
- Treatment Methods: Steroid Injections, Laser Therapy, and Silicone Gel Sheets.
- Keloid Scars:
- Appearance: Thick, raised scars that extend beyond the original acne site. Often darker or redder than the surrounding skin.
- Treatment Methods: Corticosteroid Injections, Cryotherapy, and Surgical Excision.
3. Pigmentation Changes (Post-Inflammatory Hyperpigmentation)
While not true scars, discolouration left after acne clears can persist for months. This includes red, brown, or purple marks on the skin.
- Appearance: Flat spots that can range from pink to dark brown, depending on the skin type.
- Treatment Methods: Chemical Peels, Laser Treatments, Topical Lightening Agents, and Microdermabrasion.
When to Consult a Specialist
For those unsure of their scar type or looking to achieve the best results, a consultation with a dermatologist or surgeon can provide a personalised treatment plan. Specialists like Dr Andreea Anton, Mr Georgios Pafitanis, and Dr Jana Torres-Grau at City Dermatology Clinic offer expert guidance and access to advanced treatment options.
Comparison of Acne Scar Removal Treatments
Below is a table that provides in-depth insights into the best acne scar removal treatments. Each method is explained in terms of how it works, the number of sessions needed, recovery time, expected results, and who it is best suited for.
| Treatment Method | How It Works | Sessions Needed | Recovery Time | Expected Results | Best For |
|---|---|---|---|---|---|
| Laser Treatments | Uses fractional or ablative lasers to resurface the skin, stimulating collagen production and smoothing scars. | 3–6 sessions, 4–6 weeks apart | 5–7 days (redness, peeling) | Reduces scar depth, improves skin texture | Atrophic scars, particularly boxcar and rolling scars |
| Microneedling | Involves tiny needles creating micro-injuries to promote natural collagen growth and skin renewal. | 4–8 sessions, every 4–6 weeks | 2–5 days (mild redness) | Effective for mild to moderate scarring, enhances skin firmness | Ice pick, rolling scars, and fine lines |
| Chemical Peels | Applies a chemical solution to exfoliate the top layers of skin, revealing new, smoother skin underneath. | 3–6 sessions, 2–4 weeks apart | 3–7 days (peeling, redness) | Improves surface texture and evens skin tone | Hyperpigmentation, superficial scars |
| Dermal Fillers | Injects fillers into depressed scars, lifting them to an even skin level and improving appearance immediately. | 1–2 sessions per year | Minimal downtime, mild swelling | Instant results, ideal for shallow scars | Boxcar scars, rolling scars |
| Subcision | Uses a needle to break up scar tissue under the skin, allowing the skin to rise and appear smoother. | 1–3 sessions, based on severity | 5–10 days (bruising, swelling) | Significant improvement in scar depth, particularly rolling scars | Deep rolling scars, tethered scars |
| Steroid Injections | Reduces inflammation and flattens raised scars, particularly effective for hypertrophic and keloid scars. | 3–6 sessions, every 4–6 weeks | Minimal downtime, mild discomfort | Flattens raised scars, reduces redness and size | Hypertrophic and keloid scars |
| Microdermabrasion | Gently exfoliates the skin surface, promoting new cell growth and reducing pigmentation and minor scars. | 6–10 sessions, every 2–4 weeks | 1–2 days (mild redness) | Best for surface-level scars and improving skin tone | Pigmentation issues, superficial scarring |
| Surgical Techniques | Surgical excision or punch excision removes deep, narrow scars, followed by stitching or grafting. | 1 session, with possible follow-up | 7–14 days (stitches may be needed) | Permanent removal of deep scars, minimal scarring | Ice pick scars, deep isolated scars |
When to Consider Each Treatment Method
- Laser treatments and microneedling are ideal for most types of atrophic scars, providing significant improvement over multiple sessions.
- Subcision and dermal fillers work well for rolling scars and boxcar scars, often used in combination to achieve optimal results.
- Steroid injections are particularly effective for raised scars, helping to flatten and soften the appearance of keloid and hypertrophic scars.
- Surgical techniques are reserved for deep, narrow scars, offering a permanent solution with minimal downtime.
Selecting the right treatment method involves a professional assessment by a dermatologist or surgeon, ensuring the treatment plan is tailored to individual needs and skin type.
When to Choose Each Treatment Method
Selecting the right treatment method for acne scar removal depends on several key factors, including the type of scars, skin type, and treatment goals.
Matching Treatments to Scar Types
| Type of Acne Scar | Recommended Treatment Methods | Why These Treatments Work |
|---|---|---|
| Ice Pick Scars | TCA Cross, Laser Resurfacing, Surgical Excision | These methods target deep, narrow scars and stimulate collagen production. |
| Boxcar Scars | Microneedling, Dermal Fillers, Subcision | Help smooth the skin’s surface and elevate depressed scars. |
| Rolling Scars | Subcision, Radiofrequency Microneedling, Fillers | Breaks up scar tissue, promoting a smoother appearance. |
| Hypertrophic Scars | Steroid Injections, Cryotherapy, Laser Treatments | Effective for flattening raised scars and reducing redness. |
| Keloid Scars | Corticosteroid Injections, Surgical Excision, Silicone Sheets | These minimise scar size and prevent regrowth. |
| Pigmentation Scars | Chemical Peels, Laser Therapy, Topical Creams | Lighten dark spots and promote an even skin tone. |
Considerations Based on Skin Type and Sensitivity
- Darker Skin Tones:
- May require gentler treatments to avoid hyperpigmentation.
- Treatments like microneedling and chemical peels with low-strength acids are generally safe.
- Avoid aggressive laser treatments that can cause discolouration.
- Lighter Skin Tones:
- Typically respond well to laser resurfacing and chemical peels.
- More options available for intensive treatments without a high risk of pigmentation changes.
- Sensitive Skin:
- May benefit from gradual treatments like microneedling or non-abrasive chemical peels.
- Important to use soothing skincare products and avoid harsh ingredients during recovery periods.
Combining Treatments for Best Results
For complex or stubborn acne scars, combining treatments can enhance outcomes:
- Subcision followed by Microneedling: Improves rolling scars by breaking scar tissue and boosting collagen production.
- Laser Therapy with Chemical Peels: Helps smooth the skin surface and reduce pigmentation simultaneously.
- Fillers with Subcision: Provides immediate results for depressed scars, while subcision helps with long-term improvement.
When to See a Dermatologist
If acne scars are persistent or affecting your confidence, a consultation with a specialist can help develop a customised treatment plan. City Dermatology Clinic’s experts, including Dr Andreea Anton, Mr Georgios Pafitanis, and Dr Jana Torres-Grau, offer professional assessments and personalised treatment strategies to achieve the best possible results.
Achieving Long-Term Results
While professional treatments play a significant role in reducing acne scars, maintaining clear and smooth skin requires a consistent skincare routine and healthy lifestyle choices.
Skincare Before and After Treatments
Before Treatment
- Avoid Sun Exposure: Use a broad-spectrum sunscreen with SPF 30+ to protect the skin and prevent pigmentation changes during treatment.
- Discontinue Certain Products: Stop using retinoids, exfoliants, or acid-based skincare products at least one week before treatment to reduce the risk of skin irritation.
- Hydrate Your Skin: Well-moisturised skin responds better to treatments like laser therapy and microneedling.
After Treatment
- Keep Skin Moisturised: Use gentle, hydrating products to support healing and prevent dryness and peeling.
- Avoid Picking or Scrubbing: Allow scabs and peeling skin to heal naturally to avoid scarring.
- Protect with Sunscreen: Apply sunscreen daily, as treated skin is more sensitive to UV damage.
- Follow Aftercare Instructions: Provided by your specialist, including the use of topical treatments or antibiotic ointments if needed.
Maintenance Tips and Avoiding Triggers
- Use Non-Comedogenic Products: Choose skincare and makeup products that do not clog pores, helping to prevent new acne and future scarring.
- Incorporate Retinoids Gradually: Products like retinol can help improve skin texture over time, but introduce them slowly to avoid irritation.
- Stay Hydrated: Drinking plenty of water helps maintain skin elasticity and supports the healing process.
- Healthy Diet: Consuming a balanced diet rich in antioxidants and anti-inflammatory foods can promote clearer skin.
- Avoid Excessive Exfoliation: Gentle exfoliation helps remove dead skin cells, but overdoing it can damage new skin and prolong recovery.
When to Consult a Dermatologist
- If acne scars do not improve with at-home treatments, it may be time to consider professional options.
- A dermatologist or surgeon can recommend suitable treatments based on skin type, scar severity, and treatment goals.
- Specialists such as Dr Andreea Anton provide personalised consultations at City Dermatology Clinic, ensuring a comprehensive treatment plan tailored to individual needs.
