Introduction
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.
Types of acne scar
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.
Over-the-counter remedies
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 reviewnote, 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.
Alpha hydroxy acids
Alpha hydroxy acids (AHAs) can help increase the rate at which skin renews its cells. Some doctors recommend AHAs for treating acne and reducing the appearance of acne scars.
AHAs are a mild form of acid that scrapes away the outer layer of skin to reveal fresh, new skin underneath. This process may help reduce hyperpigmentation due to scarring.
However, swelling, burning, and itching may occur at high concentrations. It is best to speak with a doctor before trying AHAs. They can help identify the best strength to use.
Lactic acid
Lactic acid is a type of AHA. It can act as a gentle peel to pull away dead skin cells. It may help reduce the appearance of scars and smooth the skin.
One reviewe recalls a small study in which seven people with icepick scars had treatment with a product that was 92% lactic acid. There was an improvement of over 75% in one person, 51–75% in three people, 26–50% in two people, and 1–25% in one person.
Lactic acid may also help lighten dark scar tissue, although it can causee hyperpigmentation, too. It is best to test products that contain lactic acid on a small patch of skin before using them to treat acne scarring.
Many products for acne contain lactic acid. It is also present in diluted apple cider vinegar, which makes for a more natural, cost-effective treatment.
Silicone dressings
Experts do not know how these work, but they appear to help reduce the appearance and size of acne scars. They may do this by providing hydration. They can also reduce itching and pain and increase the flexibility of the skin.
A person will have to use the dressings all the time, which can be difficult on the face. Most people do not experience side effects, though some have itching and irritation.
Medical treatments
Some medical treatments may help reduce acne scars.
A dermatologist can recommend a suitable procedure or combination of therapies depending on a person’s skin type and the extent of the scarring.
Options include:
Chemical peels
A dermatologist can recommend a type of peel that is suitable for a person’s skin type, acne severity, and scarring.
The authors of a 2017 review on treatments for acne scarring note a study that found that six of 10 participants using a specific type of chemical peel called trichloroacetic acid (TCA) had at least a 70% improvement in their acne scarring.
Other chemical peels may be less effective. For instance, 25%e of those who used glycolic acid did not see any reduction in the appearance of scars.
A person may need to try different types of peel to determine which one works for them.
Injections
Injections of corticosteroids may help soften and flatten raised acne scar tissue if a person has hypertrophic or keloid scars.
The treatment typically consists of a series of injections. A dermatologist can do these injections in their office once every few weeks, monitoring the results.
Dermal filler
In some cases, dermatologists may recommend soft tissue fillers to treat atrophic acne scars. They may be particularly helpful for rolling and boxcar scars.
Options include
- collagen-based products
- polymethylmethacrylate
- hyaluronic acid
- polyacrylamide
- poly-L-lactic acid
- silicon
Depending on the filler, a person may need to repeat the treatment after some months. Hyaluronic fillers, for example, last around 3 months, but silicon and polyacrylamide may never need replacing.
Fillers can have adverse effects, but these will depend on the filler. Always speak with a doctor about the pros and cons before opting for treatment.
Microneedling
Microneedling is the process of inserting tiny needles into the skin surrounding the scar to stimulate the body to make more collagen. This collagen may reduce the appearance of atrophic acne scars by smoothing out the skin.
In a 2017 review, microneedling provided an improvement of 31–62% in the appearance of atrophic or indented acne scars.
A 2019 study found that when people combined microneedling with the use of collagen gel, the results were significantly more effective than microneedling alone.
However, microneedling can cause side effects. Many people experience redness, pain, and inflammation after the treatment. However, these effects subside over time.
Laser treatment
Laser treatment resurfaces the skin without the use of chemicals or scrubs. It removes the uppermost layer of skin to reveal the younger skin cells underneath, which can help reduce the appearance of scarring.
It can help reduce the appearance and texture of raised scars. Treatment with a pulsed dye laser can also help reduce the color of hyperpigmented scars.
Intense pulsed light treatment may be a better option for people with pale skin, according to the American Academy of Dermatology.
Laser treatment is not suitable for everyone. This will depend on the type of acne scarring and the person’s skin type. The treatment may also cause a reaction in some people, especially those with sensitive skin.
Surgery
If other treatments do not help, surgery can remove raised acne scars. Surgery alone may not be enough to solve the problem, and a doctor may recommend further treatment.
Electrodessication
Used alongside other treatments, this may help reduce the edges of boxcar acne scars, making the skin appear flatter and less indented. A doctor will use electric probes to heat the skin and kills the tissues that cause the edges around the scars.