How To Get Rid Of Acne Scars, From Dermatologists

Like any scar tissue, acne scars are complicated to treat1. Research shows that the most effective protocols involve multiple, complementary modalities2. So here's our best, most effective suggestions. 

It's estimated that 95%4 of the patients with acne vulgaris develop scarring of some kind. How the resulting scar tissue looks can actually vary quite a bit (which you'll learn below), and patients can have multiple types on the skin, even within the same area. There's also no indication of what type of scarring a person might develop. "Different people heal differently and are prone to different types of scarring. Some will be more prone to the ice pick versus rolling scars," says board-certified dermatologist Jeremy Fenton, M.D., at Schweiger Dermatology Group in New York City. "One person may get no scarring, while another gets severe scars from a similar severity of acne."  

We'll get into the details more in depth below, but as an overview here are the types of acne scars & post-inflammatory hyperpigmentation you may expect post pimple.

Ice pick scars are a form of atrophic scar, which means it's indented rather than raised. (Research shows that 80 to 90% of people5 with acne scars have indented.) Of the atrophic scars, ice picks are the hardest to treat. These look like small, narrow pinholes in the skin, with steep fall-offs. ("They are named 'ice pick' scars because they look like an ice pick was used on the skin," says Fenton.) They're also very deep, often diving into the lower levels of the dermis and are most often formed by cystic acne, or acne that forms in the lower levels of the skin.

As noted above, these are incredibly hard to treat. In some cases, you can never fully "fix" the scars, due to the depth of the injury. These will need a trip to the dermatologist's office for a professional consultation, with typical suggested treatments1 that range from filler, fractional lasers, and chemical peels to punch excision, or a form of surgery that cuts out the scar tissue and stitches the skin back together. Because of the depth of the scars, topical and natural remedies can't rid the skin of them, but they may help overall appearance. Consider stronger actives, such as retinols as they accelerate cell turnover.

Another form of atrophic scarring, boxcars look like small oval, circular, rectangular, or square pits. They often have steep drop-offs into a U-shaped scar. These are unlike ice pick scars in that they are wider and don't usually go deep into the dermis. Because they are more shallow, they also are easier to treat.  

As for at-home treatments, consider natural acids of your own: AHA or BHA acid treatments and peels can help exfoliate the top layer of skin. Also consider a retinol here, too.

Rolling scars are another form of atrophic scarring. They are characterized by wavelike, undulating skin. These are the result of long-term, chronic acne—as the repeated inflammation and trauma to the skin creates uneven scar tissue. In many cases, the appearance is shallow and perhaps not very noticeable. With time, however, rolling acne tends to exacerbate as the skin naturally starts to sag.  

At home, you can also use a glycolic or lactic acid serum or cream nightly. These acids gently buffer off the top layers of skin as well as promote healthy collagen production so you can help smooth out the uneven skin.

These aren't technically a scar in the same way the above are, but they usually fall under this umbrella when discussing acne. According to the most widely accepted standard grading scale of acne9, pigmentation issues are considered "macular," or the most mild form. These are surface-level stains where the pigment of the skin is altered due to inflammation10—essentially when skin is inflamed, it can trigger or halt pigment production. Hyperpigmentation on pale skin tones often appears red or pink, while darker skin tones usually appear brown or black. "The pigment then sits there until the body clears it out or it is exfoliated off," says Fenton. Hypopigmentation appears lighter than the rest of the skin.

In some circumstances these marks are permanent, but most will fade within six months to two years. You can usually speed up the fading process with the right topical ingredients. Look for things labeled "brightening" or "spot corrector" or that have potent antioxidants like vitamin C. 

Now, on the other hand, keloids are hypertrophic scars11, which means that instead of a depletion in the skin, there's an excess of scar tissue. These form as the result of acne as well as just general injuries. These appear more frequently from body acne. 

Keloids take dermatologic intervention, and there's not much you can do on your own. Also: If you develop them once, it likely means you are at risk at developing them again12. 

While it's important to take a target approach to your acne and scars, here's a good generalized list of actives that can encourage cell turnover, exfoliate, brighten, and improve the appearance of the skin.

As for topicals, we recommend taking a two-pronged approach. First, you stop breakouts from forming by using salicylic acid. This oil-soluble acid is incredibly effective at shimming down into pores, dissolving excess oil, and removing buildup13. And when you do get a pimple (because let's face it: It happens, people), be sure to soothe inflammation, too. Since scars are the result of damaging inflammation, anyone suffering from acne could benefit from a topical anti-inflammatory14.

Just remember, acne scars are incredibly common, and you're likely your harshest critic. Just stick to a regular skin care plan that works for you—as healthy skin will just improve the appearance of skin quality overall.