All the ways that you can get rid of acne scarring

Jennifer Larson

Jun 27, 2020, 01:15 IST

All the ways that you can get rid of acne scarring

There are four types of acne scars: ice pick scars, boxcar scars, rolling scars, and hypertrophic scars.Boy_Anupong/Getty Images

You can get rid of acne scars with topical creams like retinoids or with medical procedures like corticosteroids or laser therapy.
Vitamin A derivative creams are helpful for acne scarring because they promote new skin cell growth.
A highly effective medical treatment is micro-needling, which uses small needles to puncture the skin and promote collagen growth.
This article was medically reviewed by Debra Jaliman, MD, a board-certified dermatologist with a private practice in New York City.

Acne is a very common skin problem, one that affects 50 million people, including teens and adults, in the United States annually, according to the American Academy of Dermatology (AAD).

Even if you no longer get breakouts, you may still have some scarring left behind from acne. This scarring can be unsightly and bothersome, so here are some of your options for reducing or even eliminating it.

Types of scars

The type of treatment your dermatologist will recommend will depend in part on the type of scar you have. You can have raised acne scars or depressed acne scars.

Raised scars, or hypertrophic scars, are exactly what they sound like: thick or lumpy scars that sit on top of the skin.

Meanwhile, depressed scars, or atrophic scars, cause an indentation in the skin.

Here are the types of acne scarring and what they look like:

You can also have red patches or discolored skin where acne lesions used to be. Although it might not be scarring in the traditional sense, many people also refer to this left-behind discoloration, or pigment alteration, as scarring.

There are many options for treating all of these types of scarring, and some methods can help with more than one issue.

"The (altered) pigment is easier to treat than actual scars," says Ivy Lee, MD, a dermatologist in private practice in Pasadena, California.

Topical remedies

If you're just trying to get rid of the redness that remains from your experience with acne, your doctor may start by suggesting an over-the-counter topical cream, like a vitamin A derivative cream such as Differin. It's a mild retinoid that promotes cell turnover, meaning that it can help boost your skin's ability to shed dead and damaged cells and replace them with new ones. It can also lighten the darker pigment, says Ivy.

You could also try a stronger over-the-counter remedy like alpha hydroxy or beta hydroxy cream to address the discoloration and promote cell turnover. But be forewarned: it may be effective, but it may also be irritating to your skin, says Ivy.

If the over-the-counter creams aren't quite effective enough, your doctor can prescribe a stronger version of a vitamin A cream to help improve your skin. These prescription-strength retinoids can address both atrophic scars and discoloration, says Ivy. Many people respond very well to them.

"Very rarely do I need to resort to chemical peels or micro-needling or lasers," she says.

Medical procedures

Topical therapy might be effective enough for eradicating your acne scars. But if you have more severe scarring, you may want to turn to medical treatments. Here are some of your options:

Fillers, which can fill in those deeper depressions left behind by acne with collagen or fat. "The downside is that they tend to be expensive and require touch-up for maintenance," says Ivy.
Micro-needling, which involves using small needles to puncture the skin and breaks down collagen bundles in the top layer of skin. These tiny injuries actually stimulate new collagen growth, which improves the skin.
Laser therapy to remove scarred tissue from the surface of the skin. There are a few different kinds, but one commonly used version uses a pulsed dye laser (PDL) to reduce redness and flatten scars.
Other resurfacing procedures, such as dermabrasion or chemical peels. These work by removing layers of skin, which encourages new cell growth that can reduce the appearance of scars.
Corticosteroid injections are effective for raised scars. "Corticosteroid injections can help flatten hypertrophic scars which can occur on the chest and back," says Ivy.
Surgery can also be used to cut out scars in extreme cases.

If you're wondering what to try first, turn to micro-needling for deep scars. Ivy refers to micro-needling as her "workhorse tool" since it's safe, and it requires minimal downtime -- perhaps 24-36 hours after the procedure, compared with up to a week for laser therapy or even longer for surgery.

Research shows that micro-needling is effective for reducing deep scarring, but the American Academy of Dermatology warns that micro-needling should not be used on raised, or hypertrophic, scars.

"Micro-needling is wonderful," says Ivy. "It shrinks and tightens those scars and evens out the texture. It increases smoothness. It can also address the discoloration we see with acne, as well."

Home remedies

Some people like to try home remedies to address their acne scars. Some commonly used products include:

Milk peels: Lactic acid can provide a gentle exfoliating effect on your skin and reduce some of that left-behind redness. "It's pretty mild and incredibly safe, so there's minimal harm, but I think there's also minimal benefit," says Ivy.
Dermaroller. A derma-roller is a mini wheel covered with tiny needles that prick the face. This is the at-home version of your dermatologist's micro-needling tool. You can get good results, but the office-based rollers will stimulate further into the skin and produce better results, notes Ivy.

Tempted by remedies that you have seen online? Not so fast, says Ivy. "Baking soda and coconut oil are not helpful for acne scars so you can set those aside for cooking," she says.

The bottom line

If you're unhappy with your skin's appearance, thanks to acne scars or discoloration, talk to your dermatologist about the best way to improve your skin's appearance without causing any unnecessary irritation.