Acne scar treatment: every option, compared

Acne scar treatment means the procedures and medicines that make acne scars less noticeable. Most of them are done or supervised by a dermatologist: lasers, microneedling, chemical peels, subcision, fillers and small scar surgeries. Creams play a smaller role, limited to mild scars. The American Academy of Dermatology (AAD) sets a realistic goal: acne scars "can fade. However, they rarely go away. A board-certified dermatologist can minimize the look of the scars." This guide compares every option in one place, explains which scars each one suits, and gives the evidence, risks, recovery and costs the sources describe. Each option has its own detailed guide in this section.

Skinli gives general education and is not a doctor. Nothing here replaces an exam by a dermatologist, who is the right person to judge your scars.

First, make sure it is a scar

Two different problems get called acne scars, and they need different care.

	Flat mark	Scar
Surface	Smooth, level with the skin around it	Lower (a dent) or higher (a bump) than the skin around it
Color	Red, pink, brown or bluish gray	May be discolored at first, and that color usually fades
What happens over time	The AAD says it "usually fades over time"	The AAD says acne scars "rarely go away" on their own
Where to start	Dark marks after pimples	This guide

The AAD calls the flat mark post-inflammatory hyperpigmentation. It says the color that comes with a new scar also fades: "Over time, the discoloration usually goes away. However, the scar remains." If you are not sure, look in daylight with light coming from one side, which makes dents and bumps cast a shadow. The guide types of acne scars shows each type, and are acne scars permanent explains which ones change on their own. For a broader look at scars and marks together, see how to fade acne scars and dark marks.

Step one is clearing active acne

Every source puts active acne first. The AAD says: "If you have acne breakouts, your plan will likely begin with acne treatment. Stopping acne breakouts can reduce inflammation and prevent new acne scars. Treatment for scars typically begins after you have acne under control."

There are three reasons for this order:

• New breakouts make new scars. The AAD's aftercare page says "new acne breakouts could cause new acne scars."
• Some acne medicines affect procedures. The AAD asks you to tell the dermatologist about "all acne treatments that you are using or have used within the last two years," because "starting some scar treatments while using (or soon after stopping) certain acne medications can cause unwanted side effects."
• Scars keep changing for a while. NICE, the UK body that writes treatment guidelines, advises referral to a specialist scar team when severe scarring "persists a year after their acne has cleared."

For everyday acne, the free Skinli acne plan builds a routine around benzoyl peroxide 2.5 percent and adapalene 0.1 percent, and tells you when to see a doctor. For acne that is deep, painful or leaving scars, see a dermatologist. The 2024 acne guideline from the American Academy of Dermatology strongly recommends isotretinoin, a prescription pill, for acne that is severe or causing scars. The guide severe acne and when to see a dermatologist explains that visit.

All the options in one table

This table sums up what the AAD, the FDA and the research reviews say about each treatment. Each row links to the full guide.

Treatment	Best suited to	Sessions	Downtime	Main risks
Laser	Rolling and boxcar scars; raised and papular scars with some lasers	Often a series	None for non-ablative lasers; longer for ablative lasers	Pain, burns, dark or light patches
Microneedling	Sunken scars of mixed types	3 to 5, every 2 to 4 weeks	A few days to a week of redness	Redness, bruising, infection, color changes
Chemical peels	Ice pick scars (with TCA CROSS); shallow boxcar scars	3 to 5 for mild peels	1 to 7 days for light peels, up to 21 days for deep peels	Lasting redness, dark or light patches
Subcision	Rolling scars	Often more than one	Days of bruising and swelling	Bruising, lumps, numbness, scars can sink again
Dermal fillers	Rolling scars	A series, plus touch-ups	Usually none	Bruising, lumps; rarely blocked blood vessels
Retinoid creams	Mild scarring; preventing new scars	Daily use for months	Early redness and peeling	Irritation, sun sensitivity
Steroid injections and silicone (raised scars)	Hypertrophic scars and keloids	A series	Minimal	Thin skin, light spots, keloids returning

Treatments for sunken scars

Laser. The AAD says dermatologists "use lasers to resurface skin with acne scars. As your skin heals after laser resurfacing, it produces collagen and elastin, which can diminish the appearance of scars." Collagen and elastin are proteins that give skin its support and stretch. A 2018 review in Scars, Burns and Healing found that ablative lasers, which remove the top layers, gave the largest improvement, with the most pain, recovery time and risk of lasting changes in skin color. NICE lists CO2 laser, "alone or after a session of punch elevation," for severe scarring in a specialist team. The AAD describes the limit this way: "When you have laser scar treatment, you're replacing one scar with another less-noticeable scar."

Microneedling. A dermatologist uses tiny needles to puncture the skin, and "puncturing the skin causes the body to produce new collagen and elastin," the AAD says. The FDA has authorized microneedling devices "to improve the appearance of facial acne scars" in adults 22 or older. The AAD calls it "safe for all skin tones" and says a typical plan is 3 to 5 treatments every 2 to 4 weeks. Radiofrequency microneedling adds heat through the needles; the FDA issued a safety communication about it in October 2025 after reports of burns, scarring and nerve damage.

Chemical peels. A peel "helps the body produce more collagen and elastin," the AAD says. The strength ranges from mild to strong. A 2017 review in Scars, Burns and Healing found that ice pick scars responded well to TCA CROSS, in which a dermatologist places a strong acid into the base of each scar. NICE names a glycolic acid peel for severe scarring. The FDA warned in 2024 against strong peels sold for home use, which can cause chemical burns and "disfiguring scars."

Subcision. Rolling scars are held down by bands of tissue under the skin. In subcision, a dermatologist slides a needle or blunt tool under the scar to cut those bands. The AAD describes scar surgery in which the dermatologist "surgically lifts the scar from the underlying tissue. Once freed, the skin rises." The 2017 review found improvement "in the range of 10-100%" across 10 studies.

Fillers. The AAD says fillers add volume to depressed scars and "can also help your body produce more collagen and elastin." Most last "3 months to 2 years," and some are permanent. The FDA says permanent fillers are approved "for only nasolabial folds and cheek acne scars." A 2016 Cochrane review found "moderate-quality evidence that injectable filler might be effective," the strongest grade it gave any scar treatment.

Radiofrequency. The AAD says this procedure "uses radiofrequency waves to help your skin produce collagen and elastin," and that radiofrequency and radiofrequency microneedling "are safe for all skin tones."

Scar surgery and dermabrasion. The AAD says minor surgery "may involve removing a scar and closing the area with stitches or a skin graft," done with local anesthesia so you stay awake without pain. Dermabrasion is a surgical sanding of the top layers of skin. MedlinePlus, from the U.S. National Library of Medicine, lists "scars on the face due to acne" among its uses, and names lasting color changes and scars among its risks. It says people with dark skin "are at greater risk of having dark patches of skin after the procedure."

Platelet-rich plasma. A small amount of your blood is spun in a machine to separate the platelets, which are then applied or injected. The AAD says "using PRP along with another treatment like microneedling can lead to less visible scarring."

Creams. The AAD says that "if you have mild acne scarring, a retinoid or salicylic acid can make scarring less noticeable." A 2023 review found a "lack of evidence to support the widespread use" of creams and gels for acne scars. Creams matter most for clearing acne and preventing new scars. See tretinoin for acne scars and home remedies for acne scars.

Treatments for raised scars

The AAD explains: "When treating depressed scars, the goal is to get the body to produce more collagen to fill in the depressed areas. Raised scars develop when the body produces too much collagen, so they require different treatment." For hypertrophic scars, it lists "laser treatments, injections of corticosteroids or another medication, or applying a prescription medication to the scar(s)." For papular scars, it lists lasers.

Keloids, raised scars that grow past the original breakout, are the hardest. The AAD says they "can be difficult to get rid of, and some return after treatment," so dermatologists combine injections, freezing, laser, surgery, pressure and silicone gel sheets. It says "between 50% and 80% of keloids shrink after being injected," but "many of these keloids, however, will regrow within five years." People who form keloids should avoid microneedling, the AAD says. The guide raised acne scars covers all of this, and back acne scars covers the chest and back, where raised scars often form.

Matching the treatment to the scar

The AAD says "ice pick scars require different treatment than rolling scars," and that a dermatologist plans around "the type of acne scars you have, how many scars you have, your age and skin tone, your budget, and many other considerations." The research reviews add detail:

Scar type	What it looks like	Treatments the sources link to it
Ice pick	Narrow, deep hole under 2 millimeters wide	TCA CROSS; responds least to lasers
Boxcar	Round dent with steep edges, 1 to 4 millimeters wide	Lasers and peels for shallow scars
Rolling	Wide, shallow dip, 4 millimeters or more, wavy skin	Subcision, fillers, lasers
Hypertrophic	Firm bump inside the old breakout	Steroid injections, laser, silicone
Keloid	Bump that grows past the old breakout	Several treatments together
Papular	Small skin-colored bump on the nose, chin, jaw or back	Lasers

Most people have more than one type. The AAD says most people with acne scars "often develop more than one type of depressed acne scar," and a 2017 review says "different types of scars may also be present in the same patient."

Combining treatments

Because scars come in mixed types, combinations are common. The AAD gives examples:

• "Your dermatologist may perform acne surgery to lift some sunken scars and then inject a filler to give the treated scars more volume."
• "If a patient has deep acne scars, a dermatologist may treat the scars with a laser. The patient may also get a filler."
• Microneedling "is often used along with another treatment like radiofrequency, chemical peeling, or platelet-rich plasma."
• "Another procedure like laser resurfacing or platelet-rich plasma may be used after acne surgery to improve results."

How strong the evidence is

There are many studies on acne scars, and most have weak designs. A 2016 Cochrane review, which pools trials to judge how strong the evidence is, found "a lack of high-quality evidence about the effects of different interventions for treating acne scars because of poor methodology, underpowered studies, lack of standardised improvement assessments, and different baseline variables." It concluded that no treatment had strong enough evidence to be the first choice for everyone. The 2018 review of lasers and similar devices reached a similar view: "There is an overall lack of high-quality evidence about the effects of different interventions."

NICE's guideline committee said a "considerable amount of evidence" existed, but "the types of comparisons made interpretation of the effectiveness of treatments difficult." It chose CO2 laser, with or without punch elevation, and glycolic acid peel as options that showed some improvement in scars.

In practice, this means two things. Results vary from person to person, and the dermatologist's skill matters. The AAD says of lasers: "Your results depend largely on the skills of the person performing the laser treatment."

Treatment on darker skin

Darker skin needs extra care. MedlinePlus says people with dark skin are at greater risk of dark patches after dermabrasion, and the sources give specific advice for other treatments:

• Raised scars are "more common in people who have darker skin tones," the AAD says.
• Microneedling and radiofrequency are "safe for all skin tones," according to the AAD. The FDA adds that some authorized microneedling devices "were not studied in subjects with darker skin types."
• Chemical peels can be safe, but the AAD says people with skin of color should see "a dermatologist who has expertise using chemical peels to treat darker skin tones," to avoid "permanent pigment problems."
• Keloid freezing "can cause a permanent light spot on brown or black skin," the AAD says, and steroid injections can leave light spots.

The AAD's list of questions for any cosmetic procedure includes: "How often do you treat patients with my skin tone and type?" The guide acne on darker skin covers acne care for brown and black skin.

Cost, sessions and recovery

• Cost. The AAD says "medical insurance does not cover the cost" of acne scar treatment. Prices vary by treatment, clinic and number of sessions. This guide found no independent medical source that lists them, so ask for the full cost of the whole plan.
• Sessions. The AAD says acne scar treatment rarely takes a single session: "You may need three or more treatments to get the best results."
• Time to results. The AAD says results take time because "it takes time for your body to make collagen and elastin." For lasers, "it can take months to see the results."
• Aftercare. The AAD says to apply sunscreen every day to treated skin, avoid tanning, and limit time outdoors during the day for 6 to 8 weeks, "even on cloudy or cool days." It warns that "after treatment, the sun can darken treated skin."

Choosing a provider and preparing

The AAD recommends a board-certified dermatologist for scar procedures, and it warns against treatment in non-medical settings. For fillers, it says never to get one injected at a non-medical spa, a party, a salon or someone's home. For lasers, it says that if someone promises to treat your scar before a medical consultation, you should leave and find another provider.

Before your consultation, the AAD suggests asking yourself three questions: "Do I often wish that I could get rid of my acne scars? Do my scars limit my opportunities to date, get a job, advance my career, or perform well in school? Am I less outgoing and social now than before I had acne scars?" If you answer yes to one or more, a consultation can help. It also suggests deciding how you want to look after treatment, what you can spend, and how much downtime you can take.

At the consultation, the AAD suggests asking what results you can expect, the risks, how many treatments you will need, the recovery time, and the cost.

Home care that helps

While you plan treatment, the sources support a few home steps: protect scars from the sun, stop picking and squeezing spots, treat active acne, use a retinoid for mild scarring, and use silicone gel sheets for raised scars. The NHS warns: "do not pick or squeeze spots because this can cause scars." The guide home remedies for acne scars covers what the evidence says about aloe, vitamin E, lemon juice and other popular remedies, including the ones that can harm skin.

When to see a dermatologist

See a dermatologist as soon as acne starts leaving dents or bumps. The NHS says to see a GP if your spots "are deep, painful or causing scars," and NICE lists acne that is leading to scarring as a reason to consider referral to a dermatologist. See one too if a raised scar keeps growing, or if scars bother you after your acne has cleared.