Acne scars are often stubborn, but they can fade with treatment and time. The best at-home treatments can help lighten or hide dark marks, but dermatologists can also help create a more comprehensive treatment and prevention plan. This can include prescription medications, like isotretinoin or a topical retinoid or acid, but it could also involve laser therapy or surgical excisions for more severe cases.
The type of acne scarring a patient has and their skin tone are important factors for optimizing an individual’s treatment plan. For example, a person with rolling scars might choose to use fillers to reduce their appearance, while someone with deeper ice pick scars may opt for surgical excision and a skin textural correction procedure called subscision. Depending on the size and depth of an acne scar, some treatments require multiple sessions or a period of recovery to see results.
Dermabrasion. This technique uses a rotating brush to remove the top layer of the skin, which can minimize the appearance of surface scars and make them less noticeable. It can be mild, medium, or deep and should only be performed by a licensed professional. It can cause redness and pigment changes, which is why it’s not recommended for darker skin tones.
Chemical peels are another popular option to acne scar treatment scarring. While this is a safe and effective procedure, it can take weeks to see the results of a medium or deep peel and can cause redness and pigmentation changes in some patients. It can be combined with other procedures, such as microneedling and laser treatment, to increase the effectiveness and to lessen downtime and recovery.
Dermal fillers offer a nonsurgical option to reduce the appearance of scars, as well as improve skin texture and brightness. Several types of fillers can be used, including hyaluronic acid (HA) and polylactic acid, which are both found naturally in the body. There are also collagen boosters, which help the skin repair itself and reduce fine lines.
There are also topical products that can help with discoloration caused by scarring, especially in patients with dark skin tones. These include azelaic acid, which Farber says works by inhibiting the formation of an enzyme, tyrosinase, that produces the skin-darkening melanin. He recommends this formula from The Ordinary, which combines azelaic acid with glycolic and lactic acids for all-over fading, as well as vitamin C, which prevents free radical damage and brightens the complexion.
Surgical excision is a last resort, but it can be helpful for some people with deep boxcar or ice pick scars, which are difficult to correct with other modalities and can have an unnatural look. Dermatologists can perform a variety of surgical techniques to help eliminate these deep scars, including punch excision, elliptical excision, and subscision. These treatments can also be combined with other modalities, such as laser therapy and tissue augmenting agents.