How To Treat Acne Scars: The Complete Guide

by Gio

how to treat acne scars

“Gio, what are the best skincare products to treat acne scars?”

I hate this question. I don’t like to be the bearer of bad news. I know it’s devastating to get rid of acne, only to be left with raised, pitted scars all over your face. Ugh.

But I can’t lie to you either and tell you that drugstore glycolic acid exfoliant is gonna do the deed. It won’t.

The ugly truth is that topical skincare can’t treat acne scars. If you want to get rid of them once and for all, you need to see a dermatologist.

The treatment you get depends on the type of acne scars you’re dealing with. Here’s a quick guide to the 5 most common kinds of acne scars and how to treat them:

How To Treat Icepick Scars

What Are They?

Icepick scars are tiny, narrow holes in your skin. They look like someone took a needle (or ice pick) and punctured your skin with it. Ouch!

How Do They Develop?

Blame it on hormones. They give you cystic acne – those deep, super painful pimples on your jawline, cheeks and chin. In the process, your skin loses too much collagen. Your skin tissue falls apart, leaving tiny holes behind.

How Do You Treat Them?

Icepick scars are tricky to treat, but that doesn’t mean you’re stuck with them:

Related: Can Glycolic Acid Peels Treat Acne Scars?

How To Treat Keloid Acne Scars

What Are They?

Keloids acne scars are raised, discoloured, bumpy lumps that can grow way larger than the wound they’re healing. Often, they don’t stop growing even after it’s healed! WT…?!

How Do They Develop?

When your skin’s broken, your skin produces collagen to repair it. Normally, your body knows when the job’s done. But if it can’t tell and keeps pumping out collagen long after the wound has healed, you’re left with a keloid scar.

How Do You Treat Them?

You’re spoiled for choices here:

  • Cortisone shot/cream: this is usually the first thing your derm will try to shrink the scar. Sadly, it doesn’t always work.
  • Laser treatment: this usually reduces redness but is unlikely to make the scar itself that much smaller.
  • Retinoic acid:  daily application of 0.05% retinoid acid can reduce the appearance of acne scars by up to 79%! It works by bringing collagen production back under control. FYI, nope, topical retinol doesn’t work. You need the harsh prescription stuff for this.
  • Silicone gel sheeting: together with corticosteroid, this is the best treatment to get rid of keloid scars. Problem is, it’s cumbersome and lots of patients quit before they can see results. If you go down this routine, stick with it for several months.
  • Surgery: if the scar is huge and really bothers you, you can ask your derm to surgically remove it. I personally don’t recommend it because the nasty bugger often grows right back!!

How To Treat Boxcar Acne Scars

What Are They?

Shallow, round or oval depressions with sharp edges. Like icepick scars, they give your skin a pitted look.

How Do They Develop?

Your inflammatory acne destroys collagen, making you lose skin tissue. Left without support, that patch of skin gets pulled down, created a depressed, pitted area.

How Do You Treat Them?

Several ways, some more effective (and painful!) than others:

  • Derma fillers: think Juvederm or Restylane. They’re the quickest way to get rid of rolling acne scars. But, you guessed it, the results are temporary. You need to top up treatment regularly.
  • Fat transfer: your skin is often subcised before fat is transferred to fill in the scar. But results are only temporary.
  • Laser treatments: they trigger your skin to produce more collagen, but are best used together with other treatments.
  • Punch incision: your derm cuts out the scar before resurfacing the area. Results are slow and modest. If you want to go down this route, combine it with another treatment.
  • Subcision: in this surgical procedure, your derm cuts the fibrous base of the scar that’s pulling the skin down. Afterwards, your skin looks much smoother.

How To Treat Rolling Acne Scars

What Are They?

Rolling acne scars give your skin a wavy texture. They make you look like you have some hills all over your face. They’re soft and not sharply defined.

How Do They Develop?

You’re more likely to get rolling acne scars if you suffer from long-term inflammatory acne. Overtime, bands of tissues form between your skin and the subcutaneous tissue below. These bands pull the epidermis, making it lose its natural tightness and elasticity.

How Do You Treat Them?

Again, you have a few options:

  • Derma fillers: think Juvederm or Restylane. They’re the quickest way to get rid of rolling acne scars. But, you guessed it, the results are temporary. You need to top up treatment regularly.
  • Laser treatments: they boost collagen production and resurface the top layers of your skin. But you need numerous treatments to see significant results.
  • Subcision: in this surgical procedure, your derm cuts the fibrous base of the scar that’s pulling the skin down. Afterwards, your skin looks much smoother.

How To Treat Post-Inflammatory Hyperpigmentation

What it is?

Post-inflammatory hyperpigmentation is the dark mark a pimple has left behind after healing. It’s not a type of acne scars, but many people confuse it with scarring so it makes the list.

How Does It Develop?

Post-inflammatory hyperpigmentation happens when a pimple inflames your skin. During the healing process, your skin pumps out too much melanin (the pigment that gives your skin its beautiful, natural colour), leaving behind a dark mark.

How Do You Treat It?

Post-Inflammatory hyperpigmentation slowly disappears on its own. But you can speed up the healing process – and at home, too. Here’s how:

Best picks:

  • Dr Dennis Gross Ferulic Acid + Retinol Brightening  Solution ($88.00): retinol + licorice extract + bearberry extract. Available at Sephora.
  • Paula’s Choice Resist Brightening Essence ($42.00): arbutin + Vitamin C + Licorice extract. Available at Paula’s Choice.
  • Paula’s Choice Resist Triple-Action Dark Spot Eraser 7% AHA Lotion ($27.00): hydroquinone + glycolic acid  + kojic acid. Available at Paula’s Choice.
  • Paula’s Choice Skin Perfecting 8% AHA Lotion ($29.00): glycolic acid + allantoin + bisabobol. Available at Paula’s Choice.
  • The Ordinary Magnesium Ascorbic Phosphate Solution 10% (£7.80): Vitamin C. Available at Asos and Cult Beauty.


Related: How To Treat And Prevent Post-Inflammatory Hyperpigmentation

What’s the best to treat acne scars in your opinion? Share your experience in the comments below.



E November 26, 2018 - 7:34 pm

I got a hormonal IUD and it wreaked havoc on my skin (along with a slew of other bad side effects). I waited too long to have it removed. By the time I did, and the acne cleared up, I realized my previously unblemished skin had several rolling-type acne scars. It sucks because I was a full-grown adult without any scarring, so it’s weird to look at old photos and my face looks different now. Sigh. Thanks for the honest info, though; everyone’s always trying to give you false hope, and it’s hard to know what’s real and what’s bunk.

Gio December 9, 2018 - 10:24 am

E, I’m sorry to hear acne left you with scars. It can really give your confidence a hit, but you’re still the same beautiful person you were before. Acne scars don’t determine your beauty. Your personality does and I’m sure that’s wonderful. 🙂

You’re welcome. It breaks my heart to tell people that topical skincare products can’t treat acne scars because I know how desperate you are for a solution. But I don’t want you to waste money and hope on things that have no chance of working.

Brandi March 2, 2019 - 7:42 am

I have tried many products over the years for the odd and yet painful pimple and always spent money on top brand items. I was really impressed with the acne serum of dermalmd. It really works, no fuss, no pretensions. And the price is not crazy either.

Gio March 16, 2019 - 12:31 pm

Brandi, glad to hear you’ve found something that works for you. Thanks for the recommendation.

Carolyn April 22, 2019 - 10:51 pm

Have you tried Aerolase for hyperpigmentation?


Gio April 26, 2019 - 9:36 am

Carolyn, I personally haven’t as I don’t have pigmentation. But this laser is better for blood vessels than pigmentation.


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