95% of acne sufferers develop some scarring. The severity of your acne, delays in treatment and genetics influence scar formation. Early treatment can help to prevent scarring. Scarring and hyperpigmentation can develop without treatment.

Scarring is a natural part of the healing process. How you heal depends on your age, genetics, skin color and health.

Permanent acne scarring can considerably impact your self-esteem and quality of life. Untreated acne scars can become more visible with age. There are many effective treatments that can improve acne scarring. Combination therapy provides the best approach to treating acne scarring.

Depressed acne scars

Depressed acne scars (Atrophic scars) are the most common type of acne scarring. Best results often come from using two or more treatments. The treatments that a dermatologist may use to treat depressed acne scars include the following:

Resurfacing procedures

Resurfacing removes layers of skin, which allows the body to produce new skin cells. Resurfacing procedures are as follows:

  • Laser skin resurfacing
  • Chemical peeling
  • Dermabrasion
  • SilkPeel (Dermalinfusion)

Resurfacing works well for treating acne scars that are nearly flat (not too deep). Even dermabrasion, which removes the top layers of skin and some of the middle layers, cannot effectively treat deep acne scars.

Best for: Depressed acne scars that are not deep. Useful for contouring scar edges to make scars less noticeable.

Deep depressed scars: If you have a deep Icepick scar (often looks like a large pore), punch excision will remove the scar. The small scar created can be removed by a chemical peel or laser therapy. Another type of acne scar surgery called “subcision” may be necessary to give you the results you want.


Subcision is an in-office surgical technique to improve the appearance of depressed scars, wrinkles and cellulite. It is most commonly used to treat acne scars. However, it can also improve scars from surgery, trauma or other reasons. During the procedure, your dermatologist inserts a hypodermic needle or cannula underneath the scars to break the fibrotic strands that tether the skin to the underlying tissue. This can help lift the atrophic and depressed scar and also releases the mediators that can stimulate collagen production. Subcision should be repeated up to six times, at least four weeks apart for optimal outcome.


Dermatologists use fillers to safely and effectively plump depressed acne scars. They may fill acne scars with hyaluronic acid, the patient’s own fat, or Radiesse. Many fillers give us temporary results, which last between 6 and 18 months. Some fillers are permanent.

Skin tightening

This is a newer treatment and tends to be more affordable. This treatment is safe for all skin colors. Dermatologists often use a technology called radiofrequency to tighten the skin. As the skin tightens, depressed acne scars become less noticeable. Radiofrequency requires repeat appointments. Most patients return once a month for four months. After a radiofrequency treatment, many patients say they feel a burning sensation for about one hour and their skin has a pinkish color for two to three days. For at least one week after each treatment, you will need to apply sunscreen every morning and a moisturizing cream at night.

Best for: Depressed acne scars. Sometimes, skin tightening effectively treats deep icepick and boxcar scars.

Collagen-induction therapy

Also known as “micro-needling,” this treatment encourages your body to make more collagen. To perform this procedure, a dermatologist moves a sterile, handheld needle-studded roller across the depressed acne scars. This punctures your skin. As your skin heals, it produces collagen. Many patients require between three to six treatments every two to six weeks.  After each treatment, you may have some swelling and possibly bruising. These side effects usually clear within four to five days.

Raised acne scars


Your dermatologist may recommend injecting medicine directly into the scars. This can soften and flatten raised, thick scars. Getting the best results often requires repeat visits. These injections are usually given once every few weeks. You may need to return once every two to six weeks for a while.

Many patients receive injections of corticosteroids. A topical chemotherapy medicine can also be effective in treating raised acne scars.

Acne scar surgery

To perform acne scar surgery, a dermatologist may lift the scar. Bringing a scar closer to the surface of the skin tends to make it less noticeable. Another type of acne scar surgery involves breaking up scar tissue (subcision).

Laser therapy

Lasers and other light treatments can treat raised scars safely and effectively. Treatment with a pulsed dye laser (PDL) and Frax 1550 can help reduce the itch and pain, diminish color, and flatten a raised scar. For people with lighter skin, intense pulsed light (IPL) also may be a treatment option.

Scar creams, gels, and silicone dressings

Often available without a prescription, these products can be used at home to treat raised scars. They can help reduce the itch and discomfort as well as shrink, flatten, and fade raised scars. Silicone dressings and bandages can be especially helpful. Although no one knows exactly how these work, one possibility is that silicone helps hydrate the skin.

Treating your acne scarring can help to restore self-esteem and eliminate your efforts at hiding your scars. Contact Dr. Pantea Hashemi at the University Skin Clinic in Sacramento. She has a tool box of options to remove or reduce the appearance of your acne scars.