How to get rid of acne scars
Acne can leave scars on the face and other areas. However, natural remedies, over-the-counter treatments, and medical treatments can help get rid of pimple scars.
Options for managing acne and reducing the appearance of scars include natural, over-the-counter, and prescription remedies.
Options will depend on the type and extent of scarring and include:
- chemical peels, such as salicylic acid
- retinoids and other creams
- laser treatment, microneedling, light therapy, and various other procedures
- surgery, in some cases
In this article, learn about various ways to help reduce the appearance of acne scars and promote healthy skin.
Types of acne scar
Suitable treatment options may vary slightly depending on the type of scarring that acne has caused. There are three main types of sources of acne scars:
Atrophic scars
These scars appear as small indentations in the skin.
- Icepick scars are small scars that look like pinpricks.
- Boxcar scars are larger indentations with clear edges.
- Rolling scars have unclear edges and give the skin a rolling or undulating appearance.
They occur when the skin does not make enough fibroblasts in the healing process. Fibroblasts are cells that play a crucial role in wound healing and collagen production.
Hypertrophic scars
These occur when the skin makes too many fibroblasts as the acne spot heals, causing a raised scar.
Keloid scars
These are similar to hypertrophic scars but tend to be thicker than the original acne spot. There is often hyperpigmentation, making them darker than the surrounding skin. They may be red or brown. There may also be itching or pain.
Which treatments are best for acne on darker skin tones?
Natural remedies
Many people use natural remedies to help clear up acne scars. However, the science behind them is unclear. Some may cause further irritation or other problems so people should use them with caution.
Home remedies that people have traditionally used to treat acne scars include:
- black seed oil, which may help even out skin pigmentation
- rosehip oil, which has helped reduce discoloration in postsurgical scars
- honey, which may help trusted Source wound healing and reduce future scarring
- aloe vera, which, combined with manuka honey, may promote trusted Source scar-free healing of wounds
Over-the-counter remedies
Various over-the-counter remedies can help reduce the appearance of acne scars. Products containing the following ingredients may be useful.
However, over-the-counter creams and lotions are unlikely to fully remove or flatten a raised scar.
Salicylic acid
Salicylic acid is a naturally occurring compound that is often an ingredient in acne skin care products. Salicylic acid peels help clear dirt, skin cells, and other debris that leads to acne from the pores of the skin.
A 2023 review Source suggests using a peeling product containing 30% salicylic acid and applying it three to five times every 3–4 weeks. The authors also note that it is unlikely to cause hyperpigmentation and is, therefore, suitable for use on darker skin.
It also helps reduce swelling and redness in the area, which may minimize the appearance of scarring.
Salicylic acid can help treat all scar types.
However, people with sensitive skin should do a patch test on a small area of skin before using it on their entire face, as it may cause dryness or irritation.
Retinoids
Some topical retinoids may help get rid of acne scars. As the authors of a 2017 reviewTrusted Source note, topical retinoids block inflammation, reduce acne lesions, and speed up cell regeneration.
The authors also state that retinoids could help lighten hyperpigmented acne scars, including those in people with darker skin tones.
It is important to note that retinoids can make the skin sensitive to the sun. Anyone using retinoids for acne or scar treatment should wear sunscreen when going outdoors.
Alpha hydroxy acids
Alpha hydroxy acids (AHAs) can help increase Source the rate at which skin renews its cells. Some doctors recommend AHAs for treating acne and reducing the appearance of acne scars.
AHAs are a mild form of acid that scrapes away the outer layer of skin to reveal fresh, new skin underneath. This process may help reduce hyperpigmentation due to scarring.
However, swelling, burning, and itching may occur at high concentrations. It is best to speak with a doctor before trying AHAs. They can help identify the best strength to use.
Lactic acid
Lactic acid is a type of trusted Source of AHA. It can act as a gentle peel to pull away dead skin cells. It may help reduce the appearance of scars and smooth the skin.
One reviewTrusted Source recalls a small study in which seven people with icepick scars had treatment with a product that was 92% lactic acid. There was an improvement of over 75% in one person, 51–75% in three people, 26–50% in two people, and 1–25% in one person.
Lactic acid may also help lighten dark scar tissue, although it can cause trusted Source hyperpigmentation, too. It is best to test products that contain lactic acid on a small patch of skin before using them to treat acne scarring.
Many products for acne contain lactic acid. It is also present in diluted apple cider vinegar, which makes for a more natural, cost-effective treatment.
Silicone dressings
Experts do not know how these work, but they appear to help reduce the appearance and size of acne scars. They may do this by providing hydration. They can also reduce itching and pain and increase the flexibility of the skin.
A person will have to use the dressings all the time, which can be difficult on the face. Most people do not experience side effects, though some have itching and irritation.
Medical treatments
Some medical treatments may help reduce acne scars.
A dermatologist can recommend a suitable procedure or combination of therapies depending on a person’s skin type and the extent of the scarring.
Options include:
Chemical peels
A dermatologist can recommend a type of peel that is suitable for a person’s skin type, acne severity, and scarring.
The authors of a 2023 review trusted Source on treatments for acne scarring note a study that found that six of 10 participants using a specific type of chemical peel called trichloroacetic acid (TCA) had at least a 70% improvement in their acne scarring.
Other chemical peels may be less effective. For instance, 25%Trusted Source of those who used glycolic acid did not see any reduction in the appearance of scars.
A person may need to try different types of peel to determine which one works for them.
Injections
Injections of corticosteroids may help soften and flatten raised acne scar tissue if a person has hypertrophic or keloid scars.
The treatment typically consists of a series of injections. A dermatologist can do these injections in their office once every few weeks, monitoring the results.
Dermal filler
In some cases, dermatologists may recommend soft tissue fillers to treat atrophic acne scars. They may be particularly helpful for rolling and boxcar scars.
Options include trusted Source:
- collagen-based products
- polymethylmethacrylate
- hyaluronic acid
- polyacrylamide
- poly-L-lactic acid
- silicon
Depending on the filler, a person may need to repeat the treatment after some months. Hyaluronic fillers, for example, last around 3 monthsTrusted Source, but silicon and polyacrylamide may never need replacing.
Fillers can have adverse effects, but these will depend on the filler. Always speak with a doctor about the pros and cons before opting for treatment.
Microneedling
Microneedling is the process of inserting tiny needles into the skin surrounding the scar to stimulate the body to make more collagen. This collagen may reduce the appearance of atrophic acne scars by smoothing out the skin.
In a 2023 review, microneedling provided an improvement of 31–62%Trusted Source in the appearance of atrophic or indented acne scars.
A 2022 study Trusted Source found that when people combined microneedling with the use of collagen gel, the results were significantly more effective than microneedling alone.
However, microneedling can cause side effects. Many people experience redness, pain, and inflammation after the treatment. However, these effects subside over time.
Laser treatment
Laser treatment resurfaces the skin without the use of chemicals or scrubs. It removes the uppermost layer of skin to reveal the younger skin cells underneath, which can help reduce the appearance of scarring.
It can help reduce the appearance and texture of raised scars. Treatment with a pulsed dye laser can also help reduce the color of hyperpigmented scars.
Intense pulsed light treatment may be a better option for people with pale skin, according to the American Academy of Dermatology.
Laser treatment is not suitable for everyone. This will depend on the type of acne scarring and the person’s skin type. The treatment may also cause a reaction in some people, especially those with sensitive skin.
Surgery
If other treatments do not help, surgery can remove raised acne scars. Surgery alone may not be enough to solve the problem, and a doctor may recommend further treatment.
Electrodessication
Used alongside other treatments, this may help reduce the edges of boxcar acne scars, making the skin appear flatter and less indented. A doctor will use electric probes to heat the skin and kills the tissues that cause the edges around the scars.
How to get rid of acne boxcar scars
Boxcar scars appear as craters in the skin and can develop as a result of acne or chickenpox. Treatments are available to reduce their appearance, such as dermarolling, microdermabrasion, and surgery.
Boxcar scars are also known as craters or pockmarks. While they are not physically harmful, they can cause distress and low self-esteem, particularly when they appear on the face.
This article looks at what boxcar scars are, why they form, and how to reduce their appearance.
What are boxcar scars?
Boxcar scars are a type of atrophic acne scar. An atrophic scar is a depressed scar that heals below the normal layer of skin tissue.
There are three main types of atrophic acne scars:
- boxcar scars, which look like round or oval craters in the skin
- ice pick scars, which are small, deep, narrow scars
- rolling scars, which form when bands of scar tissue grow under the skin, giving it an uneven appearance
What causes boxcar scars?
Boxcar scars form when the skin tries to heal after an injury but does not produce enough collagen. Collagen is a substance that helps support the skin, so a lack of collagen causes pitting.
Any type of acne can cause boxcar scars. They sometimes develop following chickenpox, too. Some risk factors make acne scars more likely, such as:
- having severe or inflammatory acne (nodules and cysts)
- having untreated inflammatory acne for a long time
- popping or squeezing acne blemishes before they heal
- having relatives who are prone to acne scars
According to the American Academy of Dermatology (AAD), while genetics and other risk factors influence who will or will not develop acne scars, they are not a guarantee. It is not always clear why one person develops scars while another does not.
Can boxcar scars heal on their own?
Boxcar scars will not heal on their own. However, they may fade over time.
Treatment for boxcar scars can reduce their appearance. Sometimes, though, very deep boxcar scars remain visible even after treatment.
How to reduce the appearance of boxcar scars
There are a variety of ways to try to minimize the appearance of boxcar scars. The method a person chooses may depend on the depth and severity of the scars.
Dermarolling
Dermarolling, or microneedling, involves rolling or pressing tiny needles over the skin to create small injuries. This stimulates collagen production, which can reduce the appearance of depressed scars.
A 2014 study found that acne scars improved in their appearance after three trusted Source microneedling treatments when compared to a control group. Participants did not report much pain.
Dermarolling has few risks when performed safely. However, it takes time for collagen to form, so people may require 3-6 treatments.
Chemical peels
Chemical peels involve a dermatologist applying acids to the top layer of skin to exfoliate it. This allows new skin cells to grow. It is a form of resurfacing treatment.
A 2012 study by Trusted Source found that superficial chemical peels effectively treat atrophic scars with relatively few side effects or complications. A 2015 review suggests that five sequential sessions of 70% glycolic acid rusted Source every 2 weeks produces better results than other acid solutions.
Chemical peels can cause side effects, such as pain, redness, or flaking. This is more likely with stronger acid solutions. People may need to follow a special skincare routine while undergoing treatment and wear SPF to prevent sun damage.
Dermabrasion
Dermabrasion and microdermabrasion are facial resurfacing techniques that involve removing the epidermis, or top layer of skin cells, to encourage new skin cells to grow.
A person can choose from:
- Microdermabrasion: People who are qualified to carry out cosmetic skin treatments can carry out this procedure, which involves removing the very top layer of skin cells.
- Dermabrasion: This is a stronger form of exfoliation and removes the entire top layer of the skin. Because of this, only medical professionals should perform dermabrasion.
Dermabrasion may not be a suitable Source for deep boxcar scars. Like other resurfacing treatments, it can also increase the skin’s sensitivity to sunlight.
Laser resurfacing
Laser resurfacing is another type of skin resurfacing that can help minimize the appearance of mild to moderate boxcar scars. There are two types of trait sources:
- Ablative laser treatment: This is a laser treatment that involves removing a small patch of skin around the scar, leaving a new, smooth-looking area of skin in its place.
- Non-ablative laser treatment: In this treatment, lasers stimulate collagen production to help improve the appearance of the scar without removing any skin.
Ablative laser treatment can produce more drastic results, with significant improvements after only one treatment. However, there is also a higher risk for infection than non-ablative treatments.
Fillers
Fillers are skin injections that contain substances to plump up the skin. Depending on the type of filler, it may contain collagen or fat from another part of the individual’s body.
Fillers can reduce pitting and even out the skin. However, most give temporary results, lasting between 6-18 months. Some types of filler are permanent.
Surgery
Medical professionals can also remove acne scars surgically. This option is best for those with a small number of scars. There are two types of procedure:
- Punch excision: This involves removing individual scars, creating a new scar that is less obvious than the original. This is one way to reduce the appearance of deep boxcar scars.
- Subcision: During this procedure, a doctor inserts a needle under the skin and passes it in multiple directions, separating the scar tissue from the skin. The body then produces collagen as the skin heals. Subcision is better for shallower boxcar scars.
Some doctors also provide platelet-rich plasma (PRP) injections alongside subcision or microneedling treatment to enhance their effects.
A 2019 study suggests that over 2 years, the combination of subcision and PRP can improve scars by 32%Trusted Source. Subcision alone, by comparison, improved scars by 8.3%.
Is it safe to use dermarollers at home?
Some people use dermarollers and dermastamps at home. However, it is important to be aware that home kits may carry some risks.
It can be difficult to sterilize dermaroller needles at home properly. If a person does not sterilize or change the needle head frequently enough, they may be at risk for infection.
The needles that come in home dermarolling kits are also shorter than the ones professionals use and penetrate the skin at an angle. This may mean they do not work as effectively as professional microneedling treatments.
An older article in the Journal of Cutaneous and Aesthetic Surgery recommends:
- choosing high-quality dermarollers or stamps with needles shorter than 0.15 millimetersTrusted Source in length
- sterilizing the device with hot water or a sterilizing product after use before leaving to dry
- using the roller up to twice per week
- replacing the needle head every 100 uses and disposing of the old one safely
When to see a doctor
Boxcar scars are not something that requires immediate medical attention, but they can have a significant impact on mental health. If that is the case, people should speak to a doctor or dermatologist about their options.
Frequently asked questions
Here are some answers to questions people often ask about acne scars.
How can I prevent acne scars?
It is not always possible to prevent acne or scarring, but people with acne can take measures to reduce the risk.
These include seeking treatment while acne is present and avoiding picking, popping, or touching acne, which may lead to infections and a higher chance of scarring.
How can I remove acne scars and discoloration?
Depending on the type and extent of scarring, there are various ways to remove or reduce acne scars. Fillers, for example, can help indented or atrophic acne scars. Laser treatment may reduce hyperpigmentation and flatten raised scars.
A dermatologist can help decide on a suitable option, depending on the person’s skin type and the extent and type of scarring.
Can treatment remove scars permanently?
Treatment can often help remove scars, but scars also tend to fade with time. How effective treatment will be will depend partly on the type and extent of scarring and the person’s skin type.
Treatment can be costly and time-consuming, and it is worth thinking carefully and talking with a dermatologist about what to expect.
Summary
Acne scars can be an unwanted reminder of acne and may reduce self-esteem in some people. However, treatment can often reduce their appearance.
Many people have success using one or more home remedies. In cases of stubborn scarring, receiving medical treatments in the dermatologist’s office can also help remove acne scars.
Always work with a qualified dermatologist when seeking help for acne scars, as some treatments can have adverse effects if used incorrectly.
