Medically reviewed by: Mahir Patel, M.D.
Acne scars are a common and highly unwelcome acne complication that can shape how we see ourselves. The desire to address scarring is not just a matter of personal vanity; there is robust clinical evidence that living with acne scars can have a significant psychological impact.
A 2025 observational study found that acne scarring was strongly associated with a diminished quality of life, increased rates of anxiety and depression, and impaired social functioning. The authors concluded that treating acne scarring should be considered essential to reducing the psychological burden of this condition – not merely an aesthetic preference.
Cosmetic dermatology with Advanced Dermatology, P.C. offers a variety of effective solutions. This guide will help you compare acne scar treatment options, understand which methods work best for different scar types, and make informed decisions about your care.
Understanding acne scar types
Knowing your scar type is the first step toward choosing the best treatment for acne scars.
Atrophic scars
Atrophic scars are depressed scars; they’re the acne scars that appear as pits and pinpricks. They typically fall into three categories:
- Icepick scars: Narrow, deep, and pitted
- Boxcar scars: Broad, sharply defined edges
- Rolling scars: Wide and shallow with wavy edges
The indentation that characterizes atrophic scarring is caused by loss of collagen in the wound area during healing.
Hypertrophic and keloid scars
Hypertrophic scars are raised, firm scars above the skin’s surface. They occur when the wound (acne lesion) generates excessive connective tissue and collagen during the healing process. This additional collagen, which is thicker and less flexible than surrounding skin, is the firm bump or lump that forms the scar.
Keloid scars, like hypertrophic scars, are raised above the skin. However, while hypertrophic scars don’t extend beyond the area of the original acne lesion, keloid scars often do.
Keloid scars also differ from hypertrophic scars in color and texture. While hypertrophic scars tend to be flesh colored, pink or red, keloid scars are more often pink or purple.
Post-inflammatory hyperpigmentation (PIH)
Post-inflammatory hyperpigmentation (PIH) refers to the dark spots or patches that remain after an acne lesion has healed.
Unlike true scars, PIH does not involve a change in skin texture or structure instead, it results from excess melanin production as the skin recovers from inflammation. PIH is especially common in individuals with medium to deep skin tones, who naturally produce more melanin.
Because the additional melanin so often corresponds with lingering discoloration after breakouts or other skin injuries, targeted treatment is essential. This is not only for restoring an even complexion, but mitigating the risk of further hyperpigmentation from the treatment itself.
The board-certified dermatologists at Advanced Dermatology, P.C. offer in-depth expertise in treating acne scars on melanin-rich skin. With a nuanced understanding of pigmentation, scarring patterns, and the unique risks associated with deeper skin tones, our team tailors every treatment plan to ensure safety, effectiveness, and a smoother, more even complexion.
Microneedling for Acne Scars
Microneedling is a minimally invasive procedure that creates controlled punctures in the skin, prompting the body’s natural repair process. This signal stimulates fresh collagen production, supporting smoother, healthier skin over time.
- Softens the look of scars.
- Smooths out rough texture over time.
- Effective for atrophic scars (rolling and boxcar).
- Minimal downtime.
Microneedling triggers new collagen and softens the appearance of atrophic scars – especially rolling and boxcar types – while gradually smoothing out rough skin texture.
Microneedling is associated with minimal downtime and is typically performed in a series of sessions spaced several weeks apart.
Benefits of microneedling
- Suitable for most skin types.
- Improves atrophic (depressed) scars, including rolling and boxcar scars.
- Minimal downtime; usually mild redness for 2–3 days.
- Can be paired with radiofrequency (RF) for enhanced results, especially for darker skin.
What to expect
- Series of 3–6 sessions, spaced 4–6 weeks apart.
- Topical numbing cream for comfort.
- Noticeable results after a few sessions.
At Advanced Dermatology, P.C., your dermatologist will customize your microneedling plan based on your skin’s unique needs and response to treatment. Most patients see gradual improvement after several sessions, with each appointment allowing the skin time to rebuild between visits.
Chemical peels for acne scars
Chemical peels are a proven method for renewing the skin’s surface. They are dermatological procedures that use specially formulated acidic solutions to exfoliate and remove the damaged outer layers of skin.
During the treatment, a dermatologist carefully applies the chemical solution to the targeted area, allowing controlled resurfacing that stimulates new, healthier skin growth and improves the appearance of acne scars.
By removing damaged outer layers, these treatments create a pathway for smoother, healthier skin to emerge.
The depth of the peel determines which scars can be treated.
- Light peels are best for mild discoloration or rough texture.
- Medium peels help with moderate scarring.
- Deep peels are reserved for the most stubborn scars.
Benefits of chemical peels
- Best for mild atrophic scars and post-inflammatory hyperpigmentation.
- Can even skin tone and smooth roughness.
- Quick procedure; minimal to moderate downtime depending on peel depth.
What to expect
- Light peels: mild flaking, no downtime.
- Medium peels: 5–7 days of peeling.
- Deep peels: longer downtime, reserved for severe scars.
- Multiple sessions may be needed for best results.
It is important to recognize that peels alone will not erase every type of scar, especially those that are raised or deeply indented.
Chemical peels are frequently combined with other therapies for more comprehensive results. Our board-certified dermatologists will recommend the optimal peel depth and treatment combination based on your unique skin type and goals
Laser Treatment
Laser treatment can dramatically improve acne scars by removing damaged layers of skin or gently heating deeper tissue to stimulate the body’s natural collagen production.
According to a study published in the International Journal of Dermatology, fractional laser resurfacing can achieve significant improvements in scar depth and skin texture after only a few sessions, with most patients reporting high satisfaction rates. This approach is especially effective for boxcar scars, as their sharp edges respond well to resurfacing.
However, individuals with darker skin tones have a higher risk of pigment changes following laser procedures. This includes post-inflammatory hyperpigmentation and, rarely, loss of pigment, especially if inappropriate laser settings are used.
Benefits of laser treatment
- Effective for atrophic scars (rolling, boxcar, some icepick).
- Improves texture, reduces redness and pigmentation.
- Some options are safe for deeper skin tones.
What to expect
- Downtime varies by device (from none to 7+ days).
- Most require a series of treatments for optimal results.
- Some redness, swelling, or peeling is normal.
Laser options available at Advanced Dermatology, P.C.
- Gemini laser
- MedLite laser
- Derma V Laser
- Sofwave (safe for dark skin)
- Ulthera laser treatments
- Erbium laser skin resurfacing
With careful planning and expert selection of laser technology, these treatments can still be a safe and effective option for many patients. Your dermatologist will always review your skin tone, scar type, and healing history before recommending any laser procedure, ensuring the approach is tailored to your unique needs.
Dermal fillers for acne scars
Dermal fillers offer a targeted, minimally invasive solution for atrophic acne scars, delivering immediate improvement in skin contour and texture. Fillers are ideal for treating shallow depressions or pits caused by volume loss. They restore fullness from below, rather than relying on the body to rebuild tissue
Patients often notice a smoother skin surface almost immediately after treatment. Dermal fillers are highly effective for atrophic acne scars, especially rolling and boxcar types.
Benefits of dermal fillers
- Immediate improvement for atrophic scars (especially rolling and boxcar).
- Little to no downtime.
- Non-permanent; results last 6–18 months.
What to expect
- Quick, in-office procedure.
- May be used with subcision or other treatments.
It is important to note that most dermal fillers provide temporary results. Longevity varies by filler type and individual skin characteristics.
Our board-certified dermatologists will recommend the best option based on your unique goals and skin concerns.
Subcision
For patients with more severe atrophic scars, fillers can be paired with subcision for enhanced outcomes and a smoother skin surface.
Subcision is a minor surgical procedure that releases the fibrous scar tissue pulling the skin downward, as typically seen in rolling scars. When combined with fillers, the result is greater smoothing than with either treatment alone.
Benefits of subcision
- Targets the root cause of atrophic scars.
- Can be combined with fillers or microneedling.
- Performed under local anesthesia.
What to expect
- Mild bruising and swelling for several days.
- Noticeable improvement after 1–3 sessions.
Subcision is most effective for depressed acne scars, specifically rolling scars and deep boxcar scars.
Treatment comparison at a glance
Below is an at-a-glance comparison of common acne scar treatment options:
| Treatment | Scar type | Number of sessions | Downtime |
|---|---|---|---|
| Microneedling | Rolling scars Boxcar scars | 3-6 sessions | Minimal |
| Chemical Peel | Discoloration/mild scarring | 1-6 sessions | Moderate |
| Laser procedures | Atrophic scars Post-inflammatory hyperpigmentation | 1-4 sessions | Up to 7 days, depending upon the procedure |
| Dermal fillers | Rolling scars Boxcar scars | 1 session | None |
| Subcision | Rolling scars | 1-3 sessions | Moderate |
Frequently Asked Questions
Can acne scars be completely removed?
Most treatments can significantly improve the appearance of acne scars, but complete removal is rare. The goal is smoother, more even skin.
Which acne scar treatment has the least downtime?
Dermal fillers generally require no downtime at all. Microneedling and light chemical peels generally have very little downtime, typically resulting in mild redness or flaking for a few days.
How much does acne scar treatment cost?
Costs vary based on the procedure, number of sessions, and combination of treatments. Chemical peels tend to be the most affordable; lasers and fillers may cost more. At your consultation, you’ll receive a detailed cost estimate.
How many treatments do I need for acne scars?
Most people need a series of sessions for best results. For example, microneedling usually requires 3–6 sessions, while laser treatments may need 1–4. Your dermatologist will recommend a plan based on your skin’s needs.
Find the Right Acne Scar Treatment for You
Ready to take the next step toward clearer, more confident skin? Book an appointment with Advanced Dermatology, P.C. for a personalized acne treatment plan from board-certified dermatologists.
With over 40 locations in New York and New Jersey, expert help is always nearby.
Curious about real results? Explore our before and after gallery to see what’s possible.