Acne scars and how to get rid of them

Introduction

Acne is common, and can cause long-lasting scarring. Once the active redness and swelling (inflammation) of acne has settled, many people are interested in treatment to reduce the scars left behind. Read more about different options for treating acne scarring below.

The treatment options that might be right for you depends on a few things, including:

• What kind of acne scars you have and where on your face or body they are
• Any other scar treatments you’ve already tried
• Your general health and skin health
• Your preferences and budget.

Ice pick scars on the cheek 

Atrophic scars on the upper back (AS-patient1)

Hypertrophic scars on the back 

Camouflage

Makeup may be helpful for disguising acne scars, particularly those on the face.

Resurfacing treatments

Resurfacing procedures aim to blend acne scars into the surrounding skin by removing the top layer of skin (epidermis) to smooth out scar edges and encourage new, healthy skin cells to grow. This process may be done using:

• Chemicals of different strengths applied to the skin (eg, glycolic acid or trichloroacetic acid) — known as chemical peels
• Small needles to create hundreds or thousands of small holes in the area/s of scarring — known as skin needling or micro-needling
• Other handheld physical tools — known as dermabrasion
• Laser lights — known as laser resurfacing.

Multiple treatments may be needed to achieve the best possible result.

Lifting procedures

Lifting procedures aim to lessen the dips or hollows in the skin that are left behind in some kinds of acne scarring. This may be done using:

• Dermal fillers — injection of material such as hyaluronic acid or collagen under the scars to lift them up to be more level with the surrounding skin
• Subcision — a small needle is inserted beneath the scar to cut through tough (fibrous) threads of tissue tying the scar to deeper layers of the skin, which keep it pulled down and dented inwards. By breaking up these fibrous bands, the scar tissue can be ‘released’ up to the surface level of skin.

Excision

Sometimes acne scars are cut out completely, particularly if they are large, deep, or have healed up abnormally. This gives the area a chance to heal over again, hopefully forming a more subtle scar.

The surrounding skin may be stitched directly together; or the wound may be filled with a flap of healthy skin (graft) taken from elsewhere, such as behind the ear.

Treatment of hypertrophic or keloid acne scars

Large raised or overgrown scars (called keloid or hypertrophic scars) can also be triggered by acne. Sometimes these types of scars may grow back after being removed.

Raised tender shoulder keloid scars (AS-patient5)

In addition to some of the treatments described above, other options that can be tried for hypertrophic and keloid acne scars include:

• Strong steroid creams applied on top of the scar and covered with a tight dressing (treatment time: several weeks)
• Special silicone gel dressings (treatment time: 24 hours a day for several months)
• Steroid injections into the scar
• Cold/freezing therapy, usually with liquid nitrogen — known as cryotherapy.

Lifestyle factors

As well as treating existing scarring, other habits to help keep your skin happy may reduce the chance of future acne flare-ups and further scars. For example:

• Maintaining a healthy diet
• Drinking enough water
• Getting enough sleep
• Cutting back on or quitting smoking
• General skincare eg, removing makeup before bed, using ‘oil-free’ skin care products, and avoiding picking at any new spots or pimples that come up.

If you are dealing with acne or acne scars, see your doctor to discuss what treatment options might be right for you.

For more information about acne and its treatment, see:

• Acne (overview)
• Acne mimics: What else could it be?
• How to get rid of acne
• How to get rid of acne