Acne scars - and how you can try to remove them
Acne scars can be the result of a severe breakout – even after we’ve well and truly beaten this all-too common condition in the first place.
Typically, acne marks are left on the skin when nodules and cysts have damaged the surrounding area, leaving, in some cases, your skin looking rough and bumpy.
The good news is there are a number of acne scar treatments and removals to try.
Types of acne scars
Not all acne scars are created equal, and each can look quite different depending on how they form.
The two main types – depressed or raised – both give your skin a bumpy texture.
These usually form on the face when your body doesn't produce enough collagen as spots heal.
There are three distinct types of depressed acne scars:
- Boxcar scars – U-shaped marks that often have “sharp” edges. The shallower these scars are, the better they tend to respond to surface treatments.
- Ice pick scars – Smaller indents that often resemble a small puncture, or an oval chickenpox scar. These are often deeper than boxcar scars, so may need more thorough treatment.
- Rolling scars – Wider depressions with rounded edges and an irregular appearance. The rolling appearance is caused by bands of scar tissue forming underneath the skin.
Medically known as hypertrophic scars, these are more common in cases of body acne, such as breakouts on your back or chest. They tend to rise from the surface of the skin rather than sinking downwards like depressed scars.
They also have the opposite cause, as they develop when your body produces too much collagen as a spot heals.
It can be difficult to avoid temptation but one of the main causes of acne scarring is picking your skin. Refraining altogether is the best option, but here are some good strategies to whenever you feel the urge:
- Keep your nails short – so there’s less chance of doing damage
- Keep your hands busy – squeezing a “stress ball” or knitting
- Keep a journal – writing down thoughts and feelings each day can help you relax and reduce anxiety
- Try meditation – breathing exercises are also good for keeping calm and lowering the temptation to pick
Acne scar treatment and removal
Looking to reduce or get rid of your acne scars altogether? Here are some options you can try.
Alpha-hydroxy acids (AHAs)
AHAs are a group of acids found in many skincare products. This includes glycolic, citric, mandelic, malic, tartaric and lactic. When massaged into the skin, products containing AHAs help exfoliate the outer layer. This can bring scars closer to the surface of your skin, so they’re less noticeable. They are best used a few times per week.
Otherwise known as vitamin B3, this is helpful for improving skin barrier function, which makes it great for acne. It’s also an important anti-ageing skincare product, helping to improve uneven skin tone.
Azelaic acid can be amazing when used as a leave-on exfoliant. It helps to reduce scarring, unclogs pores, refines the skin’s surface, and improves discoloration. You’ll find it in a few different strengths – but in everyday skincare it is usually around 10 per cent, which is enough to see the benefits when applied daily. Speak to your doctor about getting stronger levels prescribed if you think it might help.
As one of the most reliable antioxidants, Vitamin C is a great addition to your skincare routine. It reduces redness, improves skin tone, and helps skin to heal. Its anti-inflammatory properties make it great for helping to reduce swelling and soothe acne-prone skin.
Lactic acid is another common element of at-home acne scar treatments – used in many peels, creams, and serums – and works well in combination with hyaluronic acid, but it will take time to see any significant results.
Dermabrasion uses a layer or gentle wire brush to help remove the top layer of skin. This can, once again, bring scars closer to the skin’s surface – helping to ‘hide’ them.
With dermabrasion, your skin can be red and sore for a few weeks after the treatment, but as it starts to heal you may well notice an improvement in the appearance of your scars.
Microneedling is becoming increasingly popular as a treatment for skin conditions, including acne scarring. Lots of tiny needles being rolled over your skin triggers your skin’s renewal processes, and the minor puncture wounds can stimulate collagen production to help fill depressed scars – potentially making them less noticeable.
RF microneedling, meanwhile, is an enhanced procedure that applies radio-frequency waves even deeper into the skin – potentially acting as an even more effective collagen induction therapy.
You might need several microneedling appointments to completely remove your scars. Supporting your treatment with good at-home skincare could also help your results.
Most people associate fillers with anti-ageing treatments, but they can also be a useful option for scarring. By plumping up depressed marks with collagen, your own fat cells or another common filler substance, fillers can help slowly remove your acne scars.
Different fillers will last for different lengths of time. Some results will be permanent, while others will only last for between six and 18 months. Make sure you discuss your options with your clinician before treatment.
Also commonly found in skincare products, retinoids can help speed up cell regeneration. This can improve texture and reduce discolouration, masking the appearance of scars.
Your doctor may be able to prescribe retinoids in a higher dose to help your skin.
Subcision treatment encourages the skin to heal correctly, reducing the appearance of your acne marks. The process involves:
- Removing the upper layer of skin
- Blood then pools under the affected area
- This should start to clot, helping to form connective tissues
Subcision typically works best for patients with rolling scars, but it can be used for patients with depressed scars.
Facial peels are best for less noticeable scarring and can give your skin an overall boost too. We always recommend seeing a professional for your peel, as they use low-pH acids, and you will really see the benefits. Choose peels with plenty of gentle exfoliation.
As well as reducing wrinkles and sagging skin, skin tightening can also work for scarring. When radio frequency treatments are used, most people feel a slight burning sensation and have a pinkish tint to their skin for a couple of days afterwards.
You may need multiple sessions before your scars improve. You’ll also need to protect your skin with plenty of sunscreen for a few days.
This versatile treatment can help both raised and depressed scars using slightly different techniques.
- Depressed scars Your clinician will use a laser to remove the top layer of skin and reduce the appearance of your scars. Fractional ablative and non-ablative lasers are commonly used for depressed scars.
- Raised scars Fractional ablative lasers are standard for raised acne scars.
Using a pulsed dye laser (PDL) can help flatten reddish acne scarring, and improve its appearance, whether it’s flat, depressed or raised.
On rare occasions, laser treatments may need bandaging afterwards, but this is unlikely.
Acne scar surgery
Surgical procedures are often quite minor and straightforward. With minimal downtime, you should only need a touch of local numbing – and should be fine to go about your daily life the very next day.
This treatment is more invasive than others, however, as it involves surgically removing the scars. Your dermatologist will consult with you about the type of result you would like to achieve, as there are several options.
- Allow the wound to heal naturally for a smoother appearance.
- Replace the scar higher up to make it less noticeable.
- Plug the wound with a skin graft from a discreet section of skin elsewhere on your body.
Any surgery should be completed by a qualified and registered dermatologist. This option is best suited to people with a few depressed scars.
Cortisone is useful in suppressing inflammation in the short term, and in the long term, dissolving scar tissue and is successful in treating raised scars.
Liquid nitrogen can be used to freeze raised scars, although a side effect of the treatment is that it can lighten the colour of the skin in the area being treated.
Acne scar facts
- Foods high in Omega-3 fatty acids can actually help reduce inflammation. Sweet potatoes contain high levels of retinols, while pumpkin is a natural source of AHAs, meaning they may help reduce the appearance or severity of your acne scars.
- Sunscreen is your skin’s best friend. Sunlight reacts with the pigmentation in your skin and makes it darker – that includes your acne scars. Using a mineral sunscreen is a great option, as are gel and water-based ones, which are less likely to clog pores.
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