Let’s talk acne scars. Because even after the pimples have cleared, the emotional and physical
reminders often stick around—and I get it. As a board-certified dermatologist, and frankly, just
someone who’s been through it too, I see patients all the time who feel like they’ve “tried
everything” and still feel stuck with the aftermath of breakouts.

Here’s the truth: You can absolutely improve your acne scars. But it takes the right plan, not just
hope in a bottle.

Not All Scars Are Created Equal

First up, we have to name what we’re dealing with. Acne scars aren’t all the same—and treating
them like they are is the fastest way to waste time and money.

Here’s your cheat sheet:

• Ice pick scars: Tiny, deep, and narrow. Think pinpoint craters with a V-shape.
• Boxcar scars: Wider with sharper edges—like a scoop out of the skin, think U-shape.
• Rolling scars: Shallow and soft, giving that wavy look.
• Keloids or hypertrophic scars: Raised, thick scars—common on the chest, back, and
  jawline.
• PIH/PIE: The brown or red spots that linger after a breakout, especially common in skin
  of color. Technically not a scar, but distressing for many.

The first step to real results? Get clear on what type (or types) of scars you’re dealing with.
Because your treatment has to match your scar.

No One-Size-Fits-All Fix

If I could hand every patient a “miracle” product, trust me, I would. But real talk: There is no
single treatment that works for every scar on every person. The best results come from
combination therapy—and knowing when to use what.

Here are the options I reach for in my own practice:

1.  Subcision - Especially helpful for rolling or tethered scars. This technique releases the bands that pull the skin down, then encourages new collagen. Laser-assisted subcision is particularly useful in
   deeper skin tones, minimizing trauma and boosting results.
2. Microneedling with Radiofrequency - This combo builds collagen and smooths texture with minimal downtime. It’s one of the most versatile tools for early scarring and subtle skin laxity.
3. TCA CROSS - Targeted acid (TCA) is placed inside each ice pick scar to stimulate collagen. Yes, it sounds intense—but when done by an expert, it can dramatically improve depth and appearance. This is safe for all skin types when done precisely!
4. Laser Resurfacing - CO2 or erbium lasers resurface the top layers of skin and boost collagen remodeling. Effective, yes—but proceed carefully if you have darker skin tones, as the risk of pigmentation increases. This is when you want to see someone really skilled with lasers!
5. Topicals for Pigmentation (PIH/PIE)

Red or dark marks left behind? Your best friends are:

• Sunscreen (non-negotiable)
• Tretinoin
• Vitamin C, niacinamide, hydroquinone, azelaic acid, tranexamic acid

Light lasers or serial chemical peels can also help pigmentation—but caution not to be too
aggressive, or you can worsen the discoloration.

Don’t Overlook Fillers and Biostimulatory Treatments

For certain types of depressed acne scars—like rolling or boxcar scars—injectables can offer fast
and visible improvement. These are especially helpful when used alongside other treatments like
subcision or microneedling.

Here’s how they work:

• Hyaluronic acid fillers: Add immediate volume to lift indented scars and smooth the
  skin’s surface. Results are visible right away and can last 6–12 months.
• Biostimulatory injectables (like Sculptra or Radiesse): Do more than just fill. These
  stimulate your skin’s natural collagen production for gradual, longer-lasting
  improvement—especially useful in combination treatments.
• Combination therapy: Often used after subcision to hold the skin up and prevent the
  scar from tethering down again.

While not a permanent fix, fillers can be a powerful tool in your acne scar treatment
plan—especially if you’re looking for quicker wins while working on long-term skin texture.

But First: Clear the Acne

Treating scars while new pimples are popping up is like patching a roof in a rainstorm. Get the
acne under control first. That might mean oral meds, topicals, or lifestyle shifts—but don’t skip
this step.

Progress Over Perfection

Let’s be honest—most people won’t see 100% scar removal. But 30–50% improvement? That’s
achievable. And that shift—when you catch your reflection and feel different? That’s everything.

My goal isn’t to promise “perfect” skin. It’s to help you feel confident, supported, and informed.

The Bottom Line

Acne scars aren’t a life sentence. With the right approach, you can smooth texture, even out tone,
and reclaim your confidence. So if you’re overwhelmed, confused by online advice, or tired of
products that don’t deliver—it might be time to see a dermatologist who gets it.