3 Types of Acne Scars—and the Best Treatments for Each

Because sometimes the end of a pimple is the beginning of the problem.

Dealing with pimples is frustrating enough, but add stubborn, lingering acne scars to the mix and you might feel downright defeated. Fortunately, massive strides in skincare have been made over the years, and we now have access to many effective acne scar treatments.

But just like not all acne is the same, not all acne scars are either. Ahead, we’re breaking down the most common types of acne scarring so you can better understand what you’re dealing with, plus-dermatologist recommended acne scar treatments for each type (including over-the-counter solutions and professional in-office treatments).

Post-Inflammatory Hyperpigmentation (PIH)

This temporary form of acne scarring shows up as pink, red, or brown marks following a breakout. Spots can linger anywhere from a couple weeks to years.

“The root cause of post-inflammatory hyperpigmentation is overactive melanocytes, which are the cells that produce melanin/dark skin pigment,” explains Tanuj Nakra, MD, a double board-certified facial and ophthalmic plastic surgeon. “No matter our skin tone, we all have melanocytes, and they can get activated when inflamed, leading to overproduction of melanin.”

Best Acne Scar Treatments for PIH

Treating PIH is two-fold: You want to minimize the discoloration while making sure you’ve eliminated the source of inflammation. The latter is easier when dealing with a minor breakout or singular pimple, but if you’re dealing with ongoing acne then you’ll want to follow a treatment plan that works.

• Retinoids: Retinoids do double duty by addressing acne at the source while minimizing discoloration. “They help regulate skin cell turnover which helps foster an even skin tone, and it also works to boost collagen production which can help to improve the textural changes to the scars,” Dr. Garshick says. Try Current State Retinol + Marula Renewing Serum ($21.99).

• Alpha Hydroxy Acids (AHAs): AHAs are another way to effectively promote skin cell turnover, says Dr. Nakra. These slough off extra pigment in the skin and lend to a more uniform complexion. Try Glow Recipe Strawberry Smooth BHA + AHA Salicylic Acid Serum ($42), which combines AHAs with salicylic acid to combat pimples and refine skin tone in one fell swoop.

• Professional Chemical Peels: To expedite PIH healing, pencil in a professional chemical peel, says Dr. Nakra. These medical-grade exfoliating facials resurface the skin more quickly than over-the-counter products.

• Sunscreen: You should wear sunscreen every day, but it’s especially important when dealing with PIH acne scarring. Dr. Garshick says, “With sun exposure, scars have the potential to darken which can make them more noticeable.” Supergoop! Unseen Sunscreen SPF 40 ($22) goes on clear and has a weightless feel.

• Antioxidants: Antioxidants, such as vitamin C, can be incorporated into a skincare routine to help with scarring. “They can help to brighten the skin and improve the overall appearance of discoloration,” Dr. Garshick says. Check out REN Glow and Protect Serum ($68), a barely-there vitamin C serum infused with kakadu plum.

Atrophic Acne Scarring

Atrophic scarring refers to indentations on the skin and goes by a handful of different monikers, including pock marks, ice picks, rolling, or boxcar scars.

They ultimately occur when there’s not enough collagen production during the wound healing and skin remodeling process, explains Marisa Garshick, MD, a board certified dermatologist. She adds that atrophic scars can sometimes also appear lighter than your skin color. Severe acne tends to heighten chances of atrophic scarring. Additional trauma caused by popping and picking can also make atrophic scarring more likely.

Best Treatments for Atrophic Acne Scars

Since this form of scarring is a textural change to the skin, it requires a more in-depth treatment approach that focuses on resurfacing the skin. Gentle over-the-counter retexturizing treatments, such as retinoids and AHAs, can help. However, you’ll likely experience better results with in-office acne scar treatments.

• Subcision: “The best way to treat atrophic scars are by releasing the scar from the underlying structures of the skin with a surgical procedure called subcision,” Dr. Kappel says. A needle or cannula is inserted into the skin to loosen scar tissue and stimulate new collagen production.

• Dermal Filler: This is a temporary fix that can address isolated atrophic acne scars. Essentially, filler is used to fill in depressed areas.

• Microneedling: “Microneedling procedures create micro-injuries to the skin to stimulate new skin cells and collagen production, which can improve the appearance of atrophic scars,” Dr. Garshick explains.

• Laser Resurfacing: Several forms of laser resurfacing treatments exist, and your treatment plan will depend on your case. These might include ablative, non-ablative, and/or fractional laser therapy.

• Medical Tattoos: “Skilled medical tattoo artists can [cover] the scar with a custom skin match to help camouflage the scars,” Dr. Nakra explains.

In cases of deep acne scarring, you may need a series of treatments in order to get desired results. A conversation with a dermatologist or facial plastic surgeon can help you understand what to expect and what treatment course is best for you.

Hypertrophic Acne Scarring

Hypertrophic acne scars appear as smooth, raised bumps isolated to the area of injury. Sometimes they’re the same color as the rest of your skin, but they can also appear red, pink, brown, or tan. These raised acne scars can occur anywhere, but more commonly occur from the neck down versus on the face. They also tend to occur in more extreme cases of ongoing acne.

“Hypertrophic scarring occurs when there is an overzealous response to trauma,” explains Stefani Kappel, MD, a board-certified dermatologist. “Your fibroblasts—which are the collagen producing cells in your skin—make too much collagen creating a thickening of the scarred area.”

Best Treatments for Hypertrophic Acne Scars

Like atrophic scarring, hypertrophic scars involve a textural change to your skin. The best treatment approach is one that focuses on resurfacing, and you’ll want to recruit help from a professional who’s skilled in this form of acne scar repair.

• Steroid Treatments: Your doctor may recommend “intralesional kenalog injections,” which are steroid treatments that minimize inflammation. These may help prevent hypertrophic scars from occurring or worsening, and can also “help with scar remodeling and improve the color of the scar,” Dr. Garshick says.

• Cryotherapy: Cryotherapy works by freezing the affected area with liquid nitrogen, which breaks down and destroys scar tissue.

• Laser Therapy: Both dye lasers or long pulsed Nd:YAG lasers can help treat hypertrophic acne scarring. They work by targeting the blood vessels in the scar, which prevents additional growth, and can also minimize discoloration.

• Surgical Removal: In some cases, a dermatologist may opt to surgically remove hypertrophic lesions. This puts less tension on the scar and allows it to heal in a more controlled manner, Dr. Kappel explains.

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