How to Get Rid of Acne Scars: Dermatologist-Recommended Treatments

Understanding the Types of Acne Scars

Not all acne scars look the same, and that matters a great deal when choosing treatment. The two broad categories are atrophic (depressed) scars and hypertrophic or keloid (raised) scars.

Atrophic scars are the most common type and result from tissue loss after inflamed acne heals. There are three subtypes:

Ice pick scars are narrow, deep, V-shaped channels that extend into the dermis. They are the most difficult type to treat because of their depth and sharp margins.

Boxcar scars are wider, round, or oval depressions with defined vertical walls. They can be shallow or deep, and shallow ones tend to respond better to resurfacing treatments.

Rolling scars have a wave-like, undulating texture caused by bands of fibrous tissue that anchor the skin surface to the underlying tissue. Subcision is often the most effective treatment for this subtype.

Hypertrophic scars and keloids form when the body produces excess collagen during healing, resulting in raised, thickened tissue. Hypertrophic scars stay within the original wound boundary. Keloids extend beyond it and can continue growing. Both are more common in people with darker skin tones and on the chest, shoulders, and jawline.

Post-Inflammatory Hyperpigmentation vs. True Scarring

One of the most common points of confusion is mistaking post-inflammatory hyperpigmentation (PIH) for acne scars. PIH is flat discoloration, ranging from pink to red to dark brown, left behind after a pimple resolves. It is not a scar. There is no change to the skin's texture or structure. PIH typically fades on its own over weeks to months, though treatment can speed that process considerably.

True acne scars involve structural changes to the skin and do not fade without some form of intervention. If you notice textural irregularities, pitting, or raised tissue alongside the discoloration, you are likely dealing with a combination of both.

Treatments for PIH (brightening agents like vitamin C and niacinamide) differ from those for atrophic scars (resurfacing, collagen stimulation). Identifying which you have is the first step toward an effective plan.

At-Home Treatments for Acne Scars

Over-the-counter options are a reasonable starting point for mild to moderate scarring and PIH. Expect gradual improvement over three to six months with consistent daily use.

Retinoids

Retinoids are vitamin A derivatives that increase cell turnover and stimulate collagen production. Retinol is available without a prescription; tretinoin and adapalene (at higher strengths) require one. They work on both PIH and shallow atrophic scars by accelerating surface renewal and building new dermal tissue over time. Start with a low concentration, two to three nights per week, to minimize irritation, and always follow with sunscreen in the morning.

Alpha Hydroxy Acids (AHAs)

Glycolic acid and lactic acid are AHAs that exfoliate the skin's surface and support collagen remodeling. They are particularly useful for improving skin texture and helping fade PIH. Regular use of a low-percentage AHA toner or serum can make boxcar and rolling scars appear smoother over time.

Vitamin C

Vitamin C (ascorbic acid) is an antioxidant that inhibits melanin production and supports collagen synthesis. It is most useful for addressing PIH and early, shallow discoloration. Look for stabilized formulas (L-ascorbic acid at 10 to 20 percent) and store them away from light and heat, which degrade the ingredient.

Niacinamide

Niacinamide (vitamin B3) reduces inflammation, regulates melanin transfer, and strengthens the skin barrier. It is well tolerated by most skin types and particularly effective at fading PIH. It works well layered with retinoids or AHAs and does not require special storage or handling.

Silicone Sheets and Gels

For raised scars (hypertrophic or keloid), topical silicone is one of the few OTC interventions with solid evidence behind it. Silicone sheets or gels applied consistently over eight to twelve weeks can flatten, soften, and lighten hypertrophic scar tissue by hydrating the stratum corneum and modulating collagen production. They are not effective for atrophic scars.

Professional Treatments for Acne Scars

When OTC options are not producing sufficient results, or when scarring is deep or widespread, professional procedures offer more targeted and dramatic outcomes. Most professional treatments require multiple sessions, spaced four to eight weeks apart.

Chemical Peels

Chemical peels use acids at higher concentrations than any retail product can safely provide. Superficial peels (glycolic, lactic, salicylic) primarily address PIH and improve skin texture. Medium-depth peels (trichloroacetic acid, or TCA) penetrate deeper and can improve boxcar and rolling scars. Deep peels offer the most significant resurfacing but require longer recovery and are typically reserved for severe cases. A consultation with a board-certified dermatologist covering acne scar treatment options can clarify which peel depth and acid type are appropriate for your scar profile and skin tone.

Microneedling

Microneedling uses fine needles to create controlled micro-injuries in the skin, stimulating a wound-healing response that increases collagen and elastin production. It is effective for rolling and boxcar scars, and it is generally safe across a wide range of skin tones with a lower risk of post-inflammatory hyperpigmentation than laser treatments. Results emerge gradually over three to six months after a series of three to six sessions.

Fractional Laser Resurfacing

Fractional lasers deliver energy in microscopic columns, leaving surrounding tissue intact to speed healing. Ablative types (CO2, Er: YAG) remove surface layers for more aggressive resurfacing. Non-ablative types heat the dermis with less downtime but need more sessions. Laser therapy is highly effective for atrophic scars but requires careful selection in darker skin tones due to the risk of hyperpigmentation.

Dermal Fillers

For deep atrophic scars, particularly rolling and boxcar scars, injectable fillers can restore lost volume and elevate the scar base to the level of the surrounding skin. Hyaluronic acid fillers are the most common option and produce immediate results. The effect is temporary (six to eighteen months, depending on the product), but repeated treatment can trigger lasting collagen remodeling in some cases.

Subcision

Subcision is a minor surgical technique in which a needle or cannula is inserted beneath the scar to cut the fibrous bands tethering the skin surface downward. It is the most targeted treatment for rolling scars and is often performed in combination with other procedures, such as microneedling or fillers, to maximize results.

Corticosteroid Injections

For hypertrophic scars and keloids, intralesional corticosteroid injections are a first-line treatment. They flatten raised tissue and reduce redness over a series of sessions spaced four to six weeks apart. Keloids often need a combination therapy, including cryotherapy or laser, alongside injections.

The Role of Sunscreen

Consistent sun protection is non-negotiable during any scar treatment program. UV exposure stimulates melanocyte activity, causing PIH to darken and making it harder to fade. It can also worsen the appearance of atrophic scars by thinning the dermis over time.

Use a broad-spectrum sunscreen with SPF 30 or higher every morning, regardless of the weather. Mineral sunscreens (zinc oxide, titanium dioxide) are often preferred for acne-prone skin because they are non-comedogenic and sit on top of the skin rather than being absorbed.

Sun avoidance alone will not reverse structural damage, but it is critical for preventing existing acne scars from darkening or becoming harder to treat.

Timeline Expectations

Results from acne scar treatment are measured in months, not weeks. PIH can fade significantly in two to three months with consistent OTC treatment. Shallow atrophic scars may improve after three to six months of retinoid use paired with AHAs.

Deeper scars treated professionally typically require three to six sessions, with results becoming visible over six to twelve months as collagen remodeling continues after each procedure.

A consistent regimen matched to your specific scar type outperforms cycling through trendy ingredients every few weeks.

When to See a Dermatologist

A board-certified dermatologist is the right next step if you have deep ice-pick scars, keloids, or widespread atrophic scarring that hasn't improved after 6 months of OTC treatment. Keloids in particular require professional intervention from the start and can worsen with incorrect treatment.

You should also consider a skin evaluation if your PIH isn't fading despite sunscreen and brightening agents, or if active breakouts are continuing to create new scars (controlling active acne is a prerequisite for meaningful scar improvement).

Dermatology appointments are not always easy to access quickly. Telehealth is a practical alternative for an initial skin assessment and treatment planning.

The Bottom Line

Acne scars are a legitimate medical concern, not just a cosmetic one, and effective treatment is available for every scar type and skin tone. The key is matching the right intervention to the right scar: silicone for raised tissue, resurfacing and collagen stimulators for atrophic scars, and brightening agents for flat discoloration.

If you want to understand your skin better before committing to a treatment plan, Doctronic.ai connects you with licensed clinicians for a virtual skin assessment, giving you a clearer picture of what you are dealing with and what is most likely to work.

For more on gentler approaches, see natural ways to fade acne scars and how they fit into a broader treatment strategy.