Acne scarring can be a real headache—trust me, I’ve been there and still somewhat there! The type, depth, and extent of scarring can make treatment feel like a game of ‘which one’s going to work?’ In this post, I’ll dive into various acne scar treatments, some of which I’ve personally tried-complete with photos, videos, or both. Each treatment has its own set of strengths, and often, mixing and matching is the secret sauce to seeing noticeable, lasting results. But a word of caution: every treatment comes with its own risks. So, I highly recommend chatting with a seasoned professional who understands your skin type. They can tailor a treatment plan to your specific scars and goals. After all, this is your skin we’re talking about.
Types of Acne Scars
1. Ice Pick Scars: are deep, narrow scars that look like small, sharp indentations in the skin, resembling the marks made by an ice pick. They are often difficult to treat because they extend deep into the skin.
2. Rolling Scars: These scars have a wave-like appearance with broad depressions that create a rolling or undulating effect on the skin. They are caused by damage beneath the surface, leading to an uneven texture.
3. Boxcar Scars: These scars are broad, shallow, and have well-defined edges, resembling the shape of a box or crater. They are often found on the cheeks and temples, giving the skin a pitted look.
I pretty much had all three scar types. This photo is before major procedures. (Yes, the below picture is my skin). I can honestly say I have come a VERY long way.
Acne Scarring Treatments
1. Topicals: retinoids, hydroquinone, and vitamin C promote skin renewal, reduce pigmentation, and improve skin texture over time.
Best for: mild scarring or as a maintenance treatment post-procedures.
Price Range: $10-$100 per product
Pain Level: Low
Downtime: None
Personal Experience: I've tried several topicals, including the ever-popular Tretinoin, but honestly, the scars themselves didn’t budge much. On the bright side, my hyperpigmentation had lightened up—so, small wins! As a dedicated lurker on the acne scar subreddit, I’ve noticed that Tretinoin gets a lot of love. Maybe it’s one of those things where everyone’s skin is different, or perhaps my scars are just extra stubborn!
2. Dermapen: uses tiny needles to create micro-injuries in the skin, stimulating collagen production and skin rejuvenation.
Best for: mild to moderate scarring. Not suitable for very deep scars.
Price Range: $50-$500 per session (unless you order a pen from online)
Pain Level: Moderate
Downtime: 2-7 days (redness, minor swelling)
Personal Experience: After a late-night YouTube binge, I impulsively bought the Dermapen on Amazon, convinced it would be my secret weapon against acne scars. I gave it a few tries but, to my disappointment, didn’t see much of a change. It dawned on me that perhaps I wasn't exactly a Dermapen pro, and that some things are best left to the experts—especially when it involves poking your own face with tiny needles!
3. Microneedling: is similar to Dermapen, this involves using a device with fine needles to create controlled micro-injuries in the skin, promoting collagen production and skin remodeling.
Best for: mild to moderate scarring. Can be combined with other treatments for enhanced results.
Price Range: $200-$500 per session
Pain Level: Moderate
Downtime: 2-7 days (redness, minor swelling)
Personal Experience: I’ve had microneedling done by an experienced esthetician roughly about 10 times. The first time I tried it, I was impressed—my skin looked instantly smoother, though a bit swollen for 2-3 days. It was the kind of smooth that made me want to show it off-I usually just covered it with makeup and went about my day. But once the swelling went down and my skin healed, it looked pretty much the same as before. I found myself booking microneedling sessions right before big events or nights out with friends, just to get that temporary glow. Long-term improvement? Not so much.
4. Radiofrequency (RF) Microneedling: uses energy to heat the skin’s deeper layers, promoting collagen production and skin tightening, which can reduce the appearance of scars.
Best for: mild to moderate scarring, particularly rolling and boxcar scars.
Price Range: $500-$2,500 per session
Pain Level: Moderate to high
Downtime: 3-5 days (redness)
5. Trichloroacetic acid (TCA) Peels: are chemical peels that remove the top layers of skin, promoting new skin growth and collagen production.
Best for: superficial to moderate scarring, particularly effective for boxcar scars. Deeper scars might require stronger peels or additional treatments.
Price Range: $250-$1000 per session
Pain Level: Moderate to high (burning)
Downtime: 1-2 weeks (redness and peeling)
Personal Experience: I have received my fair share of peels, but I would never notice a remarkable difference in my skin.
6. BBL (BroadBand Light): uses intense pulsed light (IPL) to target pigmentation and redness, stimulating collagen production. It’s mainly used for pigmentary issues but can improve texture with multiple sessions.
Best for: superficial scars to moderately acne scars with associated pigmentation issues.
Price Range: $400-$900
Pain Level: Moderate to high (discomfort)
Downtime: 3-7 days (redness and mild swelling)
Personal Experience: I noticed a remarkable difference in my skin during the first few weeks after treatment. I was thrilled with the early results, but once my skin fully healed—about a month later—I realized the improvement was closer to 10%. To be fair, I only did two BBL sessions. Had I done more, I’m sure I would’ve seen even better results.
7. TCA Chemical Reconstruction Of Skin Scars (CROSS): a chemical that is applied directly to the individual scar, causing the edges of the scar to contract. It promotes scar remodeling and collagen production. There are different concentrations of the TCA acid.
Best for: ice pick and deep boxcar scars. Effective even for severe scarring.
Price Range: $300-$2000
Pain Level: High (stinging)
Downtime: 1-2 weeks (redness and scabbing)
Personal Experience: I've undergone a few TCA peels, and just like with the BBL treatment, I was initially over the moon with the results—my skin felt as smooth as a baby’s. But, as with all good things, reality set in once the healing process was complete. With a TCA peel, your skin will scab and eventually peel off, revealing the results underneath. In my case, I noticed about a 10% improvement—just enough to keep me hopeful, but not enough to quit my day job as a skincare enthusiast.
8. Dermabrasion: involves mechanically exfoliating the top layers of the skin using a rotating device, which removes damaged skin and promotes the regeneration of smoother, healthier skin.
Best for: superficial to moderately deep scars. Not suitable for deep ice pick scars or very severe scarring and may cause pigmentation issues in darker skin tones.
Price Range: $1000-$4000
Pain Level: High
Downtime: 2-3 weeks (redness and swelling)
9. Laser Treatment: creates microscopic wounds in the skin, which trigger the body's natural healing process, leading to collagen remodeling and scar reduction.
Best for: boxcar and rolling scars. Not suitable for ice pick scars.
Price Range: $300-$5000 per session
Pain Level: Moderate to high (burning and stinging)
Downtime: 1-2 weeks (redness and crusting)
Personal Experience: I started a series of laser treatments at Laser Away in Los Angeles. I received about 15 procedures and noticed about a 5-10% improvement on my scars.
10. Fat and Stem Cell Transfer/Fat Grafting: often enriched with stem cells, is harvested from another area of the body and injected into depressed scars to add volume and stimulate collagen production.
Best for: Best for deep, atrophic scars. Requires a surgical procedure and may not be suitable for everyone.
Price Range: $2000-5000 per session
Pain Level: Moderate to high (swelling and tenderness)
Downtime: 1-2 weeks (swelling and bruising)
11. Subcision: a needle is inserted under the skin to break the fibrous bands pulling the scar down, allowing the skin to lift and smooth out.
Best for: moderate to severe, depressed scars.
Price Range: $600-$6000 per session/ depends on the areas covered
Pain Level: High (burning and bruising)
Downtime: 1-2 months (swelling, bruising, tenderness, and redness)
Personal Experience: Of all the treatments I’ve tried, this one definitely took the prize for most painful—but also the most rewarding. After completely healing from this procedure, I noticed my skin was much smoother, 50% improvement to my forehead, about a 50-75% improvement to my left and right (upper and lower) cheeks.
Summary of Treatment Selection:
Mild Scarring: Topicals, RF, BBL, Dermapen
Moderate Scarring: Microneedling, TCA peels, TCA CROSS, Dermabrasion, Laser, Subcision
Severe Scarring: Fat Transfer, TCA CROSS, Subcision, Sculptura Injections(not mentioned)
Conclusion:
Although I try to live a life with no regrets, I wish I would have focused on clearing my active acne first then going to a specialist that solely focused on acne scarring, while regularly going to an esthetician. It would have saved me a lot of time, heartaches, and money.
Again, I recommend going to a seasoned professional for all of these treatments. I often hear horror stories of person's taking the cheap route (which is totally overstandable'), by ordering specific items from online vendors-not getting the results they hoped for but instead the opposite.
If I missed any treatments that may help someone with their acne scarring, please feel free to reach out to me so I can add it to the list.
Be careful and remember #Ilivedit
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