Acne is a very common, often frustrating condition that sometimes leads to scarring and dark spots. While acne scars won’t entirely go away on their own, there are a number of ways you can encourage them to fade.
Here’s what you need to know about the causes and treatments for acne scarring.
Inflammatory acne can cause painful, swollen, red, and deep skin lesions that damage the skin and underlying collagen. As these lesions heal, the body produces collagen. Too much or too little collagen production results in acne scars that don’t look like the surrounding skin.
A few factors can increase the risk of scarring, including:
- genetics (i.e., a close family member who has acne scarring)
- delaying treatment for inflammatory acne
- picking or popping acne
- the severity of the acne, which usually correlates to the amount of scarring a person will experience
Hyperpigmentation is a darkened patch where skin has healed. It occurs when inflammatory acne increases the amount of melanin in skin. This pigment gives skin its color. Dark spots usually affect people with darker skin.
Acne scars do not go away entirely on their own. Depressed acne scars often become more noticeable with age as skin loses collagen. However, there are a variety of treatments that can make acne scars less noticeable.
Post-inflammatory hyperpigmentation may lighten on its own within several months. However, it may take years to go away without treatment for some people.
There are a number of different types of acne scars. They fall into one of the following categories:
Depressed (atrophic) scars
Depressed acne scars happen when there’s a loss of collagen as skin heals. Types include:
- Icepick scars: small, deep holes in the skin
- Boxcar scars: wider oval or round areas of depressed skin with distinct edges that look like chicken pox scars
- Rolling atrophic scars: wide depressions in the skin with a rolling or undulating appearance, like an “M” pattern
Raised (hypertrophic) scars
As the skin heals from acne, it sometimes produces too much collagen. This leads to the formation of elevated scars. They’re usually found on the chest and back.
Dark spots (post-inflammatory hyperpigmentation)
While dark spots technically aren’t scars, they are a visible reminder of acne. The inflammatory process of acne can result in hyperpigmentation, or deeper coloration where acne has healed. Hyperpigmentation can also be a temporary side effect of treatments for acne scars, especially in people with darker skin.
How you get rid of acne scars will differ depending on what types of scars you have and how severe they are. Treatment shouldn’t be started until the acne has completely healed.
- Resurfacing procedures: Laser therapy, dermabrasion, microdermabrasion, and chemical peels can help improve the appearance of acne scars that aren’t very deep. They all involve removing layers of skin cells to encourage skin to produce new cells.
- Fillers: Your dermatologist can fill in shallower scars with substances like hyaluronic acid, collagen, or your own fat. Results usually last a few months, although some fillers are permanent.
- Microneedling: Also known as collagen induction therapy, this is a good option if you have a lot of depressed acne scars. It involves pressing a needle-studded roller into depressed acne scars to stimulate collagen production.
- Radiofrequency skin tightening: This treatment can sometimes effectively treat deep icepick and boxcar scars. A doctor will use radio frequency to tighten skin and make depressed acne scars less visible.
- Electrodessication: This is an add-on treatment for boxcar acne scars that uses electric probes to heat the tissue and even out a scar’s edges.
- Injections: A series of repeated injections of medicine such as corticosteroids into skin can flatten and soften raised and thick scars.
- Surgery: Surgery involves excising and raising tissue or breaking up tissue to reduce the appearance of depressed acne scars. Cryosurgery freezes off raised acne scars, but it’s not recommended for people with darker skin.
At-home or natural remedies
You should always check in with a dermatologist before trying new acne scar treatments. A doctor can determine that you actually have acne scars and not another condition, as well as recommend the most effective treatment.
Many ingredients in over-the-counter chemical peels have been shown to improve acne scarring and hyperpigmentation by encouraging skin cell turnover. Look for products with the following ingredients:
Acne scars form when the skin produces too little or too much collagen as it heals. There are several different types of acne scars, including icepick, boxcar, rolling atrophic, and raised scars. Acne can also leave behind dark spots known as hyperpigmentation, especially in people with darker skin.
While acne scars won’t go away entirely on their own, a number of treatments can improve their appearance. This includes in-office dermatological procedures such as resurfacing with lasers or microdermabrasion, fillers, microneedling, skin tightening, and surgery. At-home chemical peels with ingredients like retinoids and salicylic acid can encourage skin cell turnover to reduce scarring.
Talk with a doctor to get recommendations for the best treatment plan for your type and severity of acne.