Finding the best acne scar treatment can be difficult, not to mention frustrating. One of the worst parts about acne is that even once it clears up, it leaves behind scars that can be just as prominent as the acne itself. Still, even though acne scars are irritating, they are also treatable, through a variety of methods. You will likely see the best results from dermatological products or procedures, but there are DIY and over-the-counter remedies that are worth a try too, especially if you’re on a tight budget. But before you can make any real headway in treating your acne scars, it’s important to stop them from forming, which requires a gentle, consistent skin care routine.
The First Step: Prevention
You can start acne scar treatment at any time, but for the best results, you’ll want to prevent the creation of new ones as soon as possible, and the best way to prevent acne scars is to prevent acne. We all know that’s easier said than done, but that’s because many acne treatment products are too harsh. With a gentle treatment that you can keep up with every day, you might be surprised at how quickly your acne fades.
Gentle treatment is the best acne treatment because it prevents new acne from forming. Many acne products on the market right now use harsh ingredients at harsh concentrations because it can get rid of the acne you currently have relatively quickly. But this kind of treatment fails to look at the big picture, because all that harshness is a surefire way to cause even more acne. When the skin is irritated by something harsh, it responds with inflammation and oil production, two of the three main causes of acne (the third is bacteria, which can also increase any time there’s an increase in oil production). Because of this, harsh treatments often cause the creation of new acne even as they treat the acne already on your skin.
Exposed Skin Care takes a different approach. We want to treat your current acne and prevent future acne at the same time, which is why we combine scientific and natural ingredients in all of our products. Exposed uses proven acne-fighting ingredients like benzoyl peroxide and tea tree oil alongside soothing ingredients that keep the skin healthy and prevent irritation, like green tea extract or aloe vera. It might not get rid of acne as fast as those harsh products will, but it also won’t irritate the skin and cause a never-ending cycle of acne (like those harsh products will).
Types of Acne Scars
To find the best acne scar treatment, it’s important to know what kind of acne scarring you have. Are your scars depressed? Raised? Darkened? Pin pointing what kind of scars you have can clue you in on how they form, which can help you prevent them in the future, but it can also help with treatment. Different types of scars require different treatments, so the first step is finding out what you’re dealing with.
There are three main types of depressed scars: Ice Pick, Boxcar, and Rolling. All of these are indented in the skin, just to different degrees and in different sizes, and they are very common. If your dermatologist said you have “atrophic” scars, these are the kind they mean. Depressed scars form when skin cells don’t recover after an acne lesion heals and there’s a lack of skin tissue.
Ice pick scars are very small but relatively deep dots in the skin. They get their name because they look somewhat like a very small ice pick punctured the skin, and they are generally caused by cystic or nodular acne that extends deep into the skin. Because of their depth, ice pick scars are unlikely to disappear completely, but they can be significantly improved with different treatment options.
Boxcar scars are wider and usually shallower than ice pick scars. They have nearly vertical edges rather than sloping or gradually deepening edges, which give them the somewhat severe appearance of being “punched out,” like a hole punch. Boxcar scars are generally caused by any kind of inflammatory acne, from papules to cysts. Although boxcar scars rarely fade entirely, the right acne scar treatment can significantly reduce them.
Rolling scars are wide and shallow, and get their name because when several occur together, the skin can have a slightly wavy look. Slightly inflamed acne like papules or pimples typically cause this type of scarring. In response to the inflammation, a fibrous section of tissue develops beneath the surface of the skin and binds itself to lower layers of the skin, creating a wide indentation. Rolling scars may require minor surgery to improve.
Unlike depressed scars, which come in a variety of forms, raised scars are a more general category for any acne scars where excess skin tissue is produced as an acne lesion heals. They are sometimes called “hypertrophic” scars. Inflammation is how the skin responds to the infection associated with pimples and cysts, and raised scars occur when this response doesn’t seem to go away once the acne has healed. New skin cells continue to be produced and the area becomes more and more inflamed, until a raised scar is formed. There are several options for treating raised scars, but especially severe raised scars, called keloids, usually require dermatologist intervention to improve.
Sometimes after acne heals, dark spots appear and they can last anywhere from a few weeks to more than a year. This is called post-inflammatory hyperpigmentation, although it’s typically simply referred to as hyperpigmentation, and it is not technically a kind of scar. Still, we thought it should be included here, since there are ways to treat them and they can cause the same frustration as scarring.
Hyperpigmentation occurs because melanin is part of the wound healing process. Melanin deposits skin pigment to the cells, so the longer it takes for an acne lesion to heal, the more melanin gets deposited and the darker the hyperpigmentation becomes. There are several ways to reduce hyperpigmentation, but preventing it altogether by speeding up the healing process is the most effective option.
The Best DIY Acne Scar Treatment
There are countless ways to treat acne scars, but do-it-yourself remedies are by far the most fun. Our top recommendation: a lemon juice and honey mixture, followed by an aloe vera mask.
- 1 tablespoon raw honey
- 1 teaspoon fresh lemon juice
- 1 tablespoon aloe vera
There are two steps to this process: the lemon-honey mask, and the aloe vera mask. The lemon-honey mask will speed the healing process, reducing scar formation, and exfoliate dead skin cells and some scar tissue cells. The aloe vera mask will work to encourage the growth of new, healthy skin cells and prevent any irritation potentially caused by the lemon in the lemon-honey mask.
First, make sure your honey is raw, meaning there are no other ingredients listed on the bottle, and you use a fresh lemon to get your lemon juice. Bottled lemon juice and honey with added ingredients are great for recipes, but they lose many of the benefits they could provide for your skin.
Combine the honey and lemon until evenly mixed and apply to the skin. Allow the mask to set for half an hour, then remove it by rinsing your face with cool water and gently rubbing the skin with your fingertips. Pat dry with a soft towel, and then it’s on to step two
The aloe vera mask is very straightforward: you simply apply the aloe vera to your face and allow it to set for anywhere between 30 minutes to an hour. Pure aloe vera taken directly from the plant is always best, but bottled is fine as long as the only ingredient is aloe vera. Once the mask has set for your desired amount of time, you can remove the mask just like you removed the lemon-honey mixture. Combined, these masks should help shed scar tissue and encourage new, healthy cells to take its place.
The Best Over-the-Counter Acne Scar Treatment
Over-the-counter options differ based on what kind of scarring you’re trying to reduce, but they generally work best on mild scarring. Mild raised scars typically respond well to hydrocortisone creams that reduce inflammation. These creams can stop the excessive inflammation and skin cell production that accompany raised scars.
Depressed scars typically improve with any over-the-counter product that exfoliates the skin because exfoliation makes way for new healthy cells to replace the scar tissue cells. Lemon juice, salicylic acid, and over-the-counter chemical peels can all exfoliate the skin enough to improve depressed scars slightly. The exception is rolling scars, which will probably see less improvement because they are caused by excess fibrous tissue beneath the surface, which exfoliation can’t help.
One of the most common suggestions for treating hyperpigmentation is hydroquinone, a skin lightener. This can be very effective on pale or even medium skin, but medium-dark to dark skin tones typically see better results from retinoids, some of which are starting to come out over-the-counter now. Hydroquinone has been known to cause light spots on dark skin, and it can turn hyperpigmented spots even darker.
The Best Acne Scar Treatment Prescription
If you’re looking for a prescription to help reduce scar tissue, retinoids are your best option. Retinoids work by regulating skin cell life cycles, making sure they are produced and die at a healthy rate. Scars often form because skin cells die too quickly, or the skin cells at the site of the acne lesion are damaged and don’t reproduce properly. Retinoids can help keep your skin cells on track, which lessens the appearance of any scarring.
However, be sure that you use an excellent moisturizer. Retinoids are known for irritating the skin, so if you have raised scars they could actually make things worse if used alone.
The Best Dermatologist Procedures for Acne Scar Treatment
DIY recipes and over-the-counter and prescription creams can help with mild to moderate acne scarring, but if you have severe scars, you will likely need to visit a dermatologist to see improvement. Dermatologist offices offer a wide variety of services, from laser resurfacing to injections to minor surgery.
Dermatologists have found that acne light therapy can be an excellent form of acne treatment, and it turns out that concentrating that light into a laser creates an excellent acne scar treatment as well. Lasers can be used to resurface small areas of the skin to even things out. This means that lasers can help both raised and depressed scars, but it is not always the safest option for dark skin. In the right hands, laser resurfacing is safe for all skin tones, but many dermatologists aren’t aware of or knowledgeable in the differences between fair and dark skin and how that changes the treatment. If you have dark skin and want to try laser resurfacing, make sure you find a dermatologist with an excellent reputation with skin of color.
Injections can be used for depressed or raised scars, but the type of injection each kind gets is very different. Depressed scars can benefit from filler injections, which are typically made of collagen or your own fat. These are injected beneath the surface, and they can raise the depressed scar to bring it closer to surface level. Fillers aren’t permanent, unfortunately, and this procedure needs to be redone every year to a year and a half. Raised scars, on the other hand, can receive injections of corticosteroids to reduce inflammation and stop the process of excess skin cell production.
Finally, it may sound extreme, but surgery really can be the best acne scar treatment in some cases. Rolling scars, for instance, are best treated with a minor surgery that cuts away the fibrous tissue pulling the surface of the skin down. Large keloids can also be treated with a surgery that removes the keloid and leaves a much smaller scar in its place. Surgery, along with injections and laser therapy, are much more expensive than other options and they aren’t always covered by insurance, so even though they are typically the most effective, you may want to try a few other options first. You may be surprised at how well they work!