Specific dermatological procedures to minimize acne scars will be determined by your health care provider based on:
Your age, overall health, and medical history
Severity of the scar
Type of scar
Your tolerance for specific medications, procedures, or therapies
Your opinion or preference
Although acne can be a chronic condition, even if it occurs only during adolescence, it can leave lifelong scars. Acne scars can be depressed due to the loss of tissue and look like "ice pick" pits, or can be rolling, creating a wavy texture in the skin or boxlike, sometimes referred to as "boxcar acne scars." Acne scars can also be raised due to excess tissue in the form of a keloid or hypertrophic scar. Lastly, acne can leave colored spots referred to as postinflammatory hyperpigmentation. These spots can be purplish, red and pink in lighter skin, and tan to dark brown in darker skin. These are technically not scars and will commonly fade over time. Although proper treatment for acne may help minimize scarring, several dermatological procedures may help to further minimize any acne scars, including the following:
Dermabrasion. Dermabrasion may be used to minimize small scars, minor skin surface irregularities, surgical scars, and acne scars. As the name implies, dermabrasion involves removing the top layers of skin with an electrical machine that abrades the skin. As the skin heals from the procedure, the surface appears smoother and fresher. You will typically need 5 to 7 days at home to recover. Microdermabrasion is a less invasive option typically performed in a series of treatments that do not require the same downtime.
Chemical peels. Chemical peels are often used to minimize sun-damaged skin, irregular pigment, and superficial scars. The top layer of skin is removed with a chemical application to the skin. By removing the top layer, the skin regenerates, often improving its appearance.
Dermal filler injections. These are injected beneath the skin to replace the body's natural collagen that has been lost. Injectable dermal fillers are generally used to treat wrinkles, scars, and facial lines. Most fillers are temporary, lasting about ! year.
Laser resurfacing and light therapies. Laser resurfacing uses high-energy light to burn away damaged skin. Laser resurfacing may be used to minimize wrinkles and fine scars. A pulsed dye laser may be used to specifically treat raised acne scars. Additionally, for lighter-skinned people, intense pulsed light may be another treatment option.
Punch grafts. Punch grafts are small skin grafts used to replace scarred skin. A hole is punched in the skin to remove the scar, which is then replaced with unscarred skin (often from the back of the earlobe). Punch grafts can help treat deep acne scars.
Subcutaneous incision. A surgical probe is used to separate the skin and scar tissue. This will raise the skin and, over time, flatten the surface of depressed acne scars. This is also called subcision.
Autologous fat transfer. An autologous fat transfer uses fat taken from another site on your own body and it is injected into your skin. The fat is placed beneath the surface of the skin to elevate depressed scars. This method is used to correct deep contour defects caused by scarring from nodulocystic acne. Because the fat may be reabsorbed into the skin over a period of months, there may be a need for the procedure to be repeated.
Injections. Commonly referred to as intralesional injections. These involve injecting a medication, usually a steroid, directly into a raised scar, causing it to flatten and soften.
Cryotherapy. The purpose of this treatment is to freeze scar tissue, causing it to die and eventually fall off. Sometimes, this is used in combination with intralesional injections. One potential risk of cryotherapy, however, is lightening the skin, causing the treated area to be lighter than the surrounding skin.
Topical creams. Creams with retinoids or silicone can also help reduce the appearance of scars,