Medically reviewed by Dr. Nancy Shannon, MD, PhD on May 12, 2021
As if acne weren’t frustrating enough to deal with as it is. While most pimples go away entirely after a while, some can leave long-lasting marks in the form of acne scars. Scars are more likely to develop after bouts of moderate to severe acne vulgaris, acne fulminans, or cystic acne — though not every acne breakout will result in scarring, and some people will never experience scarring at all.
While the best way to combat acne scarring is through prevention — acne scars are far more likely to develop if you pick at them — you still have treatment options available if they do develop. Here’s what you need to know:
Types of Acne Scars
The first step to knowing how to treat your acne scars is knowing what kinds of scarring you have.
– Ice Pick
Ice pick scars get their name from their shape: they appear as narrow, deep indentation in the top layer of the skin — looking almost as though they’ve been dug with an icepick. Because of their depth, they’re relatively difficult to treat using only at-home methods.
Boxcar acne scars are much broader than ice pick scars and are rarely uniform in their depth. Despite their uneven nature, their edges are usually steep and sharply defined. Boxcar scars usually appear on the thicker parts of the skin: think the chin, jaw, lower parts of the cheek, and other parts of the body.
Rolling scars aren’t as sharply defined as ice pick or boxcar scars, and they generally extend over an entire region of the face as opposed to being localized to a single spot. While they vary in depth and location, it’s not uncommon for sections of rolling scars to cover an entire cheek.
Hypertrophic scars are raised skin that form around sites of skin trauma. They can sometimes be the result of scar tissue building up over several different acne breakouts, though hypertrophic scars can form from other types of skin trauma as well and are most commonly found on the body.
Keloid scars are similar to hypertrophic scars in as much as they’re raised off of the skin itself, but keloid scars grow larger than the original trauma site whereas hypertrophic scars stay the same size or get smaller.
Areas of hyperpigmentation are neither raised nor depressed: they’re areas of the skin that have discolored slightly after being damaged by acne and are not technically scars The color they change to is dependent upon your skin type and often has the potential to fade naturally over time with diligent sun avoidance (e.g. wearing sunscreen SPF 30+ and sun protective clothing, avoiding sun during peak hours 10a-2p).
Making Acne Scars Less Visible
Not all solutions will work for everyone, but there are a number of options at your disposal if you’re hoping to temper your acne scarring. If you have sensitive skin you may want to test some of these options on a small patch of skin first. Here’s what you can do:
Even if certain acne scars can’t be done away with entirely, reducing their pigmentation can make them significantly less noticeable. One of the best ways to do this is through the regular application of sunscreen and diligent sun avoidance, which can help to soften the contrast between normal and hyperpigmented skin.
Sun protective tips include:
- Wear broad-spectrum UVA/UVB sunscreen SPF 30+ and reapply every 2 hours when outdoors or after getting wet
- Considering wearing sun protective clothing, like hats and shirts that are rated UPF 50+
- Avoid direct sun exposure during peak hours of sun intensity (10a-2p)
Just be sure to use non-comedogenic sunscreen, though, as you don’t want your skincare products to cause further acne breakouts. Even with sun protective measures, it can take many months for post-inflammatory hyperpigmentation to fade, particularly in people with darker skin tones.
– Natural Remedies
In the most basic sense, acne scarring is the result of skin damage and inflammation. While some scars may be too serious to combat using only household antiinflammatories, they may be worth trying in most cases. Certain oils like coconut oil, tea tree oil, or black seed oil can help decrease inflammation. If you’re hoping to reverse some hyperpigmentation, consider using aloe vera, or shea butter. Keep in mind that for hyperpigmentation, time is the most effective natural remedy for fading it; being too aggressive with the skin can worsen hyperpigmentation or lead to scarring.
– Salicylic Acid and Chemical Peels
These common treatments for acne don’t help with acne scarring exactly, but it can help with post-acne hyperpigmentation by helping exfoliate the skin. Acids and chemical peels work by removing the top layers of your skin, allowing healthier skin to grow back in its place. They’re available for at-home use, but these DIY peels will not have real impact on scars, which happen at the middle layer of your skin (stronger versions may be available from an in-person dermatologist). While salicylic acid and chemical peels will not heal scars per se, they can be useful in exfoliating the top layer of the skin to help lighten the appearance of hyperpigmentation, smoothen the texture of skin, and help to unclog pores (to avoid future acne break-otus). Common ingredients found in at-home chemical peels include alpha hydroxy acids (like glycolic and lactic acid) and beta hydroxy acids (like salicylic acid). Stronger types may be accessible through your dermatologist. Please note: If you plan to do a chemical peel you should stop your acne medication before doing it as your skin could experience an adverse reaction.
– Dermatological Procedures
If no at-home methods work for you, there are a number of different procedures that dermatologists can perform to help ameliorate your scarring, including laser skin resurfacing, chemical peels or dermabrasion.
If you’re feeling lost when it comes to all things acne, we’re here to help. Reach out to our team of medical professionals here at Nurx today to learn about what your best options may look like.