The bad news: There’s no secret ingredient or miracle gadget that makes scars totally disappear. Don’t get discouraged, though. Some of the best acne scar treatments can significantly diminish the discoloration and texture a blemish can leave behind.
Before diving into the solutions, let’s sort out the basics about acne scars. For starters, a lot of what you may think of as acne scarring is really post-inflammatory hyperpigmentation or erythema — brown or red spots — rather than a permanent change in the texture of the skin. “Scars and discoloration occur as a result of injury to the skin, and in the case of acne, the injury is related to excess oil production, inflammation, and bacteria,” says board-certified dermatologist Marisa Garshick, M.D., who is based in New York City. She also notes that when the skin tries to repair itself after a breakout, it can leave a red, pink, tan, or brown mark behind, depending on the blemish and the individual’s skin tone.
“Pimples that scar usually have dead skin cells, oil, bacteria, fluid, and white blood cells in them,” explains Boston-based board-certified dermatologist Papri Sarkar, M.D. “These things take up space by stretching the skin and cause inflammation that can break down the pore that they’re in and the surrounding skin.”
What are the different types of acne scars?
Due to its inflammatory and bacterial aspects, post-inflammatory hyperpigmentation after acne is considered its own category in the world of discoloration and scarring. “This differs from sunspots or hyperpigmentation that is the result of an increase in melanin from UV exposure and environmental stressors — [both of which can] lead to free-radical damage that can manifest as brown spots,” Dr. Sarkar explains.
If there’s been too much skin warping by the original pimple, it may cause a scar that looks indented. Or on the other end of the texture spectrum, “when the blemish heals a little too well, you can get an excess of skin added that forms a bump or raised scar,” says Dr. Sarkar. “Either way, acne scars cause a textural change that leaves hills and valleys on the face that bother people greatly.”
Acne scars are slightly different than other pigmentation and texture changes. Many people can have acne without any resulting scab or textural change. “The lesions that tend to form scars are the ones that are really inflamed or really large,” says Dr. Sarkar. She notes that the deeper, more painful acne bumps that have a lot of contents within them tend to be the ones that leave a mark or scab behind. “The worse the acne, the more likely your skin is to have acne scarring,” Dr. Sakar adds.
What are the best treatments for acne scars?
Luckily, there’s a bevy of gels, creams, and treatments that can bring blemish-induced discoloration down. Dr. Sarkar says that collagen-building ingredients will generally help acne scars, so she looks to retinoids, vitamin C, and alpha hydroxy acids (AHAs) when treating her patients.
“Retinoids, a vitamin A derivative, help to increase collagen, even out skin tone, and prevent future acne,” she explains. “Vitamin C is a brightening agent and an antioxidant, and it has been shown to build collagen as well. Glycolic, lactic, and mandelic acids help to resurface the skin to even out skin tone.”
Can I permanently remove acne scars?
Dr. Garshick says the potential removal of acne scars typically depends on the type of scar and the extent of the scarring. “For example, faint discoloration may fade with time and can certainly be improved with topical treatments alone, while deep ‘ice pick’ scarring won’t go away with [just] topicals,” she says.
It’s best to approach acne scars with multiple different treatment modalities that address the different components, so work with your dermatologist to sort out the best regimen for your level of scarring.
In addition to the aforementioned ingredients that you should add to your scar-reducing regimen, Miami-based board-certified dermatologist Annie Gonzalez, M.D., puts equal emphasis on what to avoid when treating acne scars. She steers her patients clear of cleansers and toners containing alcohol, which, she says, can dry out the skin and make the sebaceous glands produce more oil to compensate, thus causing acne and potentially resulting scars.
“It’s also important to note that using too many treatments at once, using extraction tools by yourself, and over-exfoliating can make acne scars worse,” says Gonzalez. “Doing these things could cause inflammation, which may lead to a new acne outbreak. In addition, the skin may become red, which may highlight the appearance of an [existing] acne scar.”
Taking note of which ingredients to look for when seeking the best acne scar treatments, we asked several dermatologists to recommend the most effective products to diminish the marks left behind by breakouts. Scroll to see their top picks.