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The Ultimate Guide To Acne Scars: Formation, Types, And Treatment Options

Acne causes a lot of frustration for those of us trying hard to avoid pimples. Even worse, acne frequently damages the skin's texture and can even result in scarring.

Luckily, most acne scars can be treated, and they can fade over time.  

In this article, we outline everything you need to know about acne scars and how to treat them. 

Not only does this include how to identify and treat them, but we've also compiled a list of treatment options and best practices to help you achieve your best skin.


  • Acne scars usually appear after a moderate to severe breakout that damages and alters the skin's texture.
  • Inflamed blemishes break down elastin fibers that normally keep the skin firm and supple. When these fibers are damaged, healthy skin tissue is lost, and acne scars appear.
  • Acne scars often occur deep within the layers of skin and may result in permanent damage if left untreated.
  • Depending on the severity, you may need several months of treatment before you can heal acne scars. This may include a combination of high-quality skincare products, prescriptions, and even aesthetic treatment sessions.

What Are Acne Scars?

Acne scars occur when the skin is damaged after a moderate to severe breakout.

These scars usually occur as a result of inflamed acne blemishes breaking down elastin—these are fibers that help maintain a firm complexion.

Elastin is also essential for maintaining healthy tissue that prevents the skin from sagging.

If the skin loses healthy tissue as a result of acne damage, acne scars can appear or become more noticeable. 

To prevent this from happening, the skin generates more collagen proteins to repair this damaged region. However, due to poor diet or lifestyle habits, excessive sun exposure, or aging, the skin isn’t always able to produce enough collagen.

This can lead to a loss of healthy tissue and can cause acne scars that look like indents to develop on the skin. 

If the skin produces too much collagen, on the other hand, the complexion can end up with an excess of healthy tissue. This leads to the formation of raised acne scars.

Types of acne scars

Acne scars can appear on the skin in a few different ways. These are typically grouped into three categories:

  • Atrophic scars
  • Hypertrophic scars
  • Discolored scars

To determine the right way to treat your acne scars, you must first identify the type of scar you have before you can seek treatment.

Atrophic or depressed scars

Atrophic acne scars appear as indents on the skin due to a loss of healthy tissue. This type of scarring is common around the cheek and forehead, where inflammatory acne often occurs.

There are three types of atrophic lesions:

  • Rolling scars: Broad indents with sloping edges create a “cobblestone” effect on the skin. Rolling scars often form after long-term inflammatory acne and are generally the easiest to treat. 
  • Boxcar scars: These are broad indents with sharply defined edges that are distinct from the other layers of skin. The sharper edges make boxcar scars more challenging to treat.
  • Icepick scars: Deep, narrow scars that look like open or enlarged pores—this is one of the most difficult lesions to treat.

Hypertrophic and keloid scars

Hypertrophic scars are thick, raised bumps on the skin. These occur when the skin produces too much collagen when combatting damage caused by acne breakouts.

This creates an excess of skin tissue, forming a lump on the outer layer of the complexion.

Hypertrophic acne scars form in the area where the original blemish was and don't expand. These scars are common around the jawline.


Keloids and hypertrophic scars form in the same way—when excess collagen causes a bump to appear on the skin.

They also often expand beyond the original blemish area and are usually much bigger than hypertrophic scars.

These scars are usually smooth with a purplish-pink or dark brown color. Keloids rarely form on the face, commonly occurring on the shoulders, chest, and back. However, people who have developed keloids on their body may be vulnerable to blemishes forming along the jawline as well.

Discolored scars

Skin discoloration is common after you've had acne and can appear as red, pink, or dark brown spots all over the complexion.

Although these spots usually go away over time, the color change can become permanent.

Since this type of scar can go away on its own without treatment, they’re often the easiest to heal and fade. If treatment is needed, it’s usually noninvasive and can using over-the-counter (OTC) remedies.

A woman with acne scars with her chin in hand

Are Acne Scars Common?

About one in five people who develop acne as a teenager or young adult will have acne scars.

Some acne sufferers are at increased risk of scarring, too. Factors increasing the risk for acne scars include:

  • Inflammatory acne: This causes swollen, painful nodules and cysts to form deep underneath the skin.
  • Picking, popping, or squeezing acne cysts: This aggravates existing inflammation under the skin and encourages excess collagen production. Too much collagen leads to extra tissue that forms a lump on top of the skin.
  • Genetics: If a parent has acne scars, it's likely their child will also have scars if acne develops.
  • Delaying or neglecting to treat acne: The longer you allow acne to worsen and spread, the bigger the risk of developing acne scars.

How Do I Know If I Have Acne Scars?

It's important to note that not all blemishes will turn into acne scars. Some blemishes might only leave an acne mark behind.

Remember that scarring happens when there is permanent damage to the skin. If you run your hand over acne scars, they may feel bumpy and rough to the touch.

Acne marks are often temporary, discolored spots that appear after a breakout—also called post-inflammatory hyperpigmentation (PIH).

These usually go away on their own and don't affect the skin's texture.

Can Acne Scars Fade on Their Own?

Some acne scars will fade on their own. However, this will depend on the type and severity of the scarring.

Surface-level acne scars like discolored patches may fade over time since they don't change the skin's texture.

Scarring that occurs on a deeper level—like atrophic or hypertrophic lesions—will most likely need treatment before they begin to fade.

Because atrophic and hypertrophic scars damage the structure and texture of the skin, it takes longer for the complexion to heal. That's why these scars often become permanent or need several months of consistent treatment before they lighten.

What’s the Best Way to Treat Acne Scars?

From at-home remedies to aesthetic therapies with a dermatologist, there are many options for treating acne scars.

The goal of most acne scar treatments is to encourage the production of new skin cells and essential proteins to promote healing.

This also helps even the skin tone to reduce the appearance of scarring.

Depending on the severity of your acne scars, you may need to combine a few treatment options before you see visible results. A dermatologist (like those at Nava MD) can help you find the right solutions.

Let's take a look at the options.

Use the right skincare ingredients and products

Fine-tuning your skincare regimen and using effective OTC products can be one of the best ways to treat acne scars at home (and avoid them in the first place!). These products are also cost-effective, readily available, and gentler on your skin compared to some aesthetic treatments.

Although shopping for the right products is a good start, effective ingredients are critical. A few scar-soothing ingredients, and why, are listed below.

  • Vitamin C: An ascorbic acid that can help neutralize elements that damage skin cells and fibers, it also stimulates the production of new skin cells that can replace damaged scar tissue and reveal smoother skin.
  • Azelaic acid: An anti-inflammatory, antibacterial ingredient that can reduce the severity of an acne breakout and minimize the risk of deep scars forming. It kills harmful bacteria that contribute to infections and inflammation while encouraging the production of new skin cells. Azelaic acid may also help control the formation of dark spots and reduce discoloration caused by blemishes.
  • Clindamycin: A topical ingredient that reduces the volume of harmful bacteria on the skin that contribute to inflammation, acne, and ultimately acne scars. It may also help to manage redness and prevent deep scars from forming.
  • Topical retinoids: Retinoids are powerful vitamin A derivatives that can help renew the skin by stimulating the production of new cells and collagen. Retinol, retinaldehyde, tretinoin, and tazarotene are often used as a primary acne scar treatment due to their ability to reduce inflammation and improve the skin’s healing capabilities. 

More on Retinoids for Scarring

Retinoids speed up the skin’s healing abilities. This is called the skin’s cell turnover process, and it’s essential for breaking down scar tissue to heal skin and fade lines or bumps.

Retinoids also exfoliate the skin in the process. As more new cells are made and pushed to the surface of the skin, dead skin cells, dirt, and debris trapped in pores can be removed from the surface more quickly. Over time, this exfoliation process reveals new skin that’s not damaged by acne scars, dark spots, or fine lines.

Topical retinoids are also clinically proven to inhibit the development of new acne lesions and microcomedones—blemishes that can indicate the start of an acne scar.

Studies have proven that 0.01% and 0.025% tretinoin reduces microcomedone development by up to 80% when used daily for 12 weeks. When the formation of microcomedones is reduced, the appearance of acne scars and hyperpigmentation can be minimized.

Topical retinoids are also effective in treating secondary lesions associated with acne, such as PIH.

This condition is often seen in people with moderate to severe acne. Usually pink, tan, or brown in color, PIH happens when the skin produces too much pigment (melanin) in response to acne inflammation.

Topical retinoids containing tretinoin can significantly lighten PIH by inhibiting the transfer of melanin to skin cells and accelerating cell growth and turnover. In fact, a pilot study involving individuals with acne scarring who used a topical retinoid showed significantly reduced scar visibility and smoother skin texture after six months.

Tretinoin for acne scars

Tretinoin is one of the most commonly used retinoids. It is prescription only, yet it’s much more gentle than some other prescription retinoids, like tazarotene.

Various brand names of tretinoin formulations available in the U.S. include:

  • Retin-A (cream or gel with 0.025% tretinoin).
  • Renova (cream only with 0.02% tretinoin).
  • Avita (cream or gel with 0.025% tretinoin).
  • Atralin (gel only with 0.05% tretinoin).
  • Retin-A Micro (cream or gel with 0.04% tretinoin).
  • Generic Tretinoin cream in a range of concentrations. Tretinoin is commonly employed in custom formulas by Nava MD.

Personalized formulas by Nava MD

Nava MD specializes in custom, dermatologist-recommended formulas for your skin’s needs. 

Much like an in-person dermatology visit, our “online” dermatologists can prescribe ingredients like tretinoin, clindamycin, niacinamide, and more for acne treatment and acne scar treatment. 

They’re blended in a single formula, which is sent to your door, if approved, with no in-office dermatology visit required and ongoing access to your prescriber any time through our patient portal. These solutions are intended to produce visible results within 60 to 90 days, and improvements can continue to build through your first year of consistent use. 

Getting prescription acne treatments has never been easier or more affordable.

Pixel laser resurfacing treatments

Laser treatments are an option some dermatologists recommend for acne scars because it offers rapid results.

Pixel laser resurfacing treats small areas of the skin without affecting the surrounding areas of the complexion.

During each treatment session, a laser light breaks up scar tissue by removing the top layer of the skin. Although this sounds like it may damage the skin, it actually stimulates collagen production in the deeper skin layers to help tighten tissue underneath and around scars.

Because a laser can reach deep into the skin, this can be a good treatment option for stubborn acne scars—like those caused by atrophic or hypertrophic conditions.

You may need three to four laser sessions before your acne scars begin to fade. It's also recommended you give the skin up to two weeks to heal before going for another session.


Microneedling—also known as collagen induction therapy—is done using an device containing tiny rotating needles.

This device is pressed directly into the acne scars to break up damaged tissue and stimulate collagen production.

It's one of the most effective treatment options for atrophic scars.

Combination treatments like radiofrequency (RF) microneedling are another effective way to rejuvenate skin. RF microneedling uses the heat of radio frequencies to warm the skin and increase blood flow. At the same time, microneedles enter the skin to prompt collagen production and healing.

A woman undergoing an in-office facial treatment

Chemical peels

While chemical peels are generally not recommended for use during acne outbreaks, they can help reduce acne scars and mild hyperpigmentation.

This aesthetic clinical treatment uses chemicals to remove the top layer of the complexion, stimulating collagen creation and the production of new skin cells. When this layer is removed, the layer that rebuilds underneath it as the skin heals is often smoother and has fewer scars.

Skin peels can vary in strength and ingredients.

If the scarring is severe, dermatologists may use a "deep" chemical peel that includes additional substances that can work deeper beneath the skin.

How Long Does It Take for Acne Scars to Fade?

Healing acne scars takes time and patience. Since treatments involve revitalizing and rebuilding your skin's structure, it can take a while before you start seeing results.

Depending on the severity of your scarring, you may start to see results anywhere between four weeks to six months. Some gentler treatments and ingredients can take up to a year to work.

Aesthetic treatment options also require your skin to heal in between sessions. This means that the recommended three to six sessions can be spaced months apart. These treatments must also always be administered by a qualified professional. If not, there's a high risk of worsening the scarring and increasing the time it will take to heal.

Achieve Smooth and Healthy Skin with Nava MD

At Nava MD, we understand how frustrating it can be to deal with the after-effects of acne.

That's why our licensed clinicians work hard to get you the best possible formulas to treat your acne scars and improve your complexion gently and effectively.

Our range of prescription and OTC products include powerful ingredients to help you achieve your best skin. For acne scarring, our personalized prescription formulas contain varying concentrations (based on your condition and tolerance) of ingredients like:

  • Azelaic acid
  • Niacinamide
  • Tretinoin
  • Clindamycin
  • And more

Our dermatologists create personalized treatment plans that are tailored to your skin's specific requirements and sensitivities, and it’s all done online.

It starts with a free online skincare consultation, and it ends with a personalized prescription formula in your mailbox, if approved.

We’ve made dermatology easy with online care, licensed medical professionals, and unlimited follow-up with your prescriber. Fast, effective, and affordable, with no in-office visits required.

Start your journey to scar-free skin with Nava MD today.

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This article is intended for informational purposes only and should not be considered medical advice.
Consult a healthcare professional or call a doctor in the case of a medical emergency