Early treatment of active acne reduces scarring risk. For existing scars, dermatologists use a range of procedures - fractional lasers (ablative and non-ablative), microneedling, subcision, chemical peels, fillers, and fat grafting - often combined for best results. Aftercare focuses on gentle cleansing, moisturization, avoiding picking, sun protection with broad-spectrum sunscreen, and discussing medications that affect healing with your clinician. Treatments can significantly improve appearance but rarely erase scars completely.
Overview
Treating acne early reduces the chance of permanent scarring. If scars have already formed, dermatologists now combine procedural and topical approaches to improve texture, tone, and contour. Treatment choices depend on scar type (icepick, boxcar, rolling, hypertrophic) and skin type.Common procedural options
- Laser therapy: Both non-ablative and ablative fractional lasers (for example, fractional CO2 or erbium) are commonly used to remodel collagen and improve surface irregularities. Non-ablative lasers generally have less downtime; ablative lasers produce stronger results but require longer healing.
- Microneedling: Controlled micro-injury stimulates collagen and can be combined with topical serums or platelet-rich plasma (PRP) as an adjunct in some practices.
- Subcision: A scalpel or needle releases tethered (rolling) scars under the skin to lift depressed areas.
- Chemical peels and dermabrasion/microdermabrasion: Superficial to medium-depth peels and microdermabrasion help smooth mild surface irregularities; deeper dermabrasion is less commonly used now because lasers and other techniques offer more predictable outcomes.
- Fillers and fat grafting: Temporary hyaluronic acid fillers or longer-lasting autologous fat grafting can restore lost volume in deep atrophic scars.
- Intralesional injections: Corticosteroid injections reduce inflammation and flatten hypertrophic or keloid scars. Other intralesional agents are used selectively.
Choosing a plan
Dermatologists often combine treatments (for example, subcision plus fillers or microneedling plus PRP) to address different scar components. Skin tone, scar depth, medical history, and patient goals guide the plan. Discuss expectations and the number of sessions likely required.Aftercare and daily skin routine
Gently cleanse treated areas twice daily with a mild, non-irritating cleanser. Moisturize to support barrier repair. Avoid picking, rubbing, or squeezing lesions - touching prolongs inflammation and raises the risk of new scars or dark spots.Shampoo hair regularly if oil from hair contributes to acne; if hair is oily, daily washing may help. Men who shave after treatments should test electric and safety razors to find what irritates least. Use a sharp blade, soften the beard with warm water, and apply shaving cream.
After many resurfacing procedures you should avoid sun exposure while healing. Use broad-spectrum sunscreen (SPF 30 or higher), wear a hat, and follow your clinician's instructions about timing of sun exposure and return to active outdoor routines. Some oral or topical medications can increase photosensitivity; discuss current medications with your provider (for example, isotretinoin) before scheduling invasive procedures.
Risks and realistic expectations
Procedures can improve but rarely eliminate scars completely. Risks include temporary redness, pigmentation changes (especially in darker skin tones), and prolonged healing with some interventions. Choose a clinician experienced with your skin type and request before-and-after examples similar to your case.- Confirm current clinical guidance on timing and safety of invasive dermatologic procedures after isotretinoin (systemic retinoid) use.