How to Treat Acne Scars: Dermatologist-Approved Methods That Work

Acne scars can be one of the most frustrating aspects of living with acne-prone skin. Even after you have successfully cleared your breakouts, the marks they leave behind can linger for months or even years. The good news? With the right approach, most acne scars can be significantly reduced.

As a clinical esthetician, I have helped thousands of clients fade everything from mild hyperpigmentation to deep, rolling scars. The key is understanding what type of scarring you have and using the right combination of topical ingredients, professional treatments, and preventive care.

Types of Acne Scars

Before you can treat acne scars effectively, you need to understand what kind you are dealing with. Not all scars respond to the same treatments, and using the wrong approach can waste time and money.

Atrophic Scars (Depressed Scars)

These are the most common type of acne scars. They occur when the skin loses collagen during the healing process, leaving a depression or "pit" in the skin. There are three subtypes:

• Icepick scars — Narrow, deep, V-shaped pits that extend into the dermis. They resemble the puncture wound from an icepick and are the most difficult to treat.
• Boxcar scars — Broad, rectangular depressions with well-defined edges. They look similar to chickenpox scars and can be shallow or deep.
• Rolling scars — Wide, shallow depressions with sloping edges that give the skin a waved or uneven appearance.

Hypertrophic Scars (Raised Scars)

Less common than atrophic scars, hypertrophic scars occur when the body produces too much collagen during healing, resulting in a raised bump. These are more common on the chest, back, and shoulders than on the face.

Post-Inflammatory Hyperpigmentation (PIH)

Technically not a scar, PIH refers to the dark or discolored marks left behind after a pimple heals. These marks are flat (not raised or depressed) and range from pink to deep brown depending on your skin tone. PIH is the most treatable type of acne mark and usually fades on its own over several months with the right support.

Image: Acne Scar Types

Topical Treatments (AHAs, Vitamin C, Retinoids)

Topical ingredients are the first line of defense against acne scars and hyperpigmentation. While they cannot completely eliminate deep atrophic scars, they can significantly improve texture, fade discoloration, and stimulate collagen production over time.

Alpha-Hydroxy Acids (AHAs)

AHAs like glycolic acid, lactic acid, and mandelic acid exfoliate the top layer of dead skin cells, revealing fresher, brighter skin underneath. They are particularly effective for treating PIH and shallow boxcar scars.

• Glycolic acid — The most potent AHA. Best for experienced users; can cause irritation.
• Lactic acid — Gentler than glycolic, with added moisturizing benefits.
• Mandelic acid — The gentlest AHA, ideal for sensitive and acne-prone skin. Found in CLEARSTEM's CLEARITY Serum.

Vitamin C

Vitamin C is essential for collagen synthesis and is one of the most effective ingredients for fading hyperpigmentation. It inhibits the enzyme tyrosinase, which is responsible for melanin production, making it a powerful brightening agent. CLEARSTEM uses the stable, gentle form Sodium Ascorbyl Phosphate (SAP) in our formulas.

Retinoids

Retinoids (including retinol, tretinoin, and adapalene) accelerate cell turnover and stimulate collagen production. They are effective for both treating active acne and improving the appearance of scars. However, they can be irritating — especially for adult skin. For those who cannot tolerate retinoids, bakuchiol offers similar benefits without the irritation.

Niacinamide

Niacinamide (vitamin B3) is a gentle but effective ingredient for fading hyperpigmentation. It works by blocking melanosome transfer — essentially preventing pigment from reaching the skin's surface. It also strengthens the skin barrier, which is essential for healing.

Ingredients That Fade Hyperpigmentation

Hyperpigmentation is the most common concern for people with acne-prone skin. The good news is that it is also the most treatable. Here are the most effective ingredients for fading dark marks:

Ingredient	How It Works	Best For
Vitamin C (SAP)	Inhibits melanin production, boosts collagen	All PIH types
Mandelic Acid	Exfoliates surface pigmentation, antibacterial	Surface PIH, active acne
Niacinamide	Blocks pigment transfer to skin cells	Stubborn PIH
Bakuchiol	Accelerates cell turnover, stimulates collagen	PIH + texture improvement
Tranexamic Acid	Reduces inflammation-induced melanin production	Red/dark PIH
Kojic Acid	Inhibits tyrosinase enzyme	Surface pigmentation

The most important rule for treating hyperpigmentation: always wear sunscreen. UV exposure darkens pigmented spots and undoes all your hard work. A broad-spectrum SPF 30+ is non-negotiable.

Professional Treatments

For stubborn or deep scars, professional treatments performed by a dermatologist or licensed esthetician can provide dramatic results that topical products alone cannot achieve.

Chemical Peels

Medical-grade chemical peels use higher concentrations of acids (typically glycolic, TCA, or salicylic acid) to remove damaged skin layers and stimulate collagen production. A series of 3–6 peels, spaced 2–4 weeks apart, can significantly improve the appearance of superficial scars and PIH.

Microneedling

Microneedling involves creating thousands of microscopic punctures in the skin using a device with fine needles. This triggers the body's natural wound-healing response, stimulating collagen and elastin production. It is one of the most effective treatments for atrophic scars, particularly rolling and boxcar scars. Most patients need 3–4 sessions for optimal results.

Laser Resurfacing

Fractional laser treatments, both ablative and non-ablative, are gold-standard treatments for acne scarring. They work by creating controlled micro-injuries in the skin, which trigger collagen remodeling. Recovery time varies from a few days (non-ablative) to a few weeks (ablative), but results can be transformative.

Subcision and Fillers

Subcision involves using a needle to break up the fibrous bands that tether down atrophic scars, allowing the skin to rise. Fillers can then be injected to lift the depression further. These are best for deep rolling and boxcar scars.

Prevention Is Key

The most effective treatment for acne scars is preventing them in the first place. Here is how:

• Treat acne early — The longer a breakout goes untreated, the deeper and more extensive the inflammation, and the higher the risk of scarring.
• Never pick or pop — Picking at pimples increases inflammation and pushes bacteria deeper, dramatically increasing scarring risk.
• Use non-comedogenic products — Products that clog pores perpetuate the acne cycle and increase the chance of scarring. Read our non-comedogenic guide to learn more.
• Wear SPF daily — UV exposure darkens existing marks and impairs the skin's ability to heal.
• Moisturize properly — A healthy skin barrier heals faster and more effectively. Check our acne-safe moisturizer guide for recommendations.

"Every scar tells a story of inflammation. The deeper the inflammation, the more likely the scar. By controlling the inflammatory response early — through gentle, non-comedogenic skincare and avoiding picking — you can dramatically reduce your risk of long-term scarring."
— Danielle Gronich, Clinical Esthetician & Co-Founder of CLEARSTEM

Image: Scar Treatment Routine

Building a Scar-Treatment Routine

Here is a sample routine for treating acne scars while keeping breakouts under control. All products should be 100% non-comedogenic.

Morning

1. Gentle cleanser — Use a non-comedogenic cleanser with vitamin C (like CLEARSTEM GENTLECLEAN) to brighten and protect.
2. Vitamin C serum — Apply an SAP-based serum to fade hyperpigmentation and protect against free radicals.
3. Moisturizer — A lightweight, non-comedogenic moisturizer with ingredients like squalane and niacinamide.
4. Sunscreen — SPF 30+ broad-spectrum, absolutely essential.

Evening

1. Cleanser — Double-cleanse if wearing makeup or sunscreen.
2. Chemical exfoliant (2–3x/week) — Mandelic acid or another gentle AHA to exfoliate and brighten.
3. Treatment serum — Bakuchiol-based serum to stimulate collagen and cell turnover without irritation.
4. Moisturizer — A slightly richer non-comedogenic moisturizer to support overnight repair.

Consistency is everything. Scar treatment takes time — typically 3–6 months to see significant improvement with topical products, and 1–3 sessions for professional treatments. Stick with it, and protect your progress with daily sunscreen.

For a complete step-by-step guide to building a full skincare routine, see our Clear Skin Routine Guide.