Finding the Best Acne Scar Treatments
Topical acne scar treatments are just one part of a healthy skincare routine for eliminating unwanted discoloration, bumps and pock marks. The other part? Professional resurfacing treatments provided by dermatologists and aestheticians, depending on the severity. Based on your case, a dermatologist may recommend microneedling, laser treatments, chemical peels, injections of corticosteroids or fillers. It’s also important to apply a 50+ SPF sunscreen at least twice daily, according to Dr. David Lim, lead dermatologist at Cutis Clinic in Brisbane, Australia.
Of course, professional resurfacing treatments are expensive, and Dr. Lim doesn’t always recommend them for mild to moderate cases. If you’re on a budget, you can still achieve great skin from home. Just temper your expectations! Topical treatments take time, and they won’t necessarily transform moderate to severe atrophic and hypertrophic scarring.
What to Consider When Choosing the Best Acne Scar Treatments
Before buying an acne scar treatment, it’s important to consider your scar type, the active ingredients that will be effective, inactive ingredients that are crucial for a healthy skin barrier, your level of sensitivity and your skin type.
Acne Scar Type
As we previously mentioned, dermatologists categorize acne scars into four types: hyperpigmentation, erythema, atrophic scars and hypertrophic scars. Hyperpigmentation (dark discoloration) is most common on darker skin tones, while erythema (red discoloration) can occur on all skin tones but is easier to detect on lighter tones.
Atrophic scars include ice pick, rolling and boxcar scars, which are all types of indentations. Hypertrophic scars are raised bumps that occur from thickened scar tissue. Generally, atrophic and hypertrophic scars are far more difficult to get rid of than hyperpigmentation and erythema.
Active Ingredients
The key to achieving results for your acne scars is knowing which active ingredients will improve your skin’s appearance without causing irritation and raising your risk of another breakout. To help you get started, check out our breakdown of the active ingredients dermatologists recommend for scarring below. (Note: If you have sensitive skin, start with products marketed towards sensitive skin. Ideally, these products will have low concentrations of retinol and other strong actives.)
- Retinoids (for all acne scar types) are forms of vitamin A or chemical compounds closely related to vitamin A. They include strong, prescription retinoids such as tazarotene, trifarotene, tretinoin and adapalene, and weaker, over-the-counter retinoids like retinyl esters, retinal and retinol. Note that adapalene in weaker concentrations is often sold over the counter.
- Azelaic Acid (for post-inflammatory hyperpigmentation and post-inflammatory erythema) is a gentle acid that works well on all skin types (dry, oily and combination) to treat dark and red acne scars. It also treats mild to moderate acne caused by inflammation.
- Niacinamide (for dark spots and red spots) is a form of vitamin B3 with a host of skin benefits, including a brightening effect on dark and red spots. It also helps reduce inflammation and prevents moisture from leaving the skin.
- Vitamin C (for dark spots and mild, atrophic scars), in the form of ascorbic acid, is an anti-inflammatory that brightens hyperpigmentation and inhibits pigment production. It also helps increase the skin’s collagen production, which improves the appearance of mild atrophic scarring.
- Hydroquinone (for dark spots) is a skin-lightening agent that brightens and reduces the appearance of skin marks.
- Arbutin (for dark spots) is a natural derivative of hydroquinone. Since it is milder than hydroquinone, it can provide the same skin-lightening benefits but is less likely to cause side effects like itchiness, redness and dryness.
- Tranexamic Acid (for dark spots) is an anti-inflammatory chemical compound that inhibits pigment production, calms the skin and helps restore the skin barrier. According to Dr. Lim, tranexamic acid is most effective when taken orally, but may have some positive effects if applied topically.
Inactive Ingredients
Hydrating and anti-inflammatory ingredients are important additions to any acne scar treatment, because they will replenish moisture and mitigate irritation. Great hydrators to look out for include glycerin, hyaluronic acid, allantoin, petrolatum and squalane. Non-active anti-inflammatories include green tea, chamomile extract, aloe vera and ceramides.
Skin Sensitivity
Your skin’s sensitivity level will help you determine the strength of your acne scar treatment. If you have very sensitive skin, we recommend choosing a gentle treatment such as encapsulated, low-dose retinol (encapsulated retinol releases gradually into the skin which reduces irritation). If you have a moderate to high tolerance to active ingredients, you may be able to handle stronger serums and creams. We also recommend avoiding fragrance (including essential oils) in your acne scar treatment to reduce your risk of irritation.
Skin Type
The best acne scar treatments are designed for oily, dry and combination skin, but certain formulas will be better suited to certain skin types. For instance, oily skin may benefit from a gel-based formula that has very lightweight hydrators like aloe vera and hyaluronic acid. Dry skin would pair well with a cream-based or serum-based formula that contains squalane or petrolatum (though aloe vera and hyaluronic acid are also beneficial). Combination skin would do well with either a gel or serum base.
What Are the Different Types of Acne Scar Treatments?
According to Dr. Muneeb Shah, board-certified dermatologist and influencer, different types of scarring require different treatments. There is some overlap — meaning certain active ingredients can help treat two or more types of scarring. Learn more about each scar type and the treatments Dr. Shah recommends below.
Post-Inflammatory Hyperpigmentation
Post-inflammatory hyperpigmentation (PIH) is dark discoloration that appears on the skin where a pimple, lesion or patch of irritation used to be. It occurs because the body creates inflammation to heal the affected area, and this inflammation causes your skin to produce more melanin. Generally, PIH is more common for people with darker skin.
So, how do you treat it? Dr. Shah recommends facial treatments that include retinoids, tranexamic acid, azelaic acid, niacinamide, vitamin C, arbutin or hydroquinone.
Post-Inflammatory Erythema
Post-inflammatory erythema (PIE) is a term that refers to pink or red marks left on your skin after a breakout. In general, PIE affects people with lighter skin. Note that PIE often resolves on its own, but if you want to speed up the healing process, over-the-counter acne products can help. Dermatologists recommend azelaic acid, retinoids and niacinamide for PIE.
Atrophic and Hypertrophic Acne Scarring
Atrophic acne scarring refers to indented scars, or ones that rest below the skin’s surface, and hypertrophic scarring refers to raised bumps. Atrophic scars form when your skin has insufficient collagen during the healing process. In contrast, hypertrophic scars form when extra connective tissue develops around the original wound.
Both types of scars are very difficult to get rid of. In addition to topical retinoids and vitamin C, dermatologists recommend trying microneedling, laser peels or chemical peels for atrophic and hypertrophic scars.
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