Yes, there are effective ways to significantly reduce acne scars, though the right approach depends on the type of scar you have. Most professional treatments produce 30% to 70% improvement in scar appearance, and combining methods often gets better results than any single treatment alone. Complete erasure isn’t always realistic, but meaningful improvement is achievable for nearly every scar type.
Why Scar Type Matters
Acne scars fall into two broad categories: depressed scars that sit below the skin’s surface and raised scars that stick up above it. Depressed scars are far more common, and they come in three varieties. Ice pick scars are small, narrow holes that point deep into the skin, most often on the cheeks. Boxcar scars are wider, box-shaped depressions with sharp edges, typically found along the lower cheeks and jawline. Rolling scars have sloped, uneven edges that give the skin a wavy texture.
Raised scars, called hypertrophic or keloid scars, form when the body overproduces scar tissue at the site of a former breakout. Hypertrophic scars stay within the boundaries of the original acne spot, while keloids grow beyond it.
Each type responds differently to treatment. A procedure that works well for rolling scars may do nothing for ice pick scars. This is the single most important factor in choosing a treatment, so identifying your scar type (or having a dermatologist do it) is the first step.
Laser Resurfacing
Fractional laser treatments are one of the most studied options for depressed acne scars. These devices create thousands of tiny columns of controlled injury in the skin, triggering the body’s healing response and stimulating new collagen production. A systematic review of fractional laser studies found that most patients experienced 30% to 70% improvement in scar appearance.
The number of sessions varies widely. Some people see meaningful results after one or two treatments, while others need four to six sessions spaced a month or two apart. Ablative lasers (which vaporize thin layers of skin) tend to produce more dramatic results but come with longer recovery times, sometimes several days of redness and peeling. Non-ablative lasers work beneath the surface without removing skin, meaning less downtime but typically more gradual improvement.
One important consideration: ablative lasers carry a risk of post-inflammatory hyperpigmentation, especially for people with darker skin tones. That temporary darkening can last around five weeks and usually responds to topical treatments. Non-ablative options and radiofrequency devices are generally safer for darker skin because they don’t directly target pigment.
Microneedling and Radiofrequency
Microneedling uses fine needles to create controlled micro-injuries in the skin, prompting collagen remodeling as the skin heals. It works well for rolling scars and is a strong option for people with darker skin, since the risk of hyperpigmentation is lower than with laser treatments.
Radiofrequency microneedling takes this a step further by delivering heat energy through the needles into deeper layers of skin. In a preliminary study, 100% of patients showed moderate to excellent improvement in acne scars and skin texture, with 94% also seeing reduced pore size. The needles penetrate 2 to 3.5 millimeters deep, reaching the layers where scar tissue forms. Recovery is relatively short, with minimal downtime compared to ablative lasers.
Subcision and Fillers for Rolling Scars
Rolling scars have a specific structural problem: fibrous bands beneath the skin pull the surface downward, creating that uneven, wave-like appearance. Subcision addresses this directly. A needle is inserted beneath the scar to physically cut those tethering bands, releasing the skin so it can sit at a more natural level. The blood clot that forms afterward also stimulates collagen production in the area.
Combining subcision with injectable fillers often produces the best results for these scars. After the bands are released, filler is placed beneath the scar to lift it flush with the surrounding skin. The subcision creates space for the filler to work more effectively. Sessions are typically repeated every six weeks as needed. One study using a collagen-stimulating filler found that 54% of patients achieved excellent results after three to four treatments at four-week intervals.
TCA CROSS for Deep Ice Pick Scars
Ice pick scars are notoriously stubborn because they’re narrow and deep, making them difficult for lasers and microneedling to reach effectively. The TCA CROSS method was designed specifically for these scars. A high-concentration acid is applied precisely into each individual scar using a small applicator, causing controlled damage that triggers the skin to rebuild from the bottom up.
This technique requires multiple sessions, typically spaced a month apart to allow collagen to build between treatments. Results improve with each round: after three sessions, about 20% of patients in one study achieved excellent improvement, but after six sessions that number jumped to 70%. Overall, 60% of patients saw marked improvement, 30% saw moderate improvement, and only 10% had mild results. Recovery is shorter than with full-face chemical peels since only the individual scars are treated.
What Topical Products Can Actually Do
Prescription retinoids (derivatives of vitamin A) are the most evidence-backed topical option for acne scars. They promote tissue remodeling by influencing how skin cells behave and how collagen is produced. One study found that 79% of patients experienced flattening of depressed scars after treatment with tretinoin combined with mild chemical peels. In a separate study of tazarotene applied daily for three months, scar reduction was comparable to microneedling results on the other half of the same patients’ faces.
Newer retinoids show promise too. Trifarotene significantly reduced acne scarring over 24 weeks compared to placebo in a study of over 100 patients. Adapalene at higher concentrations improved skin texture by one to two grades in more than half of patients tested.
These aren’t overnight solutions. Topical retinoids typically require months of consistent use, and the degree of improvement is more modest than professional procedures. But they’re accessible, relatively affordable, and can serve as a foundation. Some dermatologists use them as preparation before in-office procedures or as maintenance afterward to extend results. For mild, shallow scarring, a topical retinoid alone may be enough.
Combining Treatments Gets Better Results
Because different scar types respond to different mechanisms, most people with acne scarring benefit from a combination approach. A common strategy pairs subcision for rolling scars with laser resurfacing or microneedling for overall texture improvement, plus TCA CROSS for any deep ice pick scars. Topical retinoids can be layered in before or after procedures to enhance collagen remodeling.
There’s no single “best” treatment. The right plan depends on your scar types, skin tone, tolerance for downtime, and budget. Professional procedures generally range from two to six sessions, with results continuing to improve for months after the last treatment as collagen remodeling continues.
Preventing New Scars While Treating Old Ones
The American Academy of Dermatology emphasizes that treating acne early is the most effective way to prevent scarring in the first place. Mild acne treated promptly with over-the-counter products is far less likely to progress into the deep, inflammatory breakouts that leave scars behind. If you’re still experiencing active acne while pursuing scar treatment, getting breakouts under control first will prevent new scars from forming while you work on improving existing ones.