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If you’ve managed to clear a severe acne breakout only to be left with bumpy skin and spots, you join millions of people who are dealing with frustrating acne marks. And you may be wondering what you need to do to make those acne scars disappear.
Here’s a look at how long it takes for acne scars to fade and what types of things healthcare professionals recommend for treating acne scars.
How long does it take for acne scars to fade?
Acne scars—those indented or raised areas of skin with a different texture than your original skin—usually don’t go away on their own. If they are mild, they may become less noticeable over time. However, you may have to take some active steps to clear your skin of acne scars (more on that later).
Are red and brown spots acne scars?
If you’re noticing red or brown spots that have the same texture as your normal skin, these are not acne scars, and they often fade.
Inflammation and swollen blood vessels sometimes leave behind those pink or red marks (called postinflammatory erythema), especially in people with lighter skin tones. They usually fade over a few weeks or months (Connolly, 2017).
The brown spots—postinflammatory hyperpigmentation—may take six months to a year to fade, depending on your skin type. Inflammation can cause these spots to occur by revving up melanin production, which can lead to brown hyperpigmented spots, especially if you have a medium to deep skin tone. Sun exposure during the healing of a blemish can also add to hyperpigmentation (Lawrence, 2021; Davis, 2010).
Why does acne cause scarring?
Acne develops when your pores or hair follicles clog with a buildup of sebum (a natural oil made by the sebaceous glands) and dead skin cells. Most pimples, blackheads, and whiteheads will not scar. But if your blemishes become inflamed and turn into cysts, they’re more likely to damage surrounding skin tissue. If the body repairs the damage with too much or too little collagen—a protein that is essential for skin health and wound healing—it can lead to scarring (Connolly, 2017).
Some factors can increase the risk of scarring, including (Connolly, 2017):
- The severity of acne: Deep cystic acne or severe breakouts are more likely to cause scarring.
- Genetics: Your genes can affect the types of breakouts and how your skin heals.
- Picking or squeezing pimples: When you pick at or squeeze your pimples, you’re creating more trauma and increasing the damage that has to be repaired.
Types of acne scars
Acne scars fall into two main categories: they either have too much tissue (hypertrophic scars) or too little tissue (atrophic scars) (Connolly, 2017).
Too much tissue (hypertrophic and keloid scars)
Hypertrophic scars are raised scars that stick out above the skin. They’re typically the size of the original pimple and are caused by an overproduction of collagen (Connolly, 2017).
Keloid scars are also due to too much collagen, but they differ from hypertrophic scars in that the scar tissue can continue to build up, growing larger than the original acne blemish (Connolly, 2017).
How to get rid of acne scars
Too little tissue (atrophic scars)
Atrophic scars appear as depressions in the skin. Unlike hypertrophic scars, which are caused by the skin producing too much collagen, atrophic scars are caused by the body not producing enough collagen during the healing process.
These indented scars are further classified as (Connolly, 2017):
- Ice pick scars: These scars are deep, resembling an ice pick gouge; sometimes, they resemble hollowed-out pores.
- Boxcar scars: These scars can be a variety of shapes and are indented with defined, steep edges.
- Rolling scars: Rolling scars are broad depressions that have sloping, rounded edges.
How to get rid of acne scars
Getting rid of acne scars completely can be difficult because scar removal can lead to additional scarring and hyperpigmentation. That said, there are treatments that can reduce the appearance of acne scars.
Treatment options fall into two general categories: topical treatments and procedures that resurface, fill, remove, or break up scar tissue.
Topical treatments for acne scars
For mild scars, over-the-counter (OTC) products like retinol and alpha and beta hydroxy acid peels (such as glycolic acid and salicylic acid) can exfoliate and improve skin appearance (Tang, 2018; Castillo, 2018).
Azelaic acid (see Important Safety Information) is another topical product that can help with inflammation, acne, redness, and dark spots (Hollinger, 2018).
Minimizing deeper acne scars, however, usually requires higher-strength products. These may include:
- Retinoids: Tretinoin (see Important Safety Information), a prescription product, is a retinoid that is often used in acne scar treatment to stimulate new skin growth, reduce hyperpigmentation, and smooth skin texture. There are also OTC retinoids like adapalene (Differin) that can be used to treat acne and reduce inflammation and hyperpigmentation. The higher concentrations found in prescription retinoids like tretinoin and prescription-strength adapalene work faster but can cause skin irritation and redness until the skin gets used to them. If you’re using retinoids, be sure to use sunscreen during treatment (Leyden, 2017).
- Chemical peels: Dermatologists can perform medium-depth and deep peels that can diminish the appearance of scars. These peels can cause hyperpigmentation (skin discoloration) for up to three months. There is also the risk of new scars forming or the loss of pigment, which creates permanent light spots on the skin (Castillo, 2018).
What would a dermatologist prescribe for acne?
Procedures to treat acne scars
Depending on your goals, procedures to treat acne scars can be used in combination with topical treatments. The following procedures may help improve the appearance of acne scars (Gozali, 2015):
- Microneedling: Skin microneedling involves puncturing the skin with rows of fine needles that break up scar tissue and encourage healing and collagen production. The data is not definitive, but this procedure may help improve acne scars (Litchman, 2022).
- Dermabrasion and microdermabrasion: Dermabrasion essentially sands down the skin and is used for deeper scars, while microdermabrasion removes only the outer layer of the skin so it isn’t effective on deep scars. The deeper you go, the more likely you’ll have post-procedure pain and longer recovery times (Bedford, 2021; Shah, 2022).
- Laser resurfacing: Lasers work to improve acne scars by causing an injury that boosts collagen production. However, it’s important to note that hyperpigmentation can occur after laser treatment, especially in those with darker skin tones. Some lasers like the YAG lasers are considered to be better for treating darker skin. Ultimately, it’s best to consult with a professional who is highly trained in laser resurfacing and dermatology if you’re considering this approach (Gupta, 2020; Bernstein, 2017).
- Steroid injections: Steroid injections can reduce the appearance of thick, raised scars, making them flatter and softer (Trisliana Perdanasari, 2015).
- Dermal fillers: Dermal fillers such as hyaluronic acid are often used to inject into a scar area. The fillers can both replace lost skin tissues and may also stimulate collagen production, which can improve the appearance of scars.
- Subcision: Subcision involves inserting a needle under the skin and breaking up the scar fibers that are holding down the scar and making it look like a dent.
- Punch excision: A punch biopsy tool can be used to literally remove ice pick scars. A tiny stitch may be used to close the site, or it can be allowed to heal open.
- Punch replacement grafting: This technique is also used for ice pick scars. It involves taking skin from another part of the body, removing the scar, and placing the newly grafted tissue in its place.
When exploring your options for certain procedures to treat your acne scars, it’s important to ask your healthcare provider about all side effects, potential complications, and what to expect after each procedure based on your skin type.
Body acne: causes, treatments, how to get rid of it
How to prevent acne scars
If you find yourself in the midst of an acne breakout and want to prevent scarring, research shows the following approaches may help (Fabbrocini, 2018):
- Try topical retinoids: Using a topical retinoid can improve skin even after a breakout has started. It can also prevent additional inflammation (Leyden, 2017)
- Avoid picking or popping your pimples: Steering clear of pimple picking is wise because this activity can increase inflammation and the spread of acne-causing bacteria.
- Wear sunscreen: Slathering on some SPF as your pimples are healing helps avoid hyperpigmentation.
- Apply scar patches or lotions: Applying scar patches and scar lotions can help with some lesions. Research suggests the silicone in these products may improve scar appearance (Goldberg, 2016).
Of course, the best way to prevent acne scarring is to prevent a breakout to begin with. Having a daily skincare routine can help. But, if you’re struggling with some stubborn acne lesions or acne scarring, a dermatologist can help come up with a treatment plan that’s best for your skin’s needs.
- Bedford, L. & Daveluy, S. (2021). Skin resurfacing dermabrasion. StatPearls. Retrieved on June 10, 2022 from https://www.ncbi.nlm.nih.gov/books/NBK558955/
- Bernstein, E. F., Schomacker, K. T., Basilavecchio, L. D., et al. (2017). Treatment of acne scarring with a novel fractionated, dual-wavelength, picosecond-domain laser incorporating a novel holographic beam-splitter. Lasers in Surgery and Medicine, 49(9), 796–802. doi:10.1002/lsm.22734. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5656887/
- Castillo, D. E. & Keri, J. (2018). Chemical peels in the treatment of acne: Patient selection and Perspectives. Clinical, Cosmetic and Investigational Dermatology, 11, 365–372. doi:10.2147/ccid.s137788. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6053170/
- Connolly, D., Vu, H. L., Mariwalla, K., et al. (2017). Acne scarring-pathogenesis, evaluation, and treatment options. The Journal of Clinical and Aesthetic Dermatology, 10(9), 12–23. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5749614/
- Davis, E. C. & Callender, V. D. (2010). Postinflammatory hyperpigmentation: A review of the epidemiology, clinical features, and treatment options in skin of color. The Journal of Clinical and Aesthetic Dermatology, 3(7), 20–31. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2921758/
- Fabbrocini, J. (2018). Evaluation, prevention, and management of acne scars: Issues, strategies, and enhanced outcomes. Journal of Drugs in Dermatology, 17(12), 44. Retrieved from https://jddonline.com/articles/evaluation-prevention-and-management-of-acne-scars-issues-strategies-and-enhanced-outcomes-S1545961618S0044X/?_page=3
- Goldberg, D. J. (2016). Efficacy and safety of a novel 100% silicone Scar Gel treatment for early intervention in Scar Management. The Journal of Clinical and Aesthetic Dermatology, 9(12), 13–20. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5300722/
- Gozali, M. V. & Zhou, B. (2015). Effective treatments of atrophic acne scars. The Journal of Clinical and Aesthetic Dermatology, 8(5), 33–40. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4445894/
- Gupta, A., Kaur, M., Patra, S., et al. (2020). Evidence-based surgical management of post-acne scarring in skin of color. Journal of Cutaneous and Aesthetic Surgery, 13(2). Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7394107/
- Hollinger, J. C., Angra, K., & Halder, R. M. (2018). Are natural ingredients effective in the management of hyperpigmentation? a systematic review. The Journal of Clinical and Aesthetic Dermatology, 11(2), 28–37. Retrieved from https://pubmed.ncbi.nlm.nih.gov/29552273/
- Lawrence, E. & Al Aboud, K. (2021). Postinflammatory hyperpigmentation. StatPearls. Retrieved May 27, 2022 from https://www.ncbi.nlm.nih.gov/books/NBK559150/
- Leyden, J., Stein-Gold, L., & Weiss, J. (2017). Why topical retinoids are mainstay of therapy for acne – dermatology and therapy. Dermatology and Therapy, 7, 293–304. Retrieved from https://link.springer.com/article/10.1007/s13555-017-0185-2
- Litchman, G, Nair, P. A., Badri, T., et al. (2022). Microneedling. StatPearls. Retrieved on June 10, 2022 from https://www.ncbi.nlm.nih.gov/books/NBK459344/
- Shah, M, & Crane J. S. (2022). Microdermabrasion. StatPearls. Retrieved on June 10, 2022 from https://www.ncbi.nlm.nih.gov/books/NBK535383/
- Tang, S. C. & Yang, J. H. (2018). Dual effects of alpha-hydroxy acids on the skin. Molecules, 23(4), 863. doi:10.3390/molecules23040863. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6017965/
- Trisliana Perdanasari, A., Torresetti, M., Grassetti, L., et al. (2015). Intralesional injection treatment of hypertrophic scars and keloids: a systematic review regarding outcomes. Burns & Trauma, 3, 14. doi:10.1186/s41038-015-0015-7. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4964100
Dr. Chimene Richa is a board-certified Ophthalmologist and Senior Medical Writer/Reviewer at Ro.