When people ask how to get rid of acne scarring, one of the first things we establish at Botonics is whether what you’re seeing is actually a scar.
A true atrophic or hypertrophic scar involves permanent damage to the skin’s collagen and rarely disappears without treatment. Flat red or brown marks, known as post-inflammatory erythema (PIE) and post-inflammatory hyperpigmentation (PIH), are changes in colour, not structure, and typically fade within a year. That distinction changes what treatment can achieve and how long improvement takes.
Skin tone matters too. In Fitzpatrick types IV to VI, aggressive lasers and high-heat treatments carry a greater risk of PIH, so treatment needs more careful planning.
Do Acne Scars Go Away on Their Own?
Some marks do, but many things people call scars aren’t scars.
A deeply inflamed breakout can reach the dermis and damage collagen. If the skin rebuilds too little collagen, it leaves an atrophic scar: a pit or dent. If it produces too much, the result is a raised hypertrophic scar or keloid. Both are structural, and neither reliably corrects itself.
PIE appears as flat red, pink or purple patches, and PIH as flat brown or tan areas. Neither changes skin texture, so the area still feels smooth. They typically fade over several months to a year, longer in deeper skin tones, and sun exposure prolongs them.
How deep the lesion went, and how long it stayed inflamed, largely determines what’s left behind. A whitehead rarely scars, while a deep nodule or cyst that stays inflamed for weeks often does. That’s also why picking matters: it keeps the area inflamed for longer.
Understanding the Types of Acne Scars
Different scars need different treatments. Icepick, boxcar and rolling scars sit below the surrounding skin, while hypertrophic and keloid scars are raised.
Keloids can spread beyond the original spot and keep growing, so they are a separate clinical problem. Raised scars need flattening rather than lifting, and ablative resurfacing can aggravate keloids, so they need careful medical assessment first.
Can You Completely Get Rid of Acne Scars?
Usually not completely. Treatment can reduce depth, soften edges, lift depressions and help skin reflect light more evenly, which matters because shadow is a large part of what makes textural scarring noticeable. It cannot erase the underlying collagen damage. Well-treated scarring can become hard for others to notice, though you may still see it under harsh or angled light.
Deep icepick and boxcar scars are hardest to correct because the damage extends further into the dermis. Shallow rolling scars often respond better because tethering is a major part of the problem. Older scars can still be treated, though very deep ones may need more sessions for a more modest change.
Beyond mild scarring, combining treatments usually makes sense, because releasing a tethered scar and stimulating collagen are different jobs. Common sequences:
- Rolling scars: subcision, then RF microneedling about four weeks later.
- Icepick scars: TCA CROSS on individual pits, then fractional laser once healed.
- Mixed scarring: subcision where tethering is present, then RF microneedling at four-week intervals.
Treatment Options for Acne Scarring
Treatments either create a controlled injury that prompts collagen rebuilding, or release tissue that is pulling a scar down. The right choice depends on the scar, your skin tone and how much recovery you can accept.
At Botonics, we offer acne scar treatment using Dermapen medical needling, skin peels, subcision, dermal fillers and prescription skin care. The other options below are included so you can compare them fairly.
Laser Treatment for Acne Scars
Ablative lasers such as CO2 and erbium remove columns of tissue and stimulate remodelling as the skin heals. Results vary, but ablative lasers generally produce the most change per treatment, and recovery is the longest of the main options. Nonablative lasers heat tissue beneath the surface while the epidermis stays intact, so recovery is easier but results are more gradual and need more sessions. Fractional versions of both treat a grid of microscopic columns, which helps skin heal faster. No laser removes scars completely.
Microneedling: How It Works and What to Expect
A microneedling pen creates thousands of tiny punctures, triggering wound healing and new collagen that lifts depressed scars from beneath. It uses no heat, so it suits a wider range of skin tones. We use Dermapen medical needling for this. Expect redness and tightness for a day or two, with most people back in make-up within 48 hours.
RF microneedling adds radiofrequency energy at a controlled depth, delivering heat where the collagen damage sits while sparing the surface. That makes it particularly useful for deeper pitted scarring.
Chemical Peels and Subcision
Skin peels suit tone, shallow texture and pigment change, but not deep boxcar scars. TCA CROSS is the exception: high-concentration trichloroacetic acid is placed only into the base of an individual icepick scar.
Subcision releases the fibrous bands that tether rolling scars. A needle is passed beneath the skin to cut them so the skin can lift, and it’s usually followed by collagen stimulation so the area doesn’t tether down again.
Laser vs Microneedling: Which Works Better?
It depends on your scarring, skin tone and downtime. Ablative laser generally produces more change per session for widespread, established scarring, at the cost of a week or more of visible recovery. Microneedling and RF microneedling improve skin more gradually over more sessions, with less disruption and lower pigmentation risk in darker skin. For mixed scarring, the best plan often uses more than one method. When results fall short, it’s often because one treatment was asked to fix several types of scar.
How to Prevent Acne Scars From Forming
- Treat inflamed acne early. Cystic and nodular lesions sit deep and can stay inflamed for weeks.
- Do not pick, squeeze or pop active lesions. Pressure can drive inflammation deeper into the skin.
- Get specialist help for repeated or severe breakouts. Roaccutane (isotretinoin) is an option for severe acne that hasn’t responded to other treatments. If you have taken isotretinoin, tell your specialist, as the right gap before laser or microneedling depends on the treatment. If new lesions are still appearing, control the acne before repairing scars.
Skincare and Home Remedies for Acne Scars
Home skincare is narrower than the marketing suggests. It can manage pigmentation and skin quality, but it won’t fill a deep scar.
Daily SPF, year-round, is the most useful habit, because UV darkens pigmentation and keeps it visible for longer. Use a broad-spectrum sunscreen of at least SPF 30. Azelaic acid and vitamin C target pigmentation, not structural scarring. Retinoids improve surface texture over months of consistent use, and prescription skin care gives access to stronger formulations than you can buy over the counter.
Silicone gel and sheeting have the strongest evidence of the non-prescription options, but mostly for raised scars, not pitted ones. Be sceptical of vitamin E: the evidence is limited, and it can cause contact dermatitis in some people.
How Long Does Acne Scar Treatment Take?
Months, because collagen takes time to form and reorganise. A microneedling course typically means 3 to 6 sessions about four weeks apart, so six sessions is around half a year. Ablative laser often needs only one or two sessions, but brings one to two weeks of visible recovery each time. Nonablative lasers and RF microneedling sit in between: more sessions, shorter recovery. Results are commonly assessed three to six months after the last treatment, so be wary of promises of fast results.
Acne Scar Treatment for Dark Skin
Darker skin tones (Fitzpatrick types IV to VI) can be treated well, but the approach needs more care. Higher-energy ablative lasers carry a greater risk of PIH, which means dark patches left behind after the skin heals. The heat that drives the treatment response can also stimulate pigment, leaving a problem that outlasts the improvement.
Gentler options tend to be a better fit: lower-energy laser settings, nonablative approaches, microneedling and RF microneedling. Patch testing a small area first shows how your pigment responds.
Raised scarring is also more common in darker skin, so any history of keloids or thick scars is worth mentioning at consultation. A keloid needs flattening and an atrophic scar needs lifting, so the two aren’t interchangeable.
Ask how often a practitioner treats acne scarring in your skin tone. It’s a more useful question than asking which machine they own.
Book an Acne Scar Consultation
The right treatment depends on the type of scarring you have, your skin tone and how much recovery time you can manage, and that is much easier to judge in person than from an article. A specialist can assess your scarring and talk you through which options are suitable for you.
If you’d like to talk it through, contact us to book a free consultation at Botonics.
