Over-the-counter retinol or vitamin A can also help. Anolik says retinols can be incredibly effective, especially higher-strength prescription retinoids: “They’re the gold standard in acne and aging treatments.” The prescription versions, from Tazorac to Differin, are usually covered by insurance in the case of acne. Vitamin C can also treat pores and exfoliate; Tammy Fender’s System ($165, tammyfender.com) comes with a vitamin C toner.
Lasers. Your dermatologist can use a laser to remove the outer layer of your skin, contour areas of acne scars, or lighten redness around healed acne lesions. Various types of lasers are used, depending on whether the acne scar is raised or flat. More than one laser treatment may be required and, depending on the laser used, you may need to several days to heal.
If there are multiple ice pick scars, acne scar treatment devices that use radiofrequency energy are Dr. Hellman’s first choice. “These treatments help build collagen from the inside out, and collagen helps to fill the scars from within,” she says. Several treatments are usually needed. The procedures are done using local anesthesia, and it’s effective in all skin types, she says. In one study, published in a 2015 issue of the Journal of Cosmetics, Dermatological Sciences and Applications, Dr. Hellman found that approximately four treatments with a radiofrequency device produced significant improvement in the depth of the scars. A follow-up study in a 2016 issue of the same journal showed that these results held for up to two years, although some people had touch-ups.
True acne scars — as in indentations in the skin like ice-pick scars — can only be erased with professional procedures like microneedling or lasers. Fortunately, what most of us refer to as “scars,” according to Julia Tzu, M.D., founder and medical director of Wall Street Dermatology, are actually marks caused by post-inflammatory hyperpigmentation (brown spots) or post-inflammatory erythema (red spots), that will fade over several months or years. Fortunately, there are products that can speed up the process.
Some patients elect combination therapies and notice an improvement by alternating metronidazole and azelaic acid: using one in the morning and one at night. Sodium sulfacetamide (Klaron lotion) helps reduce inflammation. Other topical antibiotic creams include erythromycin and clindamycin (Cleocin). Topical ivermectin cream (Soolantra Cream, 1%) is also available.
Oil-free soaps or washes won’t clog your pores or cause blackheads, acne, and whiteheads. Choose products that are labeled "oil free," "nonacnegenic” (which means it won’t cause acne) or "noncomedogenic” (which means it won’t clog your pores). Some also have ingredients recommended by dermatologists, such as benzoyl peroxide and salicylic acid. Make sure your washcloths are soft -- you can use one made for babies -- and use a clean one every time, too.
Exfoliating cleansers and masks: A variety of mild scrubs, exfoliants, and masks can be used. These products may contain salicylic acid in a concentration that makes it a very mild peeling agent. These products remove the outer layer of the skin and thus open pores. Products containing glycolic or alpha hydroxy acids are also gentle skin exfoliants.