Acne scar treatment: Energy-based skin resurfacing with a laser, radiofrequency, or an ultrasound device can help treat boxcar scars, according to Nada Elbuluk, MD, an assistant professor at the Ronald O. Perelman Department of Dermatology at New York University Langone Medical Center in New York City. “They all work by creating new collagen beneath the surface of the skin.” A series of treatments is likely needed based on the extent of scarring, she says. Chemical peels can also help but to a lesser extent. With either procedure, using a retinoid to increase cell turnover and further boost collagen can help improve results, Dr. Elbuluk adds.

When you get acne, there is intense inflammation of your facial skin and there is a loss of collagen. Collagen is the protein fiber, one of the components of skin which gives skin its elasticity. When you pick or squeeze your pimples, it leads to further inflammation and injury to your skin. It also leads the bacteria and pus in your pimple go deep down into your skin resulting in more loss of collagen which means even deeper scars on your face.

Some individuals have absolutely no symptoms, and rosacea doesn't bother them. They may enjoy perfectly healthy normal lives without any effect from this benign skin condition. Some patients really like the pink glow to their cheeks and find it gives them a pleasant color without having to use blush. They may not even know they have rosacea. They usually do not want to use any treatment.


The path to clear skin is often one of trial and error; you might need to try several acne remedies before you find the right treatment for the types of acne affecting your skin. Before trying acne medication, you may prefer to give different natural acne treatment options a chance. While there is no research supporting the effective use of natural acne treatments, here are two popular options that you may want to try.
Another source of hormonal changes: stress. Whether you work full time, are a full-time mom, or juggle both, chances are, your stress levels are high. "When you're stressed, you have an organ called the adrenal gland that makes the stress hormone cortisol, and puts it out into the body to help the body deal with stress," Dr. Schultz explains. Unfortunately, a tiny bit of testosterone leaks out with it. For a woman, this male hormone can drive the oil glands to produce more oil—the root cause of breakouts. (Thanks a lot, hormones!)

Even if battling zits is a distant memory, filed away with high-school gym class and algebra tests, acne marks and scars can annoyingly linger long after pimples are gone. “If someone gets a very large pimple or cyst, the natural healing process of the skin will create a scar,” says David Avram, M.D., of Heights Dermatology and Laser. “The more intense the inflammation, the more likely it will leave a scar.”


Punch excisions: "This procedure is best for those with icepick scars, which aren't as wide as rolling or boxcar scars," says Dr. Shah. "If you use a punch excision on a scar that's wide at the surface, you're making a bigger punch and trading in one scar for another," she says. "Your dermatologist will numb up the area and use a tiny cookie-cutter like device to cut out the scar, and then sew it closed with a tiny stitch. The stitch is removed in less than a week," says Dr. Bowe. However, Dr. Idriss cautions against this method for those with darker skin or undertones who are prone to hyperpigmentation.


The best way to fix them: You have a few options with these. The first would be to visit an aesthetician or a dermatologist for a deep-cleaning in a sterile environment. The second? Use an exfoliator. That could be a face scrub, retinol—which boosts skin cell turnover—or even facial cleansing brushes. If you go this route, just pick one. "You just don’t want to combine all them, since that’ll make skin sensitive," adds Dr. Hale.
Do not—we repeat, do not—even think about attempting to get this out yourself. "With deep zits, there’s no exit strategy, so if you’re pushing on it to try to get rid of it, it could actually leak sebum into the dermis and cause more lesions," explains Dr. Hale. Instead, this is the time to visit your dermatologist for a cortisone injection, which should take care of it in 24 hours. If you're sitting here wondering why doctors don't just shoot all of your zits up with cortisone, that's because that it can actually lead to scarring or even a depression in your skin, especially with smaller zits, says Dr. Chwalek. That's why cortisone shops reserved for the oversize monsters like these.
Fillers. A substance such as collagen, hyaluronic acid, or fat can be used to "fill out" certain types of acne scars, especially those that have resulted in a depressed appearance of the skin. Since fillers are eventually absorbed into your skin, you will have to repeat filler injections, usually every few months, depending on the type of product used. There is no downtime for recovery from this treatment.

Instead, you’ll want to talk to your dermatologist about what can be done about your scarring. There are professional procedures that can smooth the skin and minimize scars. Laser treatments are often used to treat acne scars. Your dermatologist might also suggest dermal fillers to “plump up” the depressed area leaving the skin, albeit temporarily, more smooth and even.


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.
Millions of teens and adults alike have had some form of acne at some point in their lives. It is a very common occurrence, and each type of acne that exists affects a different cross-section of people. However, what is important in every single case is finding a reliable acne treatment so symptoms go away quickly and without all that much hassle or expense.
Acne scars are most often the product of an inflamed lesion, such as a papule, pustule, or cyst. Inflamed blemishes occur when the follicle, or pore, becomes engorged with excess oil, dead skin cells, and bacteria. The pore swells, causing a break in the follicle wall. If the rupture occurs near the skin's surface, the lesion is usually minor and heals quickly. More serious lesions arise when there is a deep break in the follicle wall. The infected material spills out into the dermis and destroys healthy skin tissue.
What you can do differently: Make sure all the skin care products you're using are labeled "noncomedogenic," which means your makeup or skin care has been specifically formulated not to clog your pores. That said, even if the product is "noncomedogenic," if you're using it continuously and your breakouts continue to get worse, make an appointment with your dermatologist, as you could be allergic to another ingredient in the product that is causing your issues.
Many over-the-counter lotions and creams containing salicylic acid or benzoyl peroxide are available to help prevent acne and clear it up at the same time. You can experiment with these to see which helps. Be sure to follow the instructions exactly — don't use more than you're supposed to at one time (your skin may get too dried out and feel and look worse) and follow any label directions about allergy testing.
27. Birth control might help. Birth control pills that contain both estrogen and progesterone have been shown to lower the amount of androgens in your body (a group of hormones that causes your body to produce sebum; excess sebum triggers acne) and therefore, are sometimes prescribed to help treat hormonal acne. It can take a few months to see results and initially your acne may get worse. There are risks associated with taking birth control pills, and some types can actually make your acne worse. Talk to your doctor to see if taking birth control pills will help the kind of acne you have.

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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