It took a century and a half to get your pimples to go away, but now you’ve received their parting gift: red, sometimes indented scars. Unfortunately, these spots like to overstay their welcome too.
First, let’s figure out exactly what kind of spots you’re looking at: “There’s the pitted scarring that can occur when an inflamed blemish resolves with an ice-pick-like divot in the skin, and discoloration that occurs from inflammation, or the darkened spots as blemishes resolve,” says Susan Massick, M.D., a board-certified dermatologist at The Ohio State University Wexner Medical Center. This is actually called post-inflammatory hyperpigmentation (PIH) and is mistaken for “scars.” While pitted scarring tends to be more challenging to treat, “PIH is reversible and will fade with time, a process that can routinely take three to six months or longer,” says Dr. Massick. Hey, better than permanent damage!
So what causes acne scars, exactly?
Post-breakout tissue damage. Those annoying pink spots, for example, are “known as post-inflammatory erythema, which is when your acne goes away and you still have a pink area for a few weeks to a few months, much like with a cut or scratch,” says Jennifer T. Haley, M.D., a dermatologist practicing in Scottsdale, AZ, and Park City, UT.
Then there’s post-inflammatory pigmentation. “It occurs in those with medium- to-dark skin, where the inflammation invites pigment cells to the area and when the acne resolves, a brown spot is left for weeks, months, even years,” says Dr. Haley.
The toughest form of acne scarring is a result of severe inflammation destroying the collagen in the deeper layers of skin. As the body attempts to repair the damage in the skin, “over-production of collagen may result in raised acne scars, also known as hypertrophic scars,” explains Philadelphia-based dermatologist Rina Allawh, M.D. “Under-production may lead to depressed or pitted scars (a.k.a. atrophic), and are referred to as ice-pick scars, rolled scars, or box-car, depending on appearance.”
Choosing the best acne scar treatment for your skin
Honayst is key: Not to be all Captain Obvious, but getting your acne under control is the best first step to not only healing your acne scars, but preventing future scarring. Your skincare regimen should include a gentle or medicated cleanser, moisturizer, sunscreen, and makeup remover at night, all of which should be hypoallergenic (which won’t cause inflammation) and noncomedogenic (won’t clog pores).
Look for key ingredients: “There are numerous products being sold for acne scarring today,” says Manhattan-based board-certified dermatologist Emmanuel Loucas, M.D. “Many of the products are good, but many product’s ingredients haven’t been proven to be effective.” To ensure you have a legit product, look for one that contains retinoids (vitamin A), alpha and beta hydroxy acids, azaleic acid, niacinamide, vitamins C and E, hydroquinone, kojic acid, or resorcinol.
Know your scars: “Best results are often obtained by using many of these ingredients in combination,” says Dr. Loucas, who recommends applying your acne scar treatment after washing your face and before moisturizing.
- If your acne scarring is dark, the best ingredients to look for in your OTC products are retinol, hydroxy acids, azaleic acid, vitamin C, and hydroquinone, says Dr. Loucas.
- If acne scars have caused some deformity in the skin, “retinols and hydroxy acids are often the most effective ingredients to try and remodel the skin,” he says.
- If your acne scars are inflamed and red, you should proceed with caution. Consider dealing with the inflammation first (with ingredients such as niacinamide, ceramides, and licorice extract) before tackling your acne scars.
- If the acne scarring is significant, you may need to combine your topical regimen with dermatological procedures. “This is because these types of scars are often bound down by excessive scar tissue and need to be surgically released or removed to see improvement,” says Dr. Loucas.
Ready to get bright, even skin? Here, the best dermatologist-recommended products to help fade your acne scars, plus your full guide on how to boost their efficacy.
BEST OVERALL Differin Adapalene Gel 0.1% Acne Treatment
“Prescription-strength retinoids increase cell turnover, decrease sebum production, and diminish breakouts that can lead to PIH,” says Dr. Massick. Differen Gel is a prescription-strength retinoid (the first available over the counter!) that can prevent new blemishes from forming and strengthen damaged skin by restoring texture and tone.
BEST VALUE The Ordinary Azelaic Acid Suspension 10%
Azaleic acid can block pigment production in the skin. This prevents acne scars from getting darker and helps to fade dark and pink spots over time, says Beverly Hills-based board-certified dermatologist Tsippora Shainhouse, M.D., who recommends this lightweight cream-gel from The Ordinary.“Azaleic acid is particularly well-tolerated in patients with sensitive skin and rosacea,” adds Dr. Massick.
RAVE REVIEWS Dr. Dennis Gross Alpha Beta Peel
These pre-soaked pads contain glycolic, salicylic, malic, lactic, and citric acids to help even out tone, reduce texture, minimize lines, and boost your glow (trust us—you’ll notice a difference). The first pad exfoliates, while the second neutralizes the acids to bring back balance, thanks to soothing green tea and chamomile.
BESTSELLER Drunk Elephant C-Firma Vitamin C Day Serum
This super-potent serum contain vitamin C (to help rebuild collagen), vitamin E (to seal cracks in the skin), pumpkin ferment extract, and pomegranate enzyme that all work together to exfoliate and brighten the complexion. “Its ingredients are safe and effective, and gentle for patients with sensitive, dry, and acne-prone skin,” says Dr. Allawh.
BEST FOR SENSITIVE SKIN The Ordinary Magnesium Ascorbyl Phosphate 10%
This budget-friendly hydrator contains magnesium ascorbyl phosphate (obvi), a vitamin C derivative that offers up similar skin-brightening perks as straight- up vitamin C. However, it is less potent, making it a perfect acne scar treatment for those with sensitive skin, says Dr. Allawh.
BEST FOR KELOID SCARS bioCorneum Scar Treatment Plus SPF 30 Silicone Scar Gel
Rarely, acne will cause a keloid scar (a raised scar that can grow larger than the original area), but it can happen. If you know your skin reacts in this way, try using a liquid silicone gel like bioCorneum, says Joyce Imahiyerobo- Ip, M.D., of Vibrant Dermatology in Wellesley, Massachusetts. “The silicone puts pressure on the scar as it’s healing, making it hard for excessive collagen to form,” she says.
CeraVe Resurfacing Retinol Serum
Ideal for all skin types, CeraVe’s Resurfacing Retinol Serum is formulated with ceramides to restore the protective skin barrier and heal damage, niacinamide to reduce inflammation and redness, and retinol to speed skin cell turnover for brighter, healthier looking skin. Major bonus: It’s fragrance-free and noncomedogenic.
RoC Retinol Correxion Deep Wrinkle Facial Serum
This noncomedogenic serum by RoC has a unique formula with retinol, magnesium, zinc, and copper to help bring newer skin to the surface. “It helps lighten dark spots, remodel acne scar tissue, and smooth the skin,” says Dr. Loucas.
Peter Thomas Roth Max Complexion Correction Pads
These ultra-potent pads contain 10% glycolic acid to exfoliate the skin, encouraging newer, healthier cells to the surface. They also pack salicylic acid to keep your pores clear, smooth, and virtually nonexistent. Meanwhile, aloe vera maintains moisture and soothes the skin to keep redness at bay.
Murad Environmental Shield Rapid Age Spot and Pigment Lightening Serum
Not only does this serum combine vitamin C with hydroquinone (a skin-lightening ingredient) to help fade dark spots, it prevents future pigment formation as it brightens your complexion, earning a recommendation from Dr. Loucas.
L’Oreal Revitalift 10% Pure Vitamin C Concentrate
Dr. Shainhouse recommends L’Oreal’s Revitalift vitamin C serum, which is tested for stability and efficacy, and visibly boosts skin’s radiance in just one week. The cream formula quickly absorbs to even out hyperpigmentation. It’s also been tested on all skin types, including sensitive complexions, and doesn’t clog pores.
Neutrogena Rapid Wrinkle Repair Face Serum
Dr. Shainhouse loves this fast-absorbing retinol serum by Neutrogena because it’s made with retinol SA, which has a rep for being one of the more effective forms of vitamin A. The serum itself also contains hyaluronic acid, a moisture- attracting ingredient that helps plump the skin and reduce some of the irritation often caused by retinol.
HydroPeptide 5X Power Peel Daily Resurfacing Pads
This peel has a blend of glycolic acid (to even out tone and texture), lactic acid (to soften the skin) and salicylic acid (to fight acne). It also contains mushroom enzymes, which will gently exfoliate the skin and lighten spots without irritating, says Dr. Imahiyerobo-Ip. Each peel is individually packaged, so you can easily throw them into your travel bag.
SkinCeuticals C + AHA
“This treatment pairs vitamin C with alpha hydroxy acids, which help lighten spots and smooth the skin,” says Dr. Loucas. The 15% concentration of vitamin C does its thing by preventing UV damage and boosting collagen production, while the 10% dose of hydroxy acids gently exfoliates, revealing a brighter complexion.
Biopelle KNR Serum
Biopelle’s KNR Serum contains retinol to help support collagen health and lift off dead layers of skin that contain pigmentation, says Dr. Haley. It also contains niacinamide to nix inflammation and kojic acid to lighten and even out skin tone.
How to maximize results from your acne scar products
Always wear sunscreen: “When you have inflammation in the skin, the body automatically responds by putting down pigment,” says Dr. Shainhouse. “Because skin with more pigment will tan more readily and hold onto its color for longer, your skin won’t even out with sun exposure—rather, the scars will appear even darker and stay darker for longer.”
Wearing a broad-spectrum sunscreen with SPF 30+ and minimizing unnecessary sun exposure will keep your acne scars as light as possible, so they can blend into surrounding skin as they continue to heal. Try EltaMD UV Clear Broad-Spectrum SPF 46 sunscreen, which won’t clog pores.
Go easy on your skin: “When people have marks on their face, they tend to be harsh on their skin—trying to scrub them away—but this often makes everything more angry and inflamed,” says Dr. Haley. Ditto for picking at and popping pimples, as it can result in continued melanin production and super-stubborn spots that take even longer to fade.
Have hydrocortisone handy: Sometimes mild irritation can strike from using acne scar products. When this happens, “use OTC hydrocortisone 1% cream for a few days or longer, until your skin calms down,” says Dr. Loucas. This should allow you to continue treating your scars sans having to start and stop your treatment regimens.
Try Aveeno 1% Hydrocortisone Anti-Itch Relief Cream, which is formulated with aloe vera, vitamin E, and finely ground oats to lock moisture into your skin.
What if topical acne scar treatments don’t work?
For deeply indented scars where topical procedures alone won’t cut it, your dermatologist can add additional tools to your skincare repertoire. Fillers like Juvederm, for example, can temporarily fill the space of deep scars.
For a more permanent therapy, there’s a laser treatment called MiXto. “It’s the best out there,” says board-certified dermatologist Kenneth Mark, M.D., a clinical assistant professor at NYU Langone. “The laser shrinks the edges of the scar and stimulates collagen to lessen its depth.”