By Michael H. Gold, MD, FAAD, board-certified dermatologist and founder of Gold Skin Care Center Published October 28, 2026
Key Takeaways for Choosing the Right Acne Scar Treatment
The best acne scar treatment depends on the type of scar. Ice pick, boxcar, rolling, and raised scars each respond to different approaches.
Most people get the best results from a combination of treatments over several sessions, not a single procedure.
Active acne should be under control before scar treatment starts, or new breakouts can create new scars.
Fall and winter are a practical time to start resurfacing treatments, because treated skin needs protection from strong sun while it heals.
Acne scars can be improved, often significantly, but the right treatment depends on what kind of scars you have. Deep, narrow "ice pick" scars, wider "boxcar" scars, soft "rolling" scars, and raised scars each respond to different tools, and most people have more than one type. That is why the best plans usually combine treatments, such as laser resurfacing or radiofrequency (RF) microneedling with subcision or filler, over a series of visits.
I have been treating acne scars with lasers and energy-based devices for a large part of my career. The technology has improved a great deal, but one thing has not changed: matching the treatment to the scar matters more than the device name. Here is how that works.
First, make sure it is a scar
Not every mark left after acne is a scar. Flat red, purple, or brown spots are often post-inflammatory color changes. They are common after breakouts, especially in people with darker skin tones, and many fade over months with good sun protection and the right skin care. True scars change the skin's texture: they are either depressed below the surface or raised above it.
Telling the difference matters because color changes and texture scars are treated differently. A dermatology provider can sort this out in one visit.
Types of acne scars
According to the American Academy of Dermatology's overview of acne scars, most acne scars fall into two groups.
Depressed (atrophic) scars sit below the surrounding skin:
Ice pick scars: narrow, deep, and pointed, like a large open pore.
Boxcar scars: wider, with sharp edges and a flatter base.
Rolling scars: broad and soft-edged, giving the skin a wavy look. They are often caused by bands of tissue pulling the skin down from underneath.
Raised scars sit above the skin:
Hypertrophic scars: firm and raised, staying within the original area of the breakout.
Keloids: raised scars that grow beyond the original area. Raised scars are more common on the chest, back, shoulders, and jawline. See our page on keloid and hypertrophic scars.
Step one: control active acne
Treating scars while breakouts continue is like repainting a wall that is still leaking. New inflammation can create new scars, and some scar treatments can irritate active acne. If you are still breaking out, we start by getting acne under control with the right medical treatment, then plan scar treatment.
Treatment options for depressed acne scars
At Gold Skin Care Center, acne scar treatment is built around these tools, often in combination.
Laser resurfacing
Laser resurfacing removes or heats thin layers of skin in a controlled way, prompting the skin to rebuild collagen as it heals.
UltraPulse® CO2 laser resurfacing is an ablative treatment suited to deeper and more significant scarring. It typically involves more recovery time, with redness and peeling that can last from several days to a couple of weeks, and sometimes longer-lasting pinkness.
UltraClear is a fiber laser option that can be tuned for gentler treatment with less downtime, often used for milder texture concerns or as part of a series.
You can learn more on our laser resurfacing page. The AAD also has useful background on laser treatment for scars.
RF microneedling
RF microneedling combines tiny needles with radiofrequency energy delivered beneath the surface. The needles create controlled micro-injuries and the heat stimulates collagen in deeper layers, which can soften rolling and boxcar scars and improve overall texture. Because much of the energy is delivered below the surface, RF microneedling is often a useful option for a wider range of skin tones than some surface resurfacing lasers. Our microneedling and RF microneedling page explains the devices we use.
Subcision
Subcision is a minor in-office procedure for tethered scars, especially rolling scars. After numbing the area, a small needle is used beneath the scar to release the fibrous bands pulling the skin down. It is frequently combined with lasers, RF microneedling, or filler.
Dermal fillers
Filler can lift certain depressed scars, such as rolling and some boxcar scars, to sit closer to the level of the surrounding skin. The AAD notes that dermatologists sometimes combine treatments this way, for example releasing scars first and then adding filler for volume. Filler results are temporary, and how long they last depends on the product. See our cosmetic fillers page.
Chemical peels
Chemical peels can improve mild scarring and uneven texture, and they help with lingering discoloration after acne. They are usually part of a broader plan rather than the main treatment for deeper scars.
Which treatment fits which scar
This is a general guide. Your provider will look at your skin in person, often in angled light, because the mix of scar types and your skin type both shape the plan.
Acne scar treatment and skin of color
Darker skin tones have a higher risk of post-inflammatory hyperpigmentation, meaning temporary darkening after treatment. That does not rule out scar treatment, but it changes the choice of device, settings, and preparation. We plan these treatments carefully, and our page on skin of color treatment explains our approach. If a clinic describes any laser as safe for every skin type without asking about yours, ask more questions.
What to expect: results and recovery
Improvement, not erasure. Most people see meaningful improvement in texture and how noticeable their scars are. Complete removal is rarely realistic, and results vary.
Several sessions. Most plans involve a series of treatments spaced weeks apart. Collagen remodeling continues for months after each session.
Recovery varies by treatment. RF microneedling and gentler laser settings may mean a few days of redness. Deeper CO2 resurfacing involves more recovery time. Your provider will give you a specific aftercare plan.
Timing matters. Treated skin is more sensitive to sun while it heals. That is one reason many patients start resurfacing in the fall and winter, when Middle Tennessee's strong summer sun is behind us. Daily sunscreen remains essential year-round.
What to do next
If you are still breaking out, start with an acne visit so new scars stop forming.
Schedule a scar consultation. Bring any records of past treatments, and plan to arrive without makeup so we can see your skin clearly.
Call (615) 383-2400 or use our scheduling form to book with our Laser & Rejuvenation Center team.
New to the practice? Here is what to expect at your first dermatology appointment, and here is who you may see on our team.
Frequently asked questions
What is the best treatment for acne scars? There is no single best treatment. The most effective plans match treatments to each scar type, and most people benefit from a combination over several sessions.
How many sessions will I need? It depends on the depth and type of your scars and the treatments chosen. Many people need a series of treatments spaced several weeks apart.
Can acne scars be removed completely? Most people see real improvement, but complete removal is uncommon. A good consultation will set realistic expectations.
Is laser treatment for acne scars safe for darker skin? Many people with darker skin can be treated successfully, but device choice, settings, and preparation matter, and the risk of temporary darkening is higher. Choose a provider who asks about your skin type and explains how they will lower that risk.
This article is for general education and is not medical advice. Results vary, and every treatment carries risks. An appointment with a board-certified dermatologist or qualified dermatology provider is the best way to learn which options are right for you.
About the author
Michael H. Gold, MD, FAAD, is a board-certified dermatologist and dermatologic surgeon and the founder and medical director of Gold Skin Care Center in Nashville, which he established in 1990. He also founded the Tennessee Clinical Research Center and holds appointments as Clinical Assistant Professor at Vanderbilt University School of Nursing and Adjunct Assistant Professor at Meharry Medical College School of Medicine. Read Dr. Gold's full bio.
