Acne scars – treatment and prevention
For millions of people around the world, dealing with acne (adult pimples) is a daily and frustrating struggle. But often, even after the inflammation subsides and the active pimples disappear, a painful reminder remains – acne scars. These marks on the skin are not just an aesthetic issue; they can significantly affect self-image, confidence, and quality of life, sometimes much more than the pimples themselves.
If you have struggled with acne and are now dealing with what remains after the storm has passed, it is important to know: you are not alone, and there is something that can be done. Acne scars are a complex condition, but modern aesthetic medicine offers a wide range of solutions. Whether it involves solutions to minimize their appearance or treatment of the scars, it is always important to follow personalized recommendations rather than choosing a general solution. First of all, it is important to understand how acne develops.
What is acne and who suffers from it?
Acne vulgaris (adult pimples) is a chronic inflammatory skin disease of the hair follicle unit and the sebaceous gland. It is caused by a combination of four main factors:
Overproduction of oil (sebum).
Accumulation of dead skin cells that block the follicle opening.
Proliferation of the acne bacteria.
Inflammatory response of the body.
This condition is most common during adolescence due to hormonal changes, but it affects 40–50% of the adult population, especially women, due to hormonal fluctuations. Genetics, stress, diet, and other environmental factors can also influence the severity of the disease.
How and why do acne scars form?
Acne scars are the result of a defective healing process of the skin after a pimple has passed. When significant inflammation develops in the skin, the immune system fights the infection and inflammation. In this process, damage occurs to collagen and elastin – the proteins responsible for firming, flexibility, and structure of the skin in the dermis layer (the deeper layer of the skin). After the inflammation subsides, the body tries to repair this damage. It does so by producing new collagen fibers. Acne scars form when this repair process is not perfect. Studies show that popping pimples increases the risk of scarring by 5–10 times compared to untouched pimples.
Main Types of Scars
It is important to understand that not all scars are the same. Knowing the types is essential for tailoring treatment to each individual:
Atrophic (depressed) scars These are the most common scars. They form when the body does not produce enough collagen during healing. The inflammatory damage causes tissue loss, and the skin collapses inward, creating a depression. They are divided into three subtypes:
● Ice pick – deep, narrow, and sharp scars that look as if the skin was pierced with a needle.
● Boxcar – wider scars with clear, angular edges, similar to the depressions from chickenpox.
● Rolling – wide, shallow scars with undefined edges, creating a wavy and uneven appearance on the skin.
Hypertrophic or keloid scars These are less common on the face and more common on the back and chest (but may also appear on the face, especially in people with darker skin tones or a genetic tendency for keloids). They form in the opposite process – the body produces excess collagen in response to an injury. The result is a raised, firm bump above the skin surface.
Important to distinguish: True scar vs pigmentation
Many confuse acne scars with skin spots (post-inflammatory pigmentation).
True scar – a change in the texture of the skin (depression or raised area).
Post-inflammatory hyperpigmentation (PIH) – a change in skin color. These are the red, purple, or brown spots that remain after the pimple has healed.
Prevention: The most effective treatment for acne scars
Before rushing to expensive treatments, the best way to treat acne scars is to prevent their formation from the start.
The most important thing: Don’t touch!
The first instinct when facing a pimple is to pop it. This is the biggest mistake. When you press, scratch, or pick at a pimple:
● You push the inflammation, pus, and bacteria deeper into the skin.
● You cause physical trauma to the delicate tissue.
● You introduce new bacteria from your fingers, creating a secondary infection.
All these actions significantly increase the chance of permanent skin damage and scar formation – up to 10 times more than untouched pimples.
Treat active acne immediately
The more severe and longer-lasting the inflammation, the higher the chance of scarring. Don’t wait for it to go away on its own. See a dermatologist as soon as possible. Start an effective treatment to reduce the inflammation.
Complete sun protection
The sun is the enemy of skin recovering from acne:
● UV radiation damages collagen and interferes with normal healing processes.
● It worsens red and brown spots and makes them darker and more permanent.
It is very important to apply a broad-spectrum sunscreen (UVA/UVB) with a high SPF (at least SPF 30) daily. It is recommended to choose a mineral-based sunscreen to avoid worsening acne.
Maintain a gentle skincare routine
When the skin is inflamed, it is vulnerable. Avoid aggressive peeling and harsh cleansers. These actions injure the skin and worsen the inflammation.
What Not to Do: Common Mistakes in Scar Treatment
Before we dive into solutions, let's bust some myths and avoid common mistakes:
Do not try to buff or scrub scars at home – grainy exfoliators only work on the top layer of the skin (the epidermis). Acne scars are a problem in the dermis – scrubbing does not change deep texture and can even lead to secondary infection.
Do not waste money on “miracle creams” – there is no magic topical product that can fill pits or erase real scars. Creams containing retinoids or vitamin C can improve surface texture by 10–20% over time, but they are not a solution for deep scars.
Do not treat scars when acne is still active – Do not treat scars when acne is still active – most professional treatments (like laser or chemical peels) should not be done on inflamed skin. There is a high risk of developing new scars or infection. It is important to first get acne under control.
How Do You Treat Existing Acne Scars?
Treating acne scars is a marathon, not a sprint. It requires patience, a budget, and usually a series of combined treatments tailored personally by a professional. The goal is a 50–80% improvement — not complete disappearance, but noticeable softening and fading.
| Treatment category | Type of treatment | Types of scars | Main mechanism of action |
|---|---|---|---|
| Skin renewal and resurfacing treatments. | 3Laser resurfacing (Fractional CO2, Erbium)0%. | Ice-pick, boxcar, rolling scars | Removal of damaged skin layer and stimulation of new collagen production. |
| Dermabrasion / Microdermabrasion. | Boxcar scars, superficial scars | Mechanical removal of the upper layer of the skin. | |
| Deep chemical peel (TCA) | Boxcar scars, superficial scars | Deep exfoliation of the skin and significant | |
| Collagen-focused treatments | Microneedling (with/without RF) | Boxcar scars, rolling scars | Creating a controlled injury to stimulate the production of collagen and elastin. |
| TCA CROSS | Ice-pick scars (most effective for these scars), narrow boxcar scars. | Targeted application of a strong acid directly into the base of the scar to encourage the formation of new tissue. | |
| Injectable and surgical treatments. | Dermal fillers | Rolling, depressed boxcar scars. | Physical lifting of the base of the depressed scar by injecting filler material. |
| Subcision | Rolling scars | Release of the fibrous connective tissue pulling the skin downward. | |
| Steroid injections | Hypertrophic scars, keloids (raised scars) | Reducing inflammation and softening the raised scar. |
Treat acne to prevent future scars with SKCURE.
Prevention of acne scars is mainly achieved through fast and precise acne treatment. For this purpose, SKCURE offers a comprehensive program that begins with an AI-based diagnosis and a detailed questionnaire — an advanced diagnostic tool powered by artificial intelligence — leading to a personalized solution designed to minimize skin damage. Instead of multiple products, patients receive a single formulation, personally crafted under strict pharmacist supervision, containing an optimal combination of 2 to 6 active ingredients — some of which are unique and not available in standard pharmacies. The entire process is conducted online, without the need to visit a clinic, including online medical consultation, with discreet and fast delivery to the home.
Authored By - Dr. Shlomo Sadoun
A pioneering pharma entrepreneur with over two decades of experience in the health and biotechnology sectors. Operating at the intersection of science, innovation, and a global vision, leading the development of advanced medical solutions with a real impact on patients’ lives.