By Chelsea Campbell

While many of us outgrow acne or just find a way to manage it, it still often leaves memories of those embarrassing breakouts long after the pimple itself is gone; namely, in the form of acne scars. These stubborn pockmarks or discoloration can often be just as disheartening as acne, but luckily, there are many options available to help reduce the evidence of pimples past. With many options available to consumers, it can be confusing to navigate the various treatments. Below, we have narrowed it down by rounding up information on the most effective treatments for acne scars.

Types of Acne Scars

There are a variety of different types of acne scars. According to DermNet New Zealand, "Ice pick scars are deep, narrow, and pitted"; "rolling scars have broad depressions with sloping edges"; and "boxcar scars have broad depressions with sharply defined edges." These are the most typical kinds of physical scars and they are most commonly caused by bacteria that have destroyed tissue and collagen, leading to a collapsed appearance of the skin. 

There is also superficial scarring in the form of hypo- and hyperpigmentation, which is redness or dark spots caused by exposure to sunlight or by picking at acne.  Some people are more susceptible to scarring than others, so even if two people have the same type and amount of acne, one may have severe scarring, while the other may remain unscathed.

How to Fade Acne Scars

Luckily, there are several ways that doctors can help fade acne scars. Some of the most effective methods are as follows:

• Laser treatments like C02, Er:YAG, and fractional lasers can help ice pick, rolling, and boxcar scars by removing a layer of skin so that new skin can form in its place. These treatments usually have some side effects, such as crusting, oozing, and redness, and require days to weeks of recovery time. They also are fairly costly at around $3000-$6000. ?
• Dermabrasion, costing around $1500,  involves a high-speed brush made from diamond, wire wheel, or sandpaper, which removes the surface layer of the skin and is ideal for deep and severe scarring. This should not be confused with microdermabrasion, which is too superficial to treat acne scars, but maybe help slightly with hyperpigmentation.  ?
• Collagen or fat fillers can be injected into rolling or boxcar scars to fill the soft tissue around the scar and even out the indentation. At $500-$1500 per treatment, it should be noted that these fillers only provide temporary results that last about a year. Other injections which aim to afford the same results are steroids and cytotoxic injections. 
• Surgical options are available as well for deep scarring. Subcision is effective for rolling scars and is a technique where the scar is cut away and unbound from the tissue below, allowing blood to fill underneath and clot. This blood clot can help form connective tissue under the scar, thus leveling it with the surface?, according to Acne.org. Another treatment that involves surgery is called a punch technique, ideal for ice pick and boxcar scars. This involves the removal of a scar, which is then sewn up with sutures. The cost for this procedure is about $250-$300 per scar. 
• Deep chemical peels are often effective at reducing scarring by use of a highly acidic solution being applied to the skin, which then penetrates and removes both surface and deep layers of skin. This process allows the skin to regenerate and renew. Although highly effective, deep chemical peels are painful and serious procedures that require sedation, anesthesia, and cardiopulmonary monitoring. They cost about $2500-$6000 and require the committed use of sunblock afterward. These peels should not be confused with lighter, more mild chemical peels, which help to exfoliate imperfections on the surface of the skin but do not improve acne scarring. 
• Finally, microneedling is a procedure in which a roller studded with needles is rolled over the surface of the skin, causing tiny punctures in the skin?s surface. This signals the body to produce collagen to heal the wounds and helps even out irregularities in the skin. Downtime is minimal, and it costs around $150-500 per session, with results taking place after 1-2 sessions. 

Talk to Your Dermatologist

Acne scarring is frustrating to live with, but knowing which options are available can ease your mind and help you to be an informed consumer. As always, schedule a consultation with a dermatologist who can diagnose the type of scarring you have, speak to you about your budget and expectations, and then determine which treatment is best for your skin.