Acne scars form when inflammation from acne damages the deeper layers of the skin. As the skin heals, collagen production may be either insufficient or excessive, leading to changes in texture.

Factors that increase the risk of scarring include:

• Severe or cystic acne
• Delayed or inadequate treatment
• Repeated inflammation
• Picking or manipulating lesions

Early treatment of acne is one of the most effective ways to prevent scarring, but even long-standing scars can often be improved with the right approach.

Atrophic (Depressed) Scars

Atrophic scars are the most common type of acne scars and are characterized by a loss of collagen, resulting in indentations in the skin.

These include:

• Rolling scars, which create a wavy, uneven texture
• Boxcar scars, which have more defined edges
• Ice pick scars, which are deeper and narrower

Each type responds differently to treatment, making accurate diagnosis essential.

Hypertrophic and Keloid Scars

In some patients, acne can lead to raised scars caused by excess collagen production.

These scars may appear:

• Thickened or firm
• Elevated above the surface of the skin

Treatment approaches differ from those used for depressed scars and may involve targeted therapies to reduce excess tissue.

Post-Inflammatory Hyperpigmentation

While not a true scar, dark marks left behind after acne can persist and contribute to an uneven complexion.

These areas of pigmentation often require separate treatment strategies, such as topical therapy or light-based treatments, in addition to addressing textural concerns.

A Multi-Modal Approach to Acne Scars

At Treiber Dermatology, acne scars are rarely treated with a single modality. Instead, a combination approach is often used to target different aspects of scarring.

Treatment plans may include:

• Laser resurfacing
• Microneedling
• Subcision
• Chemical peels
• TCA CROSS for focal scars
• Dermal fillers for selected areas

This layered strategy allows for more comprehensive improvement and more natural-looking results.

Laser Treatments for Acne Scars

Fractional laser treatments such as Fraxel 1550 and CO2 resurfacing are commonly used to improve acne scars by stimulating collagen remodeling.

Fraxel 1550 is often used for:

• Mild to moderate acne scars
• General texture improvement

CO2 resurfacing may be recommended for:

• More advanced scarring
• Deeper textural changes

Laser selection is based on the depth, type, and distribution of scars, as well as downtime preferences.

Microneedling for Acne Scars

Microneedling stimulates collagen production through controlled micro-injury, helping to smooth the skin over time.

It is often used for:

• Mild to moderate scarring
• Maintenance and ongoing improvement

Microneedling may be combined with other treatments to enhance results.

Subcision for Rolling Scars

Subcision is a technique used to release fibrous bands beneath the skin that contribute to depressed scars.

By freeing these attachments, the skin can elevate and appear smoother. Subcision is often combined with other treatments, such as laser therapy or fillers, to optimize results.

TCA CROSS for Ice Pick Scars

For deeper, more focal scars such as ice pick scars, TCA CROSS involves applying a high concentration of trichloroacetic acid directly into the scar.

This stimulates collagen production within the scar, gradually improving its depth and appearance.

Dermal Fillers for Acne Scars

In selected cases, dermal fillers can be used to temporarily improve depressed scars by restoring volume beneath the skin.

This can provide immediate improvement and is sometimes used in combination with other treatments for a more comprehensive approach.

Treatment for acne scars is typically performed over a series of sessions rather than a single visit.

Each step is carefully planned, with adjustments made based on how the skin responds. This gradual approach allows for controlled improvement while minimizing risk.

Patients are guided through each phase of treatment, including preparation, recovery, and maintenance.

Recovery varies depending on the treatments used.

Patients may experience:

• Redness and swelling
• Temporary sensitivity
• Peeling or flaking after certain procedures

Downtime can range from minimal with microneedling to more significant with CO2 resurfacing.

Aftercare and sun protection are essential components of the healing process and play a key role in achieving optimal results.

Improvement in acne scars occurs gradually as collagen remodeling takes place. Patients often begin to notice changes within weeks, with continued improvement over several months.

Because multiple treatments are typically required, results evolve over time, leading to smoother, more even skin.

Acne scar treatment is appropriate for patients who:

• Have residual textural changes after acne
• Are bothered by uneven skin surface or indentations
• Are willing to undergo a series of treatments
• Want gradual, natural-looking improvement

A detailed evaluation is essential to determine the most appropriate treatment plan.

At Treiber Dermatology, acne scar treatment is approached with an emphasis on customization and precision.

No two patients have the same pattern of scarring, and treatment plans are designed to reflect this. By combining multiple modalities, it is possible to achieve meaningful improvement while preserving the natural character of the skin.

Patients throughout New York and Connecticut choose Treiber Dermatology for acne scar treatment because of the practice’s expertise in advanced, multi-modality care.

Each treatment plan is individualized, with careful attention to:

• Scar type and severity
• Skin type and tolerance
• Desired level of improvement and downtime

The focus is on achieving smoother, more refined skin in a way that is balanced and natural.