Can Acne Scars Be Removed Completely?

The aftermath of an acne breakout is a raw sight to behold. With every gaze at the mirror, your reflection only seems to amplify the recent areas of an acne occurrence. The darkened and blemished areas just seem out of place and serve as nothing but a bad distraction to your otherwise flawless skin.

Acne scarring appears as depressions, raised bumps, darkened areas and discolored skin. Each type of scarring CAN BE REDUCED and sometimes with dramatic results by deploying different methods and combinations of treatment options such as surgical procedures, derma rollers, laser treatments or chemical peels.

Most treatments count on the body’s ability to create collagen for tissue repair and thus, to “reset” the skin healing process in the problem areas. All this, by ironically creating new micro-wounds that encourage collagen production and filling in the gaps. My best advice: Start as soon as possible if you are treating acne scars, because the treatment process may take a few months to a year.

Need Some Inspiration? Be Amazed At What’s Possible!

Here are some amazing before and after photos of scar treatment that went really well, so if you have similar type of scars, you can always rest easy to know that it is possible to improve your skin health quite significantly when matched with the right type of treatments listed below. Even when the treatment is very expertly performed, it doesn’t necessarily mean that it will remove every blemish completely.

(above: hyperpigmentation scars)

(above: rolling acne scars)

(above: ice-pick scars)

The 5 Main Types of Acne Scars

If scarring isn’t severe, such as mild and small discoloured spots, these scars can heal quickly and naturally with time, as long as acne does not reappear within the same area before complete healing has taken place. Repeated acne appearing over the same area repeated scars the skin and leads to very uneven skin.

Types of Acne Scars

There are 5 main classifications of acne scars

Keloid or Hypertrophic
Ice-pick
Rolling
Boxcar
Hyperpigmentation

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Keloid / Hypertrophic Acne Scars

Keloid or hypertrophic acne scars are lumpy and appear to be excess tissue that gathers above the rest of the skin surface.

When skin tissue is damaged, fibrous tissue is created as part of the skin repair, but sometimes, excess tissue grows forming these lumps that sometimes resemble appendages that don’t belong.

Most acne keloid scars aren’t very large but they appear as bumps on the skin. Nonetheless, they can be quite unsightly. According to the American Osteopathic College of Dermatology, approximately 10% of people experience keloid scarring, which is also suggested that genetics play a role in their occurrence.

Keloid treatment is a mixed bag. There are cases where an attempt is made to remove a keloid surgically, but a larger one grows back in place, which makes things much worse. However, the typical treatment prescribed are corticosteroid injections to reduce any inflammation present.

Moisturizers will also help to reduce the hardness of the tissue.

Wound care dressings such as 3M’s Primapore helps create mild pressure over the site during the healing process of acne and can assist in preventing keloids form forming.

Tissue freezing is sometimes used to kill the skin cells and remove the keloid.

Most keloids also tend to shrink and flatten over time even without treatment, so unless your scar is very obtrusive, you may consider leaving it alone and let it self-heal.

Ice-pick Acne Scars

Ice-pick scars are a results of very deep cystic acne that develop in the deeper layers of your skin. The resulting scars that are left behind resemble very deep narrow pits in the skin. Because of the way light falls across the face, they also look like small hole punctures in the skin.

These scars are some of the difficult to remove because they work best with the combination of surgery and resurfacing according to skincare experts. No known home-remedies are known to successfully treat ice-pick acne scars.

Punch grafting is the highly-recommended treatment for ice pick scars. Surgeons would take out the scar and replace it with a skin graft taken from behind the ear. But one treatment alone may not be enough as it may take up to 15 for a single scar.

And the resulting treated area may be slightly more elevated than the surrounding tissue.

Punch excision is another method that requires surgery. Essentially what punch excision does is to cutting out the entire scar area and allowing the skin to close up without the “pit”.

What follows after is laser resurfacing to further even out any skin discoloration as a result of the surgery.

Rolling Acne Scars

Rolling scars are in essence undulating skin texture that resemble mountainous terrain which people also call a “wavy” texture. They are different from boxcar scars because they do not have sharp edges.

When fibrous tissue develops between the skin and the layers below it, the fibrous tissue stretches the top layer of skin, allowing it to bind with the deeper layers because of the acne damaged area, and as a result, when the skin heals, a recessed area forms.

Rolling acne scars are the usually the results of repeated acne that appear in the same areas, resulting in several rounds of inflammation and healing cycles that lead to the rolling scars.

Subcision is the surgical procedure that is typically implemented for rolling acne. A scalpel is inserted parallel to the skin’s surface which then severs the bands that cause the undulating top skin surface which then helps to even up the surface and make is look smoother.

Boxcar Acne Scars

Boxcar acne scars are depressions with steep and almost vertical sides and edges and look like the skin is being pulled toward the face. They resemble rolling acne scars but have the steep edges that differentiate them from rolling scars.

Boxcar acne scars are the result of acne that occur slightly deeper into the skin and is commonly found around the temples and the cheeks. Treatment is similar to rolling acne scars where subcision is used in conjunction with laser treatments to lighten up any blemishes.

Hyperpigmentation Scars

After acne has healed, there is typically an area of discoloration, or in most cases, a darkened area. This is due to the inflammatory response which creates excess melanin, a compound that causes darkening) which causes the discoloring.

Hyperpigmentation is more noticeable in darker skin types.

Laser pigment removal or pulsed dye lasers are also used to treat such discolorization scars.

Ranking the Difficulty (and Cost) of Scar Removal

If you are looking at possible treatments based on the kind of scars you may have, I thought it would be useful to list the treatment options and their respective average known costs.

How Much Would It Cost To Remove Keloid Scars?

Steroid injection: $100 per injection (4 to 8 times)

As a first-line treatment, steroid injections are the go-to treatments for keloid scars. The steroid injection would be used to debulk the scar tissue and administered by a therapeutic radiologist, family physician, plastic surgeon or dermatologist.

Cortosteroid injections are safe, but can be quite painful if you are averse to needles. Typical course of treatment is once every 4 to 8 weeks as part of the de-bulking process.

Despite being able to reduce the bulk of the affected area, if you are undergoing this treatment, you might want to know that the area once with the keloid may feel different from the other non-affected areas.

Surgical Excision $1500 (including associated anaesthesia costs)

Depending on the location and size of the keloid, it may be necessary to administer local or general anaesthesia before any attempt is made to surgically remove the keloid. Surgeons will use a scalpel to cut and remove the keloid scar tissue.

Laser treatment:

$100 for tiny scars using pulse laser,
$2000 for larger areas.
Packages cost about $3,500 for 3 fractional laser treatments.

The laser treatment would be to promote healing and reduce the discoloration usually caused by the keloid, or any pigment-related scars. The idea is to cause heat within a specific area of skin in order to stimulate the healing process and the creation of collagen to fill the same areas.

Cost of Removing Ice-Pick Scars

Depending on the area that is affected, Ice-Pick scar removal costs will vary greatly. The typical treatment plan requires punch excision and micro-needling.

Punch Excision $90 per scar

In punch excision, scars removed by cutting out the scar and stitching it closed with a fine suture. This will mean a downtime of about a week and you will most likely need to wear dressing over the surgical site in that time.

Most individuals have reported good results with punch excisions as fillers and lasers appear to be less effective for Ice-Pick Scars.

What’s the Cost to Remove Rolling and Boxcar Acne Scars?

Small acne scars can be corrected with fillers for $100

A topical anaesthetic cream is applied to de-sensitize the affected area and cleaned with cool alcohol prior to any injection. The doctor then proceeds to use a fine-gauge needle to inject the fillers across the rolling scars to fill up the areas and to reduce the depressions of the rolling scars.

Fillers however are not a permanent fix and may last about 6 to 12 months.

Combination of Subcision, Ablative and Fractional Lasers $10,000

In cases of extensive scarring, a combination of subcision to reduce bumpiness of the skin, ablative and fractional lasers may be implemented to help improve the overall skin texture and skin tone. This may cost up to $10,000 as a whole.

Subcision $500

Manual separation of the top layers of the skin from the deeper layers of the scar tissue is made with a fine needle in order to unbind the scar tissue from the skin so the depressions are reduced. There may be some minor bleeding that takes place as part of the remodelling process.

Typically it may take 2-4 weeks for the visible bruising to be reduced.

Ablative laser / CO2 fractional lasers $400 per session (5 to 10 sessions)

Ablative lasers burn off the top layers of the skin and introduces heat to it in order to encourage new healing to take place and as a result, smoother texture. The advantage of fractional lasers is that it covers less total skin area which results in a significantly reduced downtime and possible complications.

What’s the cost of removing hyperpigmentation scars?

Laser Resurfacing $400 per treatment (2-3 sessions maybe required)

Laser resurfacing essentially burns off the excess melanocytes (cells that contain melanin) under the skin. Melanocytes cause the pigmentation and thus the discoloration of the affected area. Different laser types are deployed depending on the type of hyperpigmentation that is present.

It’s generally a non-invasive treatment that strikes cells that have excessive concentrations of pigment and does not affect the surrounding tissue. The result is an immediate darkening of the area due to the dark scab that develops and sheds of in about 10 days.

Which is the Most Cost-Effective Acne Scar Treatment?

Depending on the type of scar you have, as long as you do not require subcision or excision, typical costs fall within about $1000. Laser treatments and chemical peels are such examples. If your scars require an invasive procedure, the costs goes up because of any associated anaesthetic elements such as local or general anaesthesia.

But from some extra research, it appears that derma-fillers are the best treatment that lasts for about 6 to 12 months and costs less that the more expensive surgical alternatives. However, when coupled with laser treatments, it may yield more long-term results.

However, the fact that laser treatments may require several sessions over a year, the costs may add up to about $3,000 for fillers and laser treatments.

Ultimately, it’s always a case of making sure that the treatment is suitable and effective for the type of scars that you are trying to remove as opposed to looking at it from a cost-perspective.

Do Acne Laser Treatments Actually Work?

As with any treatment, such as lasers, the efficacy of the treatment lies in the doctor operating the device. The skill of individuals vary as much as the scars being treated, so pick a reputable doctor known for good results for peace of mind. After all, it is your face and it’s got to be quite important.

Laser treatments actually do require several sessions for visible changes to be observed. This may take 4-5 treatments over a course of year.

The skin needs time to heal between each treatment, which means that the effective changes are gradual, but are noticeable. Post-operation care is also important because if your skin is being exposed to the sun and UV rays damage your freshly-lasered, skin, it could lead to complications and negating the treatment altogether.

Can Acne Scar Treatment Be Done At Home?

Yes. There are treatment options available that you can purchase and use at home such as topical creams and exfoliating kits to aid with skin-repair and reducing blemishes such as discoloration. ( I will continue to update this post with more information and techniques that have been proven effective in the home.)

For more aggressive treatments, you have the option of using dermarollers. Dermarollers are like tiny steamrollers with hundreds of little short needles whose only function is to puncture the top layer of the skin and force the body to heal the newly punctured zones.

But as with any treatment, it pays to be safe and cautious because complications can occur if you puncture your skin. If you really are going to use a dermaroller, consider how you may keep the dermaroller extremely clean and sterile as well as preparing the affected area with antiseptic wipes.

The main danger in implementing DIY methods such as the dermaroller, is that if you buy something off the shelf and don’t follow the instructions strictly, it may lead to a host of problems you may not quite be expecting. Infection from external pathogens is a possibility, so always err on the side of caution.

What’s the Best Topical Acne Scar Treatment Cream?

There are myriad of choices for acne treatments, some of which prove to be less effective as options when it comes to treating acne scarring.

Most scar treatments require invasive treatment via a small surgical procedure or even in the case of lasers, create deliberate punctures and new controlled wounds to help even out skin texture. Creams and gels alone cannot remedy deep scarring because the problem lies in the deep tissue healing structure and not so much a surface level malady.

However, for the case of hyperpigmentation that appears after your acne has healed, there are a few possible topical treatments you can consider that have been shown to be quite effective.

Hyperpigmentation occurs near the top of the skin, which can be reached more readily by topical applications, which is why creams and gels are able to address pigment related scarring. Not all topical gels work well, so a lot of money has gone into research to find the most effective combination of ingredients that work in concert to deal with pigment-related scarring.

Skinceuticals C E Ferulic is a highly-recommended formula by many skincare professionals and experts. It has potent antioxidants as well as vitamin C which is known to lighten darkened brown spots. It also contains vitamin E which is a known natural preservative and protective qualities for skincare.

By creating a layer and acting as a barrier, the C E Ferulic formula seals skin cracks effectively and reduces discoloration and gives your skin a more even appearance. For the latest discounted prices, check this link.

As an alternative option, they HydroPeptide Lumapro-C is also known to deal with hyperpigmentation effectively by brightening up the overall skin tone and reducing dark spots.

Avoiding Skin-damaging Sunlight on Acne Scars

It’s critical that if you are undergoing acne scar treatment, you will need to recognize that your skin would be extremely prone to sun-damage because it is in the process of healing. You should, under no circumstances, be under direct sunlight.

The ultraviolet rays present in sunlight will cause free-radical exchanges to occur within the skin structure and lead to further hyperpigmentation, ageing and drying, as well as possible tissue damage from sun exposure.

When your skin is undergoing acne scar treatment, it is extremely sensitive to sunlight and if you really have to be in the sun or outdoors, wear a hat, carry and umbrella and use very hypoallergenic sunblock as extra precautions.

The last thing you need is to spend good money on thousand-dollar treatments, only to set yourself back by getting your skin damaged by UV rays.

The Power of Vitamins and Daily Nutrition In Scar Removal

The human body, when properly fuelled with nutritious vitamins and foods, will always heal quickly as well as promote healthy cell-regeneration. When you consume a healthy dose of vitamin C and E, and make extra effort to avoid processed foods and snacks, it would go a long way to helping your body recover.

In order to get your body go into full-healing mode, consider using probiotics as discussed in my other article here that discusses the potent benefits of regular probiotic intake and find out how to get your body’s immune system in tip-top condition so further acne outbreaks can be further prevented.

In case you might be still suffering from regular acne “attacks” I’ve also written about a very powerful system that effectively keeps acne away, and for good. You can read my review of the system I trust in stopping acne before it even becomes an issue.

Concluding Thoughts

There isn’t a one-size-fits-all approach to acne scar removal as it is highly dependent on how your body heals after acne. Some individuals are blessed with such amazing genetics, that despite having severe acne, their skin miraculously heals with no scarring. It could be down to their DNA or simply a better diet and lifestyle, or in most cases, both.

Before you run out and attempt some invasive DIY scar removal, do consult your medical professional before embarking on any attempts to remove acne scars on your own. If you are really in a pinch, before you start dermarolling your acne scars, try using it on a less visible part of your body so in case anything goes wrong!

I hope this article has provided you with some useful information that you can consider for your acne scar treatments, feel free to subscribe to my mailing list for more useful tips and information on skin and healthcare.

As always, thank you for reading and feel free to comment if this article has helped you!