How To Treat Atrophic Acne Scars

Atrophic scarring is a common side-effect of skin trauma. 

This type of scarring usually occurs when the skin doesn’t repair itself properly after an inflammatory lesion has healed.

The body’s inability to produce enough collagen to fill up the indentation is what causes the skin to depress into a sunken or pitted appearance, resulting in imbalanced and visible scarring.

However, even though atrophic scars can be challenging to treat, plenty of treatment options can make a ton of difference and even fully get rid of this type of scarring over time.

Treatments for atrophic scars depend on several factors, including the type of scarring, the depth of the scar, the area where the scar is, and your skin type.

Shallow scars are usually easier to treat and don’t require more than two or three treatments.

Deeper scars or a combination of different types of scarring usually require a combination of treatments, and therapy lasts longer because the skin needs time to heal between each treatment.

With all that said, here are the seven best treatments for atrophic acne scars:

Microneedling

Microneedling is a minimally invasive procedure that uses tiny needles to puncture the top layer of the skin.

This triggers the body’s natural healing process, which helps to improve the appearance of scars by stimulating collagen production.

Microneedling is the best treatment for deep ice pick and boxcar acne scars.

Laser Therapy

Laser therapy uses concentrated beams of light to burn off scar tissue.

This helps to improve the appearance of atrophic scars by stimulating collagen production and evening out the skin’s texture and tone.

Laser therapy is the best treatment for all types of atrophic scarring, including scars left from acne, chickenpox, and other skin injuries.

Stem Cell Therapy

Stem cell therapy is a new treatment for atrophic scars that uses the body’s own stem cells to help regenerate lost tissue.

This treatment is still in its early stages, but preliminary studies have shown promising results.

Stem cell therapy is the best treatment for severe atrophic scarring that has not responded to other treatments.

Subcision

Subcision is a minimally invasive surgical procedure that involves inserting a needle under the skin and manually breaking up the fibrous bands that are pulling down the skin and causing atrophic scarring.

This releases the tension and allows the skin to heal in a more natural position, which helps improve the appearance of atrophic scars.

Subcision is the best treatment for all types of atrophic acne scarring, including deep ice pick scars, which are notoriously challenging to treat.

Soft Tissue Filler

Soft tissue filler injections are another minimally invasive treatment for atrophic scars.

This treatment involves injecting a soft tissue filler, such as hyaluronic acid, into the scar to help fill it out and improve its appearance.

Soft tissue filler injections are the best treatment for shallow atrophic scars such as rolling and boxcar scars.

And although the results are almost instant, they aren’t permanent and usually last between six and nine months.

Microdermabrasion

Microdermabrasion is a minimally invasive cosmetic procedure that uses a fine, abrasive tip to buff away the top layer of the skin.

This helps to improve the appearance of atrophic scars by evening out the skin’s texture and tone.

Microdermabrasion is an excellent treatment for all types of shallow atrophic scarring.

On the other hand, while microdermabrasion might improve deeper scarring, the best results will come from combining it with other treatments.

Dermabrasion

Dermabrasion goes deeper than microdermabrasion and helps to improve the appearance of atrophic scars by evening out the skin’s texture and tone.

Dermabrasion is an excellent treatment for all types of atrophic scarring, but it works best on shallow scars.

If you have deeper atrophic scarring, you’ll likely need to combine dermabrasion with other treatments.

What Causes Atrophic Scars?

Atrophic scars result from a loss of collagen in certain areas that have experienced some sort of inflammatory trauma.

Here are a few common causes of atrophic scars:

Acne

Severe acne left untreated for a long time can result in atrophic scars.

Some types of severe acne, such as cystic or nodular acne, lie deep beneath the skin’s surface, which leads to a loss of tissue when it heals.

Some examples of atrophic scarring caused by acne are:

  • Ice pick scars: small and narrow scars that look like the skin has been pricked with a needle
  • Boxcar scars: shallow scars with flat bottoms and defined borders that look like boxes
  • Rolling scars: shallow scars with no distinct edges that give the skin a wave-like appearance

Chickenpox

Chickenpox is a common childhood inflammatory illness that manifests itself as red, itchy blisters on the skin and can result in atrophic scarring.

The scars from chickenpox are often small and round and can be found on the face, chest, back, or legs.

Excessive scratching of chickenpox blisters is most frequently blamed for scarring.

Surgery

Atrophic scars can also result from surgery, especially when the skin is stretched during the healing process.

Additionally, procedures such as mole removal can often result in atrophic scarring due to the depth of the mole.

Injury or Trauma

Any sort of injury or trauma to the skin that results in an inflammatory response can also lead to atrophic scars.

This includes burns, cuts, scratches, and scrapes.

How to Identify Atrophic Scars?

There are two most common types of abnormal scarring: atrophic and hypertrophic scarring.

Atrophic scars are easy to identify because they are sunken or pitted and are often a different color than the surrounding skin.

Hypertrophic scars, on the other hand, are often raised and lumpy, and similarly to atrophic scars, they are often a different color than the surrounding skin.

The main difference between the two is that atrophic scarring is caused by loss of collagen, while hypertrophic scarring is caused by excess collagen production that results in a thickened and raised scar.

Both types of scarring result from severe inflammation or skin trauma and can be found on any area of the body but are most commonly seen on the face, chest, back, and legs.

Can You Treat Atrophic Acne Scars at Home?

While atrophic acne scarring is unlikely to be entirely removed with at-home remedies, some products can help soften the skin and improve its appearance.

Here are some at-home treatments that you can try:

Squalane

Squalane oil is rich in fatty acids and antioxidants, which can improve skin elasticity, making it an excellent at-home treatment for atrophic scars.

Vitamin C Oil

Vitamin C is an antioxidant that can help reduce the appearance of atrophic scars by boosting collagen production.

Vitamin E Oil

Vitamin E is an antioxidant that can help reduce the appearance of atrophic scars by keeping the skin moisturized and the area around the scar softened.

Best Skincare Products for Atrophic Scars

Some atrophic scars lie much deeper than the skin’s surface, so not many skin care products can help target the root of the issue.

However, some studies suggest that long-term tretinoin use can offer improvement in atrophic scars.

Tretinoin is a prescription retinoid that works by increasing cellular turnover and encouraging collagen production.

And while tretinoin alone won’t eliminate ice pick scarring, it can help improve its appearance, especially when combined with professional treatments.

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Analyzed by Simone Sydel

I am a certified Esthetician as well as a skincare, beauty, and wellness writer, and an expert in oily and acne-prone skin. Having been through the struggles of having acne for a good portion of my life, I understand exactly what needs to be done to achieve an acne-free, flawless complexion and change the perspective through which we see acne. I am a firm believer that acne doesn't show up on our skin to destroy our lives but to teach us important lessons on stepping back, being patient, and treating our skin with kindness before everything else. This is why I've made it my life's mission to educate people on taking good care of their skin and achieving their skin goals. I am passionate about sharing my professional and personal insights with those struggling with problematic and acne-prone skin, and I have helped hundreds of clients and thousands of readers make better choices with their skincare products through my private practice and my online platforms. Read more of Simone's articles.


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