The Best Treatment for Acne Scars, By Scar Type

First, is it actually a scar?

Flat brown or red marks left behind after a breakout are not scars, they are post inflammatory pigmentation and erythema, and they fade on their own over months. If you run a finger over the area and the surface is smooth, you are dealing with discoloration, and the answer is sun protection, pigment-focused treatment, and patience, not resurfacing. Only indented or raised texture is a true scar.

Rolling scars

Broad, shallow depressions with soft sloping edges that give the cheeks a wavy look, most visible in side lighting. These are caused by fibrous tethering pulling the skin downward. They are the most rewarding type to treat, and RF microneedling is the first choice because it breaks up that tethering and rebuilds collagen underneath. Expect meaningful improvement over a series of three or more sessions.

Boxcar scars

Wider depressions with sharply defined vertical walls, like small craters. They respond well to RF microneedling too, though usually more slowly than rolling scars and often needing more sessions. Improvement here is measured in softened edges and shallower depth rather than complete erasure, and any honest consultation will frame it that way.

Ice pick scars

Narrow, deep, and steep, as though a pin was pressed into the skin. These are the hardest type. Resurfacing alone reaches them poorly because the depth to width ratio works against it. RF microneedling still helps the surrounding texture, but the best plans combine it with other approaches. If someone promises to clear ice pick scarring with microneedling alone, be skeptical.

Raised and mixed scarring

Thickened, raised keloid or hypertrophic scars are a different problem entirely and need a different plan, not a resurfacing device. Most real faces present a mix of types, which is why we assess your skin in person and build a plan around the dominant pattern rather than treating every scar the same way.

What to do first

Get your acne fully under control before starting any resurfacing series, treating over active breakouts is counterproductive. If you have used isotretinoin, wait six months. Then commit to a series and a timeline, collagen remodeling runs for about three months after each session, so the picture you judge should be three months after your final treatment, not a week after your first.

Frequently asked questions

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