The right acne-scar treatment depends on the type of scar. Depressed scars — ice pick, boxcar and rolling — are treated with procedures that rebuild collagen, add volume or lift the scar, such as microneedling, laser resurfacing, chemical peels, fillers or scar surgery, sometimes in combination. Flat red, pink or brown marks left after a breakout are usually not scars and usually fade over time. A skin exam is the first step.
Acne can clear and still leave a reminder behind. The key to treating it is knowing what kind of mark you have, because different scars call for different treatments — and some marks are not scars at all. Here is how to tell them apart and what each one calls for.
First, Know What You Are Treating
The American Academy of Dermatology (AAD) notes that most people who get acne scars develop depressed scars, and often more than one type:
- Ice pick scars look small but go deep into the skin. The AAD describes them as the most common type.
- Boxcar scars are round or oval depressions, wider than ice pick scars but not as wide as rolling scars.
- Rolling scars are wide and shallow; several together can give skin a wavy look.
Some people develop raised scars instead, such as hypertrophic scars and keloids, which form when the skin makes too much collagen as it heals. The AAD notes these are more common in people with darker skin tones, and they are treated differently from depressed scars.
Then there are flat marks — red or pink on lighter skin, brown or sometimes bluish gray on medium and darker skin. The AAD calls this post-inflammatory hyperpigmentation and says these flat spots are not scars: they usually fade over time, and treatment can help them fade more quickly.
Before You Treat the Scars, Get Acne Under Control
According to the AAD, scar treatment typically begins after active acne is under control, because ongoing breakouts can cause new scars. The AAD also advises telling your provider about every acne treatment you are using or have used in the last two years, since starting some scar treatments while using — or soon after stopping — certain acne medicines can cause unwanted side effects.
Treatments for Depressed Scars
Options for depressed acne scars include:
- Microneedling. Fine needles create controlled micro-injuries that prompt the skin to make new collagen and elastin. The FDA has legally authorized microneedling devices to improve the appearance of facial acne scars in patients 22 and older, and each device’s authorization specifies the uses — and in some cases the skin types — it covers. The AAD describes microneedling as safe for all skin tones.
- Laser resurfacing. As skin heals after laser resurfacing, it produces collagen and elastin, which the AAD says can make scars less noticeable. Ablative lasers carry more downtime and a higher risk of pigment changes and scarring, especially in darker skin tones.
- Chemical peels. A peel prompts the skin to produce more collagen and elastin, which can make depressed scars less noticeable. The AAD notes that a mild peel may take 3 to 5 treatments spaced 2 to 4 weeks apart, and that you will need to protect your skin from the sun before a peel.
- Fillers. A filler adds volume to a depressed scar. Only some fillers are FDA-approved for acne scars, so ask whether the product proposed is approved for that use. Like any filler, it carries the rare but serious risk of injection into a blood vessel, which can cause tissue damage, vision problems including blindness, or stroke.
- Scar surgery. For some scars, a dermatologist may surgically lift the scar from the tissue beneath it or remove it, sometimes followed by another treatment such as laser resurfacing.
The AAD notes that ice pick scars require different treatment than rolling scars, and a plan may use more than one approach.
A note on RF microneedling. Radiofrequency (RF) microneedling adds heat delivered through the needles. On October 15, 2025, the FDA issued a safety communication reporting serious complications with certain uses of RF microneedling, including burns, scarring, fat loss, disfigurement and nerve damage. The FDA describes RF microneedling as a medical procedure, not a cosmetic treatment, and advises choosing a licensed provider trained and experienced with these devices and asking which device they plan to use.
Treating Flat Marks
If your marks are flat discoloration rather than true scars, the plan looks different:
- Daily broad-spectrum sun protection, so the marks do not darken or linger.
- Topical treatments and a consistent skincare routine, chosen with a provider.
- Gentle in-office treatments, such as light chemical peels, for some marks. Light- and laser-based treatments call for particular caution with post-inflammatory hyperpigmentation, because they can sometimes make pigment worse.
Skin Tone and Safety
Deeper skin tones can be treated successfully, but treatment selection matters. Aggressive lasers and deeper peels carry a higher risk of post-inflammatory hyperpigmentation. Device clearances also differ: the Skin Stylus on Physician’s Plan’s microneedling menu, for example, is FDA-cleared to improve the appearance of facial acne scars in Fitzpatrick skin types I to III in patients 22 and older. Ask whether the specific device or treatment proposed suits your skin type.
What to Expect
Treatment aims to make scars less noticeable over time. Collagen-building treatments work gradually, usually over a series of sessions, and results vary with your scar type, skin tone and the number of sessions. The AAD also notes that medical insurance does not cover the cost of acne scar treatment, so ask for the total price of a plan before you start.
Acne Scar Treatment at Physician’s Plan
Physician’s Plan’s menu includes microneedling with the Skin Stylus, chemical peels and laser resurfacing. Its microneedling menu also lists RF microneedling with the Pixel8-RF, a device FDA-cleared for electrocoagulation and hemostasis; no aesthetic indication is claimed for it. Use a consultation to identify your scar types and talk through the options.
Questions worth bringing to your consultation:
- Which types of scars do I have, and are any of my marks discoloration rather than scars?
- Which treatment would you start with, and why?
- Is the device or product you would use cleared or approved for my scar type and skin type?
- How many sessions do you expect, and what is the total price?
- I have used these acne medicines in the last two years — does that change the plan?
Frequently Asked Questions
Can acne scars be removed completely? Complete removal is not a realistic promise. Treatment aims to make scars less noticeable, and results vary from person to person.
Is there one treatment that works for every acne scar? No. The AAD notes that ice pick scars require different treatment than rolling scars, and a plan may combine approaches. Flat discoloration is handled differently again, with sun protection and topical care.
How long until I see a difference? Collagen-building treatments work gradually, usually over a series of sessions spaced weeks apart. Your provider can set expectations for the plan proposed for you.
Are the marks left after a pimple the same as scars? Not usually. The AAD says flat red, pink, brown or bluish-gray spots left after acne are usually post-inflammatory hyperpigmentation, not scars, and that they usually fade over time. Daily sun protection helps keep them from darkening.
Will insurance pay for acne scar treatment? The AAD notes that medical insurance does not cover the cost of acne scar treatment. Ask for the total price of your plan before you begin.
Ready to Take the First Step?
The first step to treating acne scars is knowing exactly what you are treating. Explore microneedling, chemical peels and laser resurfacing, see the practice’s scar treatment page, start with a consultation, and find the Physician’s Plan location nearest you in South or North Carolina.
This article is general health information, not medical advice, and does not replace a consultation with a licensed medical provider. Treatments, results and candidacy vary by individual. Talk with a licensed provider about the benefits and risks of any treatment for you.
