How to Treat Acne Scars

Acne scars are a common concern because they affect the appearance of the skin. Fortunately, acne scars can be treated.

What are acne scars?

Acne scars are changes in the texture of the skin surface. Acne scars can be felt when you glide your finger over the skin. You can feel an indentation in the skin. If you look closely you can see the small indentations in the skin. There are different types of acne scars, depending on what they look like. Icepick scars are small and deep. They’re called icepick scars because it looks like someone took an icepick (or a toothpick) and made a small hole in the skin. Boxcar scars are larger and look like squares. They can look like you can put a small cube inside. Rolling scars are also larger than boxcar scars, but rolling scars have smooth edges instead of vertical edges. These acne scars occur after you have acne and last forever unless you do something about them.

In addition to acne scars some people also have discolorations or dark spots on the skin. These are often also called acne scars, but they are actually discolorations. The term for this is post-inflammatory hyperpigmentation or PIH. Hyperpigmentation is darkening of the skin color and it can occur after inflammation, thus the term post-inflammatory hyperpigmentation (PIH). The reason there is a difference between true acne scars and PIH is because the treatment is different. PIH will go away on its own, although it can sometimes take weeks to months. PIH can also be treated with a variety of topical products and treatments. Usually treatments for PIH will not treat acne scars, but there are exceptions.

What causes acne scars?

When you have active acne, the breakouts cause inflammation in the skin. The more severe the acne, the more inflammation you will see. Inflammation is seen as swelling, redness, tenderness to the touch, and sometimes warmth. Inflammation is your body’s way of fighting the acne. Aestheticians and other professional are able to extract the pimples. This means that the pus inside is removed from the skin. Extractions relieve the pressure in the skin and unclog the pores that cause the breakouts. The pus that builds up in your skin creates an environment for bacteria to grow. Removing the pus gets rid of that environment and the bacteria can no longer survive. Some people pop their own pimples, and this can cause problems. If they are extracted correctly and the pus comes out, this is fine as long as the skin is clean. If the skin is not clean you can get an infection. If the pimple is popped without the pus coming out, the pus will be released into your skin. This will cause even more inflammation. When this happens, it affects everything inside the skin such as collagen. Collagen is a protein found in your skin that maintains the structure. Collagen keeps your skin firm and tight. The reason why your skin is smooth is because collagen (and other proteins such as elastin) keep it that way. The inflammation that occurs damages the collagen. So instead of keeping your skin surface smooth, you see indented scars called acne scars.

How can I treat my acne scars?

Acne scars are seen because the collagen in your skin is damaged. To treat acne scars you need to get rid of the damaged collagen and replace it with normal collagen. There are many ways of stimulating your skin to form collagen. The simplest is using topical products such as retinol, retin-A, or other retinoids such as adapalene (Differin) or tazarotene (Tazorac). Treatments can also help. Treatments vary from very mild to very aggressive. Mild treatments such as facials or microdermabrasion will make the skin look better, but have a very small effect on improving the appearance of your scars in the long terms. The strongest treatments such as fractional CO2 laser resurfacing can provide outstanding results, but there are significant risks such as infection and they come with two or more weeks of recovery time and prolonged redness for months. Microneedling is a new and effective way to treat acne scars that provides a balance between these two extremes. As its name implies, microneedling uses tiny needles to make holes in the skin. This breaks down the damaged collagen in your skin and also stimulates your body to form is own natural, new, fresh, and healthy collagen. Microneedling goes deeper than facials or microdermabrasion. It can be done using home devices or in an office. In-office treatments are much more effective than those at home. Many of the new microneedling devices use something called radiofrequency. Radiofrequency generates heat in the skin. This heat increases your skin’s response and better improvement is seen.

Dr. Alex has designed a treatment called Ultra Microneedling that works even better than traditional microneedling. Ultra Microneedling uses a laser technology to create the holes. So there are no physical needles going into your skin and there is no bleeding, which usually causes the recovery time to be up to a week. The recovery time with Ultra Microneedling is very short; you can put on makeup the next day. Also, the treatment with Ultra Microneedling is much faster (about two minutes) that a traditional microneedling treatment which takes 10-15 minutes. The other benefit of using the laser technology to create the holes is that the laser generates even more heat than radiofrequency, and the amount of heat can be adjusted. This means that the results are even better. For acne scars Dr. Alex recommends a series of at least six to ten monthly Ultra Microneedling treatments. You’ll see improvement slowly over time. As mentioned, the treatment creates new collagen. Collagen is a microscopic protein and does not form overnight. So it’s important to be patient. You’ll see the full results three, six, or even 12 months after your final treatment. You’ll also notice a number of other benefits from Ultra Microneedling such as smoothening of your skin color. Women will notice that they need less makeup and the skin looks better with the makeup. Men will notice a much smoother shave and any ingrown hairs will be improved. Making more collagen in your skin with Ultra Microneedling will also improve fine lines, wrinkles, and loose and saggy skin. What people notice the fastest is an improvement in enlarged pores. With Ultra Microneedling you can easily treat your acne scars and get a lot of other benefits for your skin.

Ultra Microneedling Demonstration


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Dr. Alex has performed over 10,000 cosmetic treatments with many satisfied patients. Contact us to schedule an appointment for a free consultation with Dr. Alex in our Encino, CA office.