Can Acne Scars Improve? A Dermatologist's Honest Answer

This is an English adaptation of a clinical article Dr. SangYoul Yun — board-certified dermatologist and Medical Director of Delight Dermatology in Gangnam, Seoul — originally published in Korean. Read the Korean original on Naver. It has been restructured and translated for international readers.

Acne scars that have nagged at you since your teens — can they get better? It's one of the most common questions I hear, so let me lay it out clearly. First, does any of this sound like you?

• You often wish your acne scars would just disappear.
• The scars make it harder to meet people, interview for a good job, or focus.
• You feel less sociable than before the scars appeared.

If these concerns resonate, it's worth talking through acne treatment with a dermatologist. Scars are not only a skin issue — they affect confidence — and, importantly, they can improve.

The types of acne scars

Acne scars show up in three broad forms.

1. Acne marks

These appear as red and brown pigmentation. Early on, a scar tends to be red; over time, brown pigmentation sets in.

2. Depressed scars

Common, and caused by permanent loss of collagen, leaving the skin sunken below the surface. There are three kinds:

• Icepick — a narrow, deep V-shaped scar. Many people describe it as an "enlarged pore." It is the deepest of all scar types, so it is not easy to treat.
• Rolling — wide, with rounded or tilted, irregular edges.
• Boxcar — a wide U shape with sharp edges; can be shallow or deep.

3. Raised scars

Caused by overgrowth of scar tissue, often on the jawline, chest and shoulders. These include hypertrophic scars (which stay within the wound) and keloid scars (which grow beyond it). (For a fuller breakdown of each type, see the four acne scar types.)

How acne scars are treated

In a scar consultation, we consider the treatment program for your scar type, together with how often you can visit, the budget you can spend, and the downtime you can accept. As a base, acne care generally starts with chemical peeling, which removes keratin and sebum and encourages the skin to produce more collagen and elastin.

1. Acne marks

• Red marks: treated with a vascular laser that selectively constricts and destroys the vessels. There is little downtime, so it is comfortable to have done.
• Brown marks: as red marks settle, pigmentation follows over time. These respond to topical agents plus repeated toning laser sessions.

Vascular and toning (Nd:YAG) lasers can also support collagen synthesis to aid scar regeneration, and combining them tends to give a better effect.

2. Depressed scars

Depressed scars are not easy to treat and call for combined therapy.

• Fractional (Fraxel) laser: alongside CO₂ and erbium lasers that resurface by damaging the surface, there are fractional lasers that preserve the surface and form heat columns in the dermis only.
• Pico fractional laser: treats rolling and boxcar scars by penetrating deep without damaging the surface. It creates tiny channels under the skin to promote collagen, lift the depressed scar and tighten pores. Downtime is usually within 5–7 days.
• Injection: Juvelook (a collagen-stimulating injectable) and filler are used to lift depressed scars, with little downtime.
• Subcision: used to cut the fibrous tissue that pulls the scar downward.
• Microneedling: fine needles create channels in the skin and allow needed agents to penetrate.
• Radiofrequency (RF): devices such as RF microneedling, Thermage and Oligio apply heat to regenerate dermal collagen and improve pores, scars and texture.
• PRP (platelet-rich plasma): a small blood sample is drawn, processed and injected back into the skin.

3. Raised scars

Hypertrophic and keloid scars are treated with ablative (resurfacing) laser, injections, and vascular laser.

These are gathered together in our acne scar treatment, and for extensive or long-standing scars in advanced scar treatment. (If you'd like to understand how a dermatologist chooses which tool for which scar, see how a dermatologist picks the tool.)

Bottom line: there are many treatment options, and the right one differs by scar type, visit frequency, budget and downtime. Rather than searching for a single "best" procedure, I decide the treatment that suits each individual through consultation. So — can acne scars improve? Yes, they can. The starting point is an accurate diagnosis of what kind of scar you actually have.

Medical disclaimer. This article is general information and does not replace individual consultation. Treatment methods and results vary with each person's skin condition; raised scars and keloids in particular require diagnosis before laser or injection. The choice, number and downtime of procedures should be decided after an in-person consultation with a dermatologist.