Ask a Dermatologist: How to Get Rid of Pitted Acne Scars

Give Your Skin a Deep, Exfoliating Clean With Salicylic Acid

Salicylic acid is a beta-hydroxy acid that is lipophilic, which means it likes to mingle with oils. This property allows it to penetrate deep into pores and clean them out. Alpha hydroxy acids, like glycolic and lactic acids, are hydrophilic, so they don’t penetrate pores as well, but they are effective at exfoliating dead skin and preventing pores from clogging. Camp suggests cleansing with this gentle face cleanser by CeraVe, which contains salicylic acid and can be used to treat acne on the face, shoulders, and back.

Use Retinoids to Boost Collagen Production

Retinoids treat acne by regulating or normalizing the process of cell turnover, which prevents blocked pores and the formation of acne bumps. "The long-term use of retinoids is thought to help with collagen production," explains Camp. He recommends Differin gel, which used to be a prescription adapalene product but is now available to purchase in stores.

Try a Chemical Peel

A quality chemical peel can expose fresh, healthy tissue and stimulate the production of new collagen to make pitted scars look less pronounced, according to Camp. "Resurfacing procedures such as resurfacing lasers, chemical peels and dermabrasion are effective options, as is microneedling and even radiofrequency devices which work by stimulating the production of new collagen," says Weitz.

Gentle on the skin but tough on scars, chemical peels often get a bad rap for being harsh or painful, but when performed properly, they can provide deep exfoliation and are painless.

Give Microneedling With Radio Frequency a Try

Microneedling creates small, narrow, superficial areas of mechanical injury that work to stimulate the repair response, increase collagen production, and improve scar appearance. When combined with radio frequency, it becomes a bit more aggressive—with energy being released deeper within the skin to trigger a more robust inflammatory and collagen response.

Ask Your Dermatologist About Accutane

A common but powerful prescription medication, isotretinoin (also known as Accutane) is a prescription acne medication that is specifically indicated for scarring acne. When other forms of treatment have been ineffective and exhausted, Camp says that isotretinoin is helpful for providing a durable remission in scarring acne. You should only begin an Accutane prescription under the guidance of your board-certified dermatologist, and it can be helpful to go into your appointment with some background knowledge of its potential side effects.

Look Into Fraxel Laser Treatments

According to Camp, Fraxel lasers can be non-ablative, meaning that they emit columns of heat beneath the skin while leaving the surface intact, or ablative, which are more aggressive and remove a narrow column of skin. Non-ablative lasers are much less invasive than ablative, requiring multiple treatments for clinical results.

Consider a Subcision Procedure to Break up Scars

Performed in-office by a dermatologist, a subcision procedure involves breaking up the cord of scar tissue responsible for tethering the skin down and making a depression (the "pitted" part of the scar). During this procedure, a needle is inserted into the skin to break the collagen cord. Camp warns it can be associated with bruising, though.

Apply an Acne Gel to Exfoliate and Brighten

Azelaic acid is derived from grains and works to kill bacteria, exfoliate dead skin, and brighten skin complexion. Camp says that Acne Gel by PCA can either be used to treat the full face or as a spot treatment. It contains both azelaic acid and salicylic acid for extra exfoliation, revealing a smoother skin surface.

Try to Plump Indentations With Hyaluronic Acid

Injections with fillers, such as hyaluronic acid, can push out and plump up puckered skin to make it more even. Camp explains that hyaluronic acid "is a natural component of the extracellular matrix, the gel that surrounds skin cells and adjoining structures."

Try Dermabrasion to Slough Scars Away

Dermabrasion (of varying depths) works in a way that's similar to chemical peels, except the process uses an abrasive, exfoliating material to remove the top layer of skin, instead of a liquid chemical. Even more, dermabrasion can help with breakouts and reduce excess oil in pores.

Tighten Your Skin With Professional Radio Frequency

Skin tightening with radio frequency energy can help make depressed scars less obvious. It creates kinetic energy that triggers the body's healing process. As a result, skin produces more collagen and softens the appearance of scars.