Will My Acne Scars Ever Go Away Completely?
It’s one of the most common questions we hear: “Will these scars ever fully disappear?” The honest answer is nuanced. It depends on the type of scar, your skin, and the treatments you pursue. Here’s everything you need to know.
A scar is the body’s natural way of healing and replacing lost or damaged skin, and scars are usually composed of fibrous tissue. This fibrous tissue, made primarily of collagen, replaces normal skin after injury and has a different structure and function than the original tissue.
Acne is already difficult enough to live with. But for many people, the real frustration begins after the breakouts clear: when they’re left staring at a patchwork of red marks, pits, or raised bumps that seem to have taken permanent residence on their skin. Acne is the most common skin condition in the world. If you’ve found yourself Googling “do acne scars go away?” at midnight, you’re far from alone.
The short answer: some marks do fade on their own, but true acne scars, the kind that involve structural changes to your skin, rarely disappear without intervention. Acne lesions occur when bacteria, oils, and dead skin cells clog and inflame the pores of the skin. Sebaceous glands, which are concentrated in areas like the face, back, and chest, play a key role in this process. Hormonal changes during puberty increase oil production in these glands, making these areas more prone to acne and subsequent scarring. The good news is that modern dermatology offers highly effective treatments that can dramatically reduce their appearance, and in many cases, deliver results that are as close to “gone” as your skin can achieve.
First: Understand what scar tissue you’re actually dealing with
Not every dark mark or rough patch left by acne is technically a “scar.” Knowing the difference is the first step toward understanding what will (and won’t) heal on its own.
Post-inflammatory hyperpigmentation (PIH)
Flat, dark spots left after a pimple heals. These are not true scars: they’re discoloration and often fade on their own over weeks to months. Post-inflammatory hyperpigmentation is a flat, discolored mark left after acne heals, and is often mistaken for a permanent scar.
Post-inflammatory erythema (PIE)
Pink or red flat marks are more common in fair skin. Also not structural scars: they indicate residual inflammation and typically improve over time.
Atrophic scars
Depressed scars (icepick, boxcar, rolling) caused by collagen loss during healing. Boxcar scars are broad, shallow depressions with well-defined edges due to collagen loss. These do not self-resolve and require professional treatment.
Hypertrophic & keloid scars
Raised scars from excess collagen production. More common on the chest, back, and jawline. These require specific clinical management.
Rolling scars
Rolling scars create a wave-like texture on the skin due to fibrous bands forming between the skin and tissues.
PIH and PIE marks can absolutely fade on their own: with time, sun protection, and sometimes topical treatments. True atrophic or raised scars, however, involve permanent structural change to the dermis. They won’t “go away” without targeted treatment.
Scar formation is a complex process in wound healing, involving the activity of collagen fibers. The healing process of a scar involves the formation of a provisional matrix, followed by collagen deposition, which results in a dense collagen scar that differs in texture and quality from the surrounding tissue. The healing process and treatment strategies should also consider the surrounding skin to optimize healing and cosmetic outcomes. Scars can form differently based on the location of the injury on the body and the age of the person, with more severe initial damage generally leading to more significant scarring.
Types of acne scars — why it matters
Not all acne scars are created equal, and understanding the specific type of scar you have is the first step toward choosing the right treatment. Acne scars generally fall into three main categories: atrophic, hypertrophic, and keloid scars.
Atrophic scars are the most common type, appearing as depressions or pits in the skin. These scars form when the skin loses tissue during the wound healing process, often due to a breakdown of collagen. Common subtypes include icepick, boxcar, and rolling scars. Because atrophic scars are caused by a loss of collagen, treatments like laser resurfacing, chemical peels, and procedures that stimulate collagen production are often recommended.
Hypertrophic scars are raised, thickened scars that stay within the boundaries of the original acne wound. They result from the body producing too much collagen during healing. These scars can feel firm or rubbery and may be itchy or uncomfortable. Treatments for hypertrophic scars often include steroid injections to reduce inflammation and flatten the scar, as well as laser resurfacing to improve texture.
Keloid scars are a more aggressive form of hypertrophic scar. They not only rise above the skin but also extend beyond the original wound site. Keloid scars can be particularly challenging, as they may continue to grow over time and can cause discomfort or itching. Managing keloid scars often requires a combination of therapies, such as steroid injections, laser treatments, and sometimes surgical removal followed by additional treatments to prevent recurrence.
Knowing your scar type is crucial because each responds differently to treatment. For example, while laser resurfacing and chemical peels can help improve atrophic scars, keloid scars may require a more tailored approach involving steroid injections or other specialized therapies. By identifying your scar type, you and your dermatologist can develop a treatment plan that targets your unique skin concerns and maximizes your chances of smoother, healthier-looking skin.
Why do keloid scars not heal on their own?
When acne causes deep inflammation, it can damage the collagen and elastin framework beneath your skin. During the healing process, the body produces either too little or too much collagen and fibrous tissue, leading to different scar types. Too little collagen and fibrous tissue results in a depression, while too much leads to a raised scar. Once this structural change sets in, especially in the case of deeper scars, the skin no longer has a natural mechanism to reverse it, unlike a surface-level wound or bruise.
Think of it like a dent in a wall. The paint might look fine eventually, but the dent itself stays until someone actively repairs it. Inflammation from acne blemishes can lead to the breakdown of the pore wall, and if the contents spill into surrounding tissue, it can result in deeper scars due to more severe tissue damage. That’s exactly what professional scar treatments do: they stimulate your body’s own healing responses, in a controlled way, to rebuild the damaged tissue.
What treatments actually work — and what to expect
Acne scar treatment has advanced significantly in recent years. The right approach depends on your scar types, skin tone, and how much downtime you’re able to accommodate — which is why a thorough in-person assessment always comes first.
There is no single treatment that works for every scar. Most patients see the best results from a combination of two or more modalities, selected and sequenced based on their individual presentation. Here are the most evidence-backed treatment options we use at our clinic.
Fractional laser resurfacing
Laser therapy, including both ablative and nonablative laser treatment, is considered the gold standard for treating atrophic scars. Ablative lasers, such as carbon dioxide (CO2) and Er:YAG lasers, remove the top layer or layer of skin to improve the appearance of acne scars and treat wrinkles, but have longer healing times and greater risks. Nonablative therapy is a minimally invasive option with shorter healing times and fewer risks, though it may offer only minor improvements for some scar types. Both types of laser therapy can also be used to treat sun-damaged skin and wrinkles, and are effective at improving the appearance of scars. Proper care of the treatment area after laser treatment is essential for optimal healing. Both types stimulate collagen remodeling over several months following treatment. Most patients require a series of sessions for meaningful improvement, and diligent sun protection afterward is essential to protect the healing skin and prevent pigmentation changes.
Subcision
Subcision is a minimally invasive procedure where a fine needle is used to break the fibrous bands tethering depressed scars to the underlying tissue. This allows for new collagen deposition and cosmetic improvement. It is particularly effective for rolling scars and is often combined with other treatments such as fillers or microneedling for enhanced results. Results continue to improve over weeks as collagen remodels. Subcision is frequently combined with fillers such as Poly-L-lactic acid in the same session to amplify and extend the outcome.
Dermal fillers
Poly-L-lactic acid (PLLA) is particularly well-suited to acne scarring: rather than simply filling space, it stimulates your skin to produce its own collagen over time, addressing both the immediate volume deficit and the longer-term structural depletion that causes scars to look sunken.
Chemical peels
Medium-to-deep chemical peels (TCA CROSS) target the top layer or layer of skin to promote regeneration, accelerate cell turnover, and improve skin texture. These treatments can also be used to treat sun-damaged skin and wrinkles, and are especially effective for PIH and superficial scarring. Chemical peels are best used as part of a multimodal approach tailored to specific scar types, often in combination with other treatments to improve the appearance of the skin.
A multimodal approach tailored to specific scar types is often required for effective acne scar reduction. A physical exam is performed to determine the best treatment plan for each patient, and post-procedure care of the treatment area is important to monitor for complications.
Treatment risks and complications you should know
While today’s acne scar treatments can deliver impressive results, it’s important to be aware of the potential risks and complications associated with each option. Every treatment, whether it’s laser resurfacing, chemical peels, steroid injections, or scar revision surgery, comes with its own set of considerations.
Laser resurfacing is a powerful tool for improving scar texture, but it can sometimes lead to post-inflammatory hyperpigmentation (PIH), especially in people with darker skin tones. This means the treated area may develop dark spots as it heals. We advise our patients to pre-treat and post-treat with our brightening pads made in clinic to prevent PIH.
Chemical peels can help fade discoloration and smooth the skin, but they may cause temporary irritation, redness, and peeling.
Steroid injections are commonly used to flatten raised scars, such as hypertrophic and keloid scars. However, overuse or improper technique can lead to thinning of the skin or lightening of the treated area.
Because everyone’s skin is unique, it’s essential to discuss your medical history, skin type, and treatment goals with a qualified healthcare provider before starting any procedure. A thorough consultation will help you understand the potential benefits and risks, so you can make an informed decision about your care and minimize the chances of unwanted side effects.
Post-treatment care: maximizing your results
Getting the best results from your acne scar treatment doesn’t end when you leave the clinic—what you do at home is just as important. Proper post-treatment care helps your skin heal, reduces the risk of complications, and ensures you get the smoothest, most even-toned results possible.
After procedures like laser resurfacing or chemical peels, your skin will be more sensitive than usual. It’s crucial to follow a gentle skin care routine: cleanse with a mild, non-irritating cleanser, avoid harsh scrubs or exfoliants, and keep your skin well-moisturized. Sun exposure can worsen discoloration and slow healing, so always use a broad-spectrum sunscreen and consider wearing a wide-brimmed hat or seeking shade when outdoors.
Your provider may recommend topical steroids or other prescription creams to reduce inflammation and support the healing process. If you’ve had a surgical procedure, such as scar revision surgery, you’ll likely receive specific wound care instructions—these may include applying ointments, keeping the area clean and covered, and watching for signs of infection. It’s important to note that sweat glands do not regenerate within scar tissue, which can impair temperature regulation and affect skin function in the treated area.
By sticking to your post-treatment care plan and communicating with your healthcare provider about any concerns, you’ll help your skin recover more quickly and achieve the best possible improvement in your scars.
Preventing future scars: what you can do now
While treating existing scars is important, preventing new ones is just as crucial for maintaining healthy, even-toned skin. Scar formation is influenced by how your skin heals after injury, sun exposure, and your daily skin care habits. By taking proactive steps, you can help your skin heal more smoothly and reduce the risk of developing deeper scars, raised scars, or unwanted discoloration.
Prioritize sun protection. Sun exposure is one of the leading causes of sun damage, which can worsen the appearance of scars, trigger age spots, and slow down wound healing. Always apply a broad-spectrum sunscreen with at least SPF 30 to all exposed skin, even on cloudy days. Reapply every two hours, especially if you’re outdoors, swimming, or sweating. Protective clothing and seeking shade during peak sun hours can further shield your skin from too much sun.
Practice proper wound care. When you have a cut, scrape, or breakout, keeping the wound clean and moist is essential for optimal healing. Gently cleanse the area with mild soap and water, then apply a thin layer of antibiotic ointment or a recommended wound healing product. This helps prevent infection and supports the formation of healthy new skin, reducing the risk of hypertrophic scars or keloid scars.
Don’t pick or squeeze. Picking at scabs, pimples, or healing wounds can disrupt the natural repair process, leading to deeper scars or raised scars. Allow scabs to fall off naturally, and resist the urge to squeeze blemishes. This simple habit can make a significant difference in how your skin heals.
Consider silicone gel or sheeting. For areas prone to raised scars, such as hypertrophic scars or keloid scars, silicone gel or sheeting can help flatten and soften scar tissue. These products create a protective barrier over the treatment area, supporting collagen production and improving the appearance of scars over time.
Explore laser skin resurfacing for early scars. If you notice new scars forming, consult your healthcare provider about laser resurfacing. Laser skin resurfacing uses targeted light energy to remove the top layer of skin, stimulate collagen production, and improve the appearance of both scars and wrinkles. Early intervention can help prevent scars from becoming more pronounced.
Maintain a consistent skin care routine. Healthy skin is more resilient and better able to heal after injury. Use a gentle cleanser, moisturize daily, and avoid harsh products that can irritate or dry out your skin. Keeping your skin hydrated supports the natural wound healing process and helps minimize scar formation.
Limit sun exposure and avoid tanning. Too much sun can not only cause sun damage and premature aging but also darken scars and make them more noticeable. In addition to sunscreen, wear hats, sunglasses, and protective clothing when spending time outdoors.
Support your skin from within. A balanced diet rich in certain vitamins, such as vitamin C and zinc, can promote healthy skin and efficient wound healing. These nutrients play a key role in collagen production and the repair of the skin’s top layer.
Avoid smoking. Smoking impairs blood flow and slows down the body’s ability to heal wounds, increasing the risk of deeper scars and delayed recovery. Quitting smoking can significantly improve your skin’s healing capacity.
Consult a dermatologist for personalized advice. If you’re concerned about scar formation or want to learn more about prevention, a board-certified dermatologist or healthcare provider can assess your skin type, medical history, and risk factors. They can recommend tailored strategies and, if needed, early interventions like laser therapy or other cosmetic procedures to improve the appearance of scars.
By making these habits part of your daily routine, you can help your skin heal more effectively, reduce the risk of new scars, and maintain a smoother, healthier complexion for years to come.
Realistic expectations: how much improvement is possible?
We believe in setting realistic expectations — it’s the foundation of good care. With the right treatment plan, most patients can achieve a 50–80% improvement in scar appearance. Some achieve even more, particularly those who begin treatment early and commit to a full protocol.
“Complete” erasure is rare for deep atrophic scars, because some degree of structural change will always exist beneath the surface. However, the visible difference after expert treatment can be so significant that scars are no longer noticeable in normal daily life, without makeup, under natural lighting, which for most of our patients, is life-changing.
Several factors influence your outcome: scar depth and type, your skin tone, your age (younger skin tends to respond more vigorously), and how consistently you protect your skin from UV exposure during treatment. For example, hypertrophic scars tend to be red in lighter skin tones and dark brown in individuals with darker skin. Hypertrophic scars are raised scars that remain within the boundaries of the original wound, while keloid scars extend beyond the original wound area and can grow indefinitely. We assess all of these at your consultation to give you a personalized prognosis.
The role of timing — why earlier is better
One of the most important factors in scar treatment outcomes is how soon you seek care. Scars that are less than a year old are generally more responsive to treatment — the remodeling process is still somewhat active, and treatments can better redirect it. Older, more established scars can absolutely still be improved, but they typically require more sessions and combination approaches.
Additionally, it’s essential to ensure active acne is under control before beginning scar treatment. Treating scars while new breakouts continue is counterproductive — like filling holes in a bucket that’s still being punctured. Our team can help you address both simultaneously with a coordinated plan.
Our take
Cost, insurance, and finding the right provider
The cost of treating acne scars can vary widely, depending on the type of treatment, the number of sessions needed, and the expertise of your provider. Insurance coverage for acne scar treatments is often limited, as many procedures are considered cosmetic rather than medically necessary. It’s important to check with your insurance provider to understand what, if any, portion of your treatment may be covered.
When choosing a provider, look for a board-certified dermatologist or plastic surgeon with experience in treating acne scars. A skilled provider will assess your scars, discuss your goals, and recommend a personalized treatment plan that fits your needs and budget: helping you achieve the best possible results safely and effectively.
The bottom line
Flat discoloration (PIH/PIE) has a good chance of fading significantly on its own, especially with diligent sun protection and appropriate skincare. True structural acne scars, the pits, rolling depressions, and raised tissue, will not resolve without treatment, but they are very treatable. The most common types of acne scars include atrophic scars, hypertrophic scars, and keloid scars.
Modern scar treatments don’t just mask scarring: they actually stimulate your skin’s biology to rebuild. The results can be profound. The key is getting an accurate assessment of what you’re dealing with, creating a personalized plan, and committing to it with patience.
You don’t have to just “live with” acne scars. And you don’t have to navigate this alone.
Ready to understand your scars and your options?
Our providers at the Scar Healing Institute specialize in scar assessment and personalized treatment planning.
