Acne scars improve, but they do it slowly. Knowing what to expect at each stage makes the process far less frustrating. This is a typical journey; your plan will depend on your scars and your skin.
Before treatment: the consultation
The dermatologist will:
- identify your scar types: rolling, boxcar, ice-pick, raised, or a mix (most people have a mix);
- separate true scars from red or brown marks, which fade with different, simpler treatment;
- check that acne is under control, and treat it first if not;
- ask about medicines (such as isotretinoin), keloids, cold sores and how much downtime you can manage.
You should leave with a written plan: which treatments, roughly how many sessions, how far apart, and an indicative cost. See acne scars for the scar types.
The plan: combining treatments
No single treatment suits every scar, so plans often combine:
- Subcision for rolling scars, to release the bands pulling the skin down. See RF subcision.
- Microneedling radiofrequency (MNRF) or fractional CO2 laser to remodel texture and boxcar scars. See CO2 vs MNRF.
- Targeted treatments for deep ice-pick scars.
- Non-ablative erbium glass laser where downtime must be minimal. See erbium glass laser.
Session one and the first month
- Downtime depends on the treatment: from a day or two of redness (MNRF, erbium glass) to about a week (fractional CO2).
- In the first weeks you may see little change, or even feel scars look more obvious while the skin heals. This is normal.
- Sun protection is essential to avoid dark marks on healing skin.
Months two to three: sessions two and three
- Sessions are usually four to six weeks apart.
- Many people notice the first real softening of scar edges and smoother texture around now.
- Photos taken in the same light and position help you see progress that is hard to judge in the mirror.
Months four to six: completing the course
- Further sessions build on the earlier ones; rolling scars released by subcision often show the most visible change.
- Typical plans involve three to six sessions, sometimes more for deep or extensive scarring.
After the last session
- Collagen keeps remodelling for six months or more. Many people see their best result well after treatment ends.
- A review visit helps decide whether any areas would benefit from a further session.
Protecting your result
- Keep acne controlled: new pimples can make new scars.
- Sunscreen daily, especially on brown skin.
- A simple routine, perhaps with a retinoid if your doctor suggests it.
Setting expectations
Most people get a clear, visible improvement, often a large one, but rarely perfectly smooth skin. A good plan, patience and protection make the difference. Read about our acne scar treatment, including the cost range.
