We Ask a Derm: What is the Best Laser Treatment for Acne Scars?

Before we dive into lasers, let’s start by clearing up a common misconception that often comes up when discussing acne scars: discolored spots left over from a recent breakout are not technically acne scars. They’re classified as post-inflammatory hyperpigmentation.

“Often, after breakouts heal, they leave behind a reddish or brownish spot. This is not a true scar, as the marks are surface level and are temporary,” explains Dr. Azadeh Shirazi, a board-certified dermatologist at La Jolla Laser Dermatology in California. Though certainly annoying, they tend to fade with time (in 3 to 6 months, to be more specific).

However, you could speed up that process a little by using skincare ingredients like retinol, which “renew the skin cells and stimulate new collagen,” says Shirazi. “Other ingredients that can help lighten the pigment left behind include kojic acid, hydroquinone, niacinamide, arbutin and vitamin C.”

All of this to say that Shirazi recommends tackling hyperpigmentation with skincare (ideally, topical prescriptions or a series of in-office chemical peels) as your first line of treatment, as “high energy lasers can sometimes cause inflammation, which can actually worsen hyperpigmentation."

OK, but are there lasers that are effective at treating hyperpigmentation?

Say you still want to go the laser route (because of time or perhaps you have a single stubborn spot or two that you’d like to target), in these cases, Shirazi prefers a light resurfacing laser like Clear and Brilliant or a light fractionated erbium laser such as the ProFractional.”

What if my acne scars are pitted or indented? What can I do about them?

“Acne scars vary in depth and size and have various names to describe them like icepick, rolling, boxcar and atrophic scars,” explains Shirazi. “Depending on which kind you have, they will be targeted using different treatments,” she adds.

“In general, ablative lasers such as the Erbium or CO2 are the most effective for indented scars. They tend to have the best results in fewer treatments but also involve a greater downtime and recovery process,” says Shirazi. (We’re talking a full week to 10 days here, so keep that in mind if you have any upcoming events.)

If you don’t have the luxury of committing to a lengthier recovery period, Shirazi recommends trying a “non-ablative resurfacing laser, such as Fraxel or Halo, which are less aggressive and involve less downtime, as the laser’s beams penetrate deep into the skin without affecting the surface layer as much.”

In addition to lasers, dermal fillers (like the ones that you’ve probably come to associate with plump lips on Instagram) can be used to “further raise indented scars and blend them into the surrounding skin.”

How many treatments are required to see best results and how far should they be spaced apart?

“Acne scars are challenging and often require multiple sessions to get optimal results,” says Shirazi. “Typically, most people require 3 to 6 sessions spaced out every 6 to 8 weeks.”

Anything else to consider before scheduling an appointment?

“Laser resurfacing should only be performed by a trained cosmetic and board-certified dermatologist, as they require precision and experience to prevent any unintended damage,” cautions Shirazi. As she mentioned above, certain lasers (especially high energy ones) can sometimes cause hyperpigmentation, which is a bigger risk if you have darker skin.

And don’t forget: Newly resurfaced skin is even more sensitive to the sun, so make sure to slather on a broad-spectrum SPF of at least 30 every time you head outdoors. (Yes, even when you’re just taking your pup out for a quick stroll around the block. If you’re spending more than two hours in the sun, reapply.)

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