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Acne scarring can be devastating! Many people call the discoloration left by acne “acne scarring,” but this discoloration, which can persist in some cases for over a year, is not really scarring and will eventually go away. True acne scarring is when the texture of the skin, not the skin’s color, is disrupted. Unlike discoloration left by acne, true acne scarring is considered permanent. Even though it may appear otherwise, true acne scarring is not a surface phenomenon. Instead, acne scarring takes place below the surface of the skin in the dermis. So, don’t waste your money on microdermabrasion, peels, creams or other topical treatments that will not get to the root cause of the problem.

“Ice pick” acne scarring is considered a small focal indentation. It is typically best treated by cutting out the scar. You will still have a scar, but the scar won’t be indented. It will be flush with the surrounding skin and much less noticeable. Undulating, or wavy, acne scarring is more difficult to treat. If it is widespread, you may benefit most by something radical, such as full facial resurfacing, which is similar to a deep burn with months of recovery. Fractionated lasers that drill holes at intervals in the skin may be helpful as well. Typically the results are not quite as dramatic, but it is a much easier treatment to go through. If a scar is not “tethered down” from below it should be able to be pulled out by stretching the surrounding skin. If this stretching of the surrounding skin makes the scar disappear, that scar may be a good candidate for using filler below the scar. Sometimes, a combination of these treatments may work. Regardless of the treatment, however, these are typically relatively difficult treatments to go through.

Although I know many of you were hoping for a miracle cream, it just doesn’t exist! And I stress that you should not waste your money on creams that profess to help acne scarring—I can promise you they don’t. And if anyone has tried a cream that has actually helped with acne scarring, I would bet that that scar was not a true scar or the scar would have improved on its own.