Per Acne.org, the skin should first be free of acne before you can start addressing scar treatments. Various treatments will be better for some than others as they address different types of acne scarring. Scarring can be shallow and cover large areas of the skin to deep individual scars. Dermatologists will often combine treatments, especially for those who suffer multiple types of scars.
Chemical Peels
Chemical peels are used to treat shallow, depressed scars. Various forms of acid are selected depending on the depth of peel needed to remove the top layers of skin. According to the American Academy of Dermatology, light peels require no downtime, while deeper peels can require up to two weeks to allow the skin to heal. Several treatments may be required, and Acne.org readers give an average rating of three out of five for effectiveness.
Fillers
Filler treatments, also known as augmentation, are used to treat deeper scars. Fillers such as forms of collagen, hyaluronic acid, PMMA (polymethylmethacrylate), fat from the patient or other types are injected under the scar to raise it to be even with the skin's surface. Most fillers are temporary, however, and will require regular treatments every six months or so to maintain the desired effect. PMMA is the only permanent filler, and using the patient's own body fat usually lasts one to three years. Liposuction is required to use body fat and downtime may be required for that process.
Resurfacing
Skin resurfacing treatments remove the top layer of skin, the epidermis. This allows for new skin to form. This can be done with either laser resurfacing or dermabrasion. Laser resurfacing uses a laser to remove the epidermis while heating the sublayers of the skin, forcing the production of collagen. Dermabrasion is the use of an electric tool with rotating wire brushes that scrape away the skin's surface. Both treatments will require some downtime to allow the skin to heal properly.
Punch Techniques
Punch techniques are used to treat individual, deep scars using a process similar to that of a hair transplant. The scar is literally punched out of the skin. The wound is either covered with a skin graft or is closed and allowed to heal. In elevation techniques, the scar is left in the skin instead of removed and is allowed to float to the skin's surface. Punch treatments are often combined with resurfacing treatments.
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