Laser Treatment for Acne Scars

Laser treatment can soften the appearance of many acne scars by smoothing the edges of indented areas and stimulating new collagen underneath. It usually takes a series of sessions, and the realistic goal is improvement rather than erasing scars completely. Some scar types respond well to laser, while others need different techniques first or alongside it.

First, make sure acne is under control

Scar treatment is most effective once active acne has settled. New breakouts can create new scars, and treating inflamed skin raises the risk of infection and pigment problems. If you still have regular breakouts, the priority is getting acne treated, often with your family doctor or a dermatologist. Medical options can include topical treatments, oral medications and, for some people, isotretinoin.

If you have taken isotretinoin, tell your clinician when you stopped. Laser timing after isotretinoin is something to discuss carefully, as recommendations on waiting periods have evolved and depend on the type of treatment.

Not all acne scars are the same

Acne scars are usually described by their shape. Most people have a mix.

• Rolling scars are broad, shallow dips with soft, sloping edges, giving skin a wavy look. They are caused by bands of scar tissue tethering the skin to deeper layers.
• Boxcar scars are round or oval depressions with sharper, well-defined edges, a bit like a chickenpox scar.
• Ice pick scars are narrow, deep pits that look like small punctures. They can extend quite deep into the skin.
• Raised scars (hypertrophic or keloid) sit above the skin and are more common on the chest, back and jawline. These are managed differently.

Scar depth, how many scars there are, and where they sit on the face all influence what is realistic. Lighting matters too: scars that look obvious under overhead bathroom light may be barely visible in daylight, so assessment is usually done under several angles of light.

Red or brown marks left after a pimple heals are not true scars. They often fade on their own over months with sun protection, and may respond to different treatments than textured scars.

What laser can do for each type

Boxcar scars, especially shallow ones, often respond well to resurfacing. The laser softens the sharp edges so they cast less shadow, while new collagen gradually lifts the base.

Rolling scars can improve with fractional resurfacing and heat-based collagen stimulation, but the tethering bands underneath may limit results. Combining laser with subcision, a procedure that releases those bands with a needle, is often considered.

Ice pick scars are usually too deep and narrow for laser alone. Techniques such as focal chemical treatment or small punch procedures, done by a suitably trained physician or dermatologist, may be needed first, with laser used afterwards to blend the surface.

The Er:YAG wavelength is commonly used for scar resurfacing, either full-field or fractional. Deeper fractional columns are often favoured for scars because they reach below the surface while healing relatively quickly. See fractional vs full-field resurfacing for how these approaches differ.

Why a series is usually needed

Scar tissue remodels slowly. Each session produces a modest change, and collagen continues to build for months afterwards. A series of treatments, commonly spaced four to eight weeks apart, is typical, though the exact number depends on scar depth, skin type and the settings used.

Between sessions, skin needs time to heal fully and for any redness to settle before the next treatment. Rushing the schedule does not speed up collagen building and can increase the chance of irritation and pigment changes. Daily broad-spectrum sunscreen throughout the series protects the new skin and helps results look more even.

Progress is easier to see in photos taken under the same lighting than in a mirror. Most people notice gradual softening rather than a sudden change. Results vary from person to person, and some scarring often remains.

Combining laser with other methods

Because acne scars are usually mixed, combination plans are common. Options that may be discussed include:

• Subcision for tethered rolling scars
• Focal treatments for ice pick scars
• Microneedling, which may suit some people, particularly those with darker skin
• Hyaluronic acid filler to lift selected broad depressions
• Chemical peels and a consistent skincare routine for overall tone and texture

Treatments are usually staged rather than all done at once. Not every option suits every person, and some may need a referral.

A typical staged plan might address tethered or deep scars first, then use laser sessions to refine the overall surface. Your clinician should explain what each step is meant to achieve, how much recovery it involves, and how it fits with your budget and schedule, so you can decide which parts are worthwhile for you.

Who should not have laser for scars, or should wait

Treatment is usually postponed or avoided if you:

• Have active acne, an infection or a cold sore in the area
• Are pregnant or breastfeeding
• Have recently used isotretinoin, until timing has been discussed
• Have a tan or expect significant sun exposure in the weeks around treatment
• Have a history of keloids or raised scarring
• Have a condition or take medication that impairs healing

Never stop a prescribed acne or other medication yourself to fit a treatment schedule. Talk to your prescriber.

Risks to understand

Redness, swelling, flaking and a rough feeling are expected for days to a week or more, depending on depth. Possible risks include infection, cold sore flares, acne breakouts during healing, prolonged redness, and pigment changes. Darker patches are more likely in medium to dark skin and usually fade with time and sun protection; lighter patches are less common but can last longer. New scarring is uncommon but possible.

Frequently asked questions

Are old scars harder to treat than new ones?

Not necessarily. Settled scars of many years can still improve. What matters more is the scar type and depth.

Can scars on the back or chest be treated?

Sometimes, but skin there heals differently and raised scars are more common, so a careful assessment comes first.

How will I know if laser is worth it for me?

An in-person look at your scars in good lighting is the key step. For some people, the improvement likely from laser is small enough that another approach, or no treatment, is the more sensible choice.

HealthPark Medical Aesthetics can assess your scar types and skin at a consultation and talk through whether laser, another method, or a referral is the right next step.