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How to treat acne scars and hyperpigmentation, according to experts

Dermatologists share their tips for treating and avoiding scarring and color changes due to acne.
Dermatologists said the best way to avoid and treat acne scarring is by first treating the acne itself.
Dermatologists said the best way to avoid and treat acne scarring is by first treating the acne itself.Vivian Le / NBC

The first step to treating acne scarring is to do your best to prevent new acne from occurring in the first place (difficult, we know). Once that’s addressed as much as possible, the best results come from lasers, injections and fillers handled by medical professionals, experts told us.

Unfortunately, you won’t find many at-home remedies that’ll make acne scars disappear. “The effectiveness of topical over-the-counter products would be proportional to the severity of scarring and depth of scarring,” said Dr. Robyn Gmyrek, a board-certified dermatologist at UnionDerm in New York City. That means that, if the acne scars are deep or have created textural changes on the skin, OTC treatments won’t be very helpful.

There are, however, some treatments you can consider if you want to improve the appearance of acne scars and reduce hyperpigmentation (color changes) on the skin due to acne. To understand how some of these at-home treatments work — and what their limitations are — we consulted dermatologists and rounded up some OTC options to consider based on their guidance.

SKIP AHEAD Best treatments for acne scars and hyperpigmentation | What causes acne scars | Types of acne scarring | How to treat acne scars and discoloration

Our top picks

How we picked the best acne scar treatments

Proper treatment of both hyperpigmentation — which isn’t considered scarring since it typically goes away on its own — and acne scars requires work by medical professionals (all our dermatologists said so). You may, however, be able to reduce their appearance over time with OTC gels, serums and exfoliants depending on the severity and depth of scarring.

If you want to minimize the appearance of acne scars or hyperpigmentation, each of the products we highlight contain one or more of the below expert-recommended ingredients.

  • Retinoids: These are powerful acne treatments that can help reduce hyperpigmentation, skin discoloration and some skin scarring by increasing skin cell turnover and stimulating collagen. Experts told us prescription retinoids are the most effective topical treatments for acne scars. However, long-term use of adapalene — the only OTC retinoid currently on the market — can be helpful at reducing acne scarring. Retinol, which is derived from vitamin A and a weaker type of retinoid, can also be found over-the-counter and helps improve uneven skin tone and texture (though it may take a lot longer to work).
  • Azelaic acid: An ingredient often found in serums or gels, azelaic acid helps even out your skin tone and helps reduce the appearance of superficial marks and hyperpigmentation left behind by acne.
  • Vitamin C: A common skin care ingredient, vitamin C is an antioxidant that can help reduce and prevent the appearance of redness and mild color changes from acne.
  • Chemical exfoliants: Commonly found in both OTC and in-office face peels, exfoliating acids like alpha-hydroxy acids (AHAs) and beta-hydroxy acids (BHAs) can keep acne under control and fix uneven skin texture and discoloration.

Best treatments for acne scars and hyperpigmentation

If you need help creating a routine or just want professional guidance, the experts we consulted recommended consulting your local board-certified dermatologist first. To that end, we highlighted a few dermatologist-recommended products that can help treat your current breakouts, minimize the appearance of acne scars and prevent them from forming.

Differin Gel

Differin Gel contains 0.1% adapalene, the “strongest OTC retinoid without a prescription,” said Gmyrek, and can help prevent breakouts, treat acne and improve acne scarring and hyperpigmentation. Most of our experts highlighted Differin Gel’s benefits, which include increasing cell turnover and stimulating collagen to help mild scarring and pigment go away over time. They advised using it only a few times a week to start and increasing the frequency to once daily as necessary.

La Roche-Posay Effaclar Adapalene Gel

Dr. Michele Farber, board-certified dermatologist at Schweiger Dermatology Group, recommended La Roche-Posay’s adapalene gel as another OTC retinoid to consider. It contains 0.1% adapalene to help unclog pores, fight acne and reduce the appearance of scars and discoloration.

The Ordinary Azelaic Acid Serum

Experts previously recommended this serum from The Ordinary in Select’s guide on azelaic acid, since it can help improve both blemishes and dark spots. The serum contains 10% azelaic acid and is gentle enough to use up to twice a day, according to the brand.

SkinBetter AlphaRet Overnight Cream

Gmyrek recommended SkinBetter’s AlphaRet Overnight Cream because it combines lactic acid — a type of AHA — and retinol to stimulate collagen. It also contains hydrating ingredients like squalane, niacinamide and ceramides to avoid dryness from the retinol, the brand says.

Farmacy 1% Vitamin A Retinol Serum

Gmyrek said this serum from Farmacy is a “strong retinol” that can help reduce the appearance of acne scars over time. This 1% vitamin A retinol serum can not only improve skin texture, but it can also target fine lines and wrinkles, according to the brand.

Peter Thomas Roth Retinol Fusion PM Night Serum

One of our favorite retinol serums, Peter Thomas Roth’s Retinol Fusion PM Night Serum contains 1.5% retinol, which is on the higher side for retinol products. The brand says the retinol is “time-released,” meaning your skin receives continuous bursts of retinol across 8 hours. The nighttime serum is also formulated with vitamins C, vitamin E and squalane to moisturize the skin, according to the brand.

SkinCeuticals CE Ferulic Serum

“Vitamin C can help to brighten the skin and, because it’s an antioxidant, it helps protect against some environmental damage,” Farber said. She recommended the SkinCeuticals CE Ferulic Serum, which is formulated with a combination of l-ascorbic acid (the most powerful form of vitamin C), vitamin E2 and ferulic acid.

Vichy LiftActiv Vitamin C Brightening Serum

Vichy’s LiftActiv Vitamin C Serum, recommended by Farber, contains 15% pure vitamin C to even out skin tone and protect the skin from the discoloration. It’s recommended for all skin types and offers a fragrance- and paraben-free formula, according to the brand.

SkinMedica AHA/BHA Exfoliating Cleanser

Dr. Marisa Garshick, a board-certified dermatologist at MDCS Dermatology in New York City, noted that exfoliating acids, including salicylic acid, lactic acid, and mandelic acid, can get rid of dead skin cells to help improve the appearance of dullness, while also improving the appearance of hyperpigmentation. She recommended using exfoliating acids with retinoids that stimulate collagen production to help reduce the appearance of scarring over time.

This exfoliating cleanser from SkinMedica contains four AHAs — lactic, glycolic, citric and malic acids — and salicylic acid, a popular beta-hydroxy acid. It also contains tocopheryl acetate — a stabilized form of vitamin E — and pro-vitamin B5, both of which are humectants and emollients to combat dryness and irritation, according to the brand.

Dr. Dennis Gross Skincare Alpha Beta Universal Daily Peel Pads

Another option containing AHAs and BHAs, this daily peel from Dr. Dennis Gross Skincare is separated into two steps: The first peel contains AHAs like glycolic acid, lactic acid and malic acid to exfoliate the skin and improve texture and tone, while the second peel is formulated with retinol and antioxidants for anti-aging benefits. The brand says these peel pads can be used twice daily and they come in a pack of five, 30 or 60 treatments.

EltaMD UV Clear Sunscreen

“Your sunscreen is very important because consistent sun exposure is going to contribute to a worsening appearance of dark marks or scarring,” Farber said. The EltaMD UV Clear Sunscreen is a favorite among our experts for those with acne-prone skin and rosacea since it’s free of heavy moisturizers that can clog pores. The mineral-based sunscreen offers SPF 46 protection and contains niacinamide, which experts told us acts as a natural anti-inflammatory.

Colorescience Sunforgettable Total Protection Face Shield Flex

Farber recommended tinted sunscreens “if you’re looking for a bit of coverage” to cover any spots (like a foundation) while protecting your skin from the sun. Farber said she’s a fan of the Colorscience Total Protection Face Shield Flex, which provides a lightweight tint and SPF 50 protection. The mineral sunscreen has a hypoallergenic, fragrance-free formula and it’s water- and sweat-resistant for up to 40 minutes, according to the brand.

What causes acne scars?

Before you choose an at-home treatment, it's important to understand what type of scarring you have: What most people consider acne scarring could actually be post-inflammatory hyperpigmentation (dark spots caused by the body’s response to acne and eczema). Since people with darker skin tones naturally have more melanin in their skin, they are more likely to experience hyperpigmentation due to those inflammatory skin issues. While experts told us that hyperpigmentation can fade away on its own within around six to 12 months, true acne scarring causes stubborn, textural changes to the skin like roughness, indentations or bumps.

“Acne scars are the result of the body’s reaction to the inflammation that occurs within and surrounding a pimple or acne cyst,” Gmyrek said. “If the inflammation results in collagen destruction, there’s a loss of skin tissue that leads to pitting or indentations in the skin, called atrophic scars. If there’s too much collagen stimulation, then raised hypertrophic scars appear,” she said. (We go into more detail on the types of acne scarring below.)

Inflammation from blackheads, whiteheads and cystic acne — large and sometimes painful breakouts — can damage skin tissue and result in acne scars. But the best way to avert them is to treat and prevent breakouts from occurring in the first place.

“The most important thing to do is make sure you have complete control of your acne before you start treating acne scars,” said Dr. Michael Cameron, founder of Cameron Dermatology and assistant professor at Mount Sinai in New York City.

What are the different types of acne scarring?

To help you identify which type of acne scar you might be dealing with, we put together a quick at-a-glance view of common acne scars. While they all vary in appearance, our experts noted that these types are just descriptors for the different shapes of acne scars.

Atrophic scars

Atrophic scars — also known as depressed scars — are caused by loss of collagen and result in the thinning of the skin, which causes a depression on the surface, according to Gmyrek. About 80% to 90% of acne scars are atrophic, and they come in three different types based on their shape:

  • Icepick scars are narrow, deep scars in the skin that form a V-shape, Gmyrek said, typically caused by small, white pustules.
  • Boxcar scars are broad depressions with sharply defined edges. They’re characterized by a square-shaped with fixed edges, so they look like they’re tethered down to the skin, according to Dr. Gilly Munavalli,the medical director and founder of Dermatology, Laser & Vein Specialists of the Carolinas.
  • Rolling scars are broad with sloping edges. “They are usually a bit wider and give a curved atrophic appearance to the skin,” Gmyrek said.

Hypertrophic scars and keloid scars

Both hypertrophic and keloid scars are raised scars, formed by an overproduction of tissue during the healing process:

  • Hypertrophic scars typically occur if the body produces too much collagen during the healing process, according to Farber. “They are typically pink, raised, and firm and remain about the size of the original pimple,” Gmyrek added.
  • Keloid scars, on the other hand, are raised and hairless scars that are usually pink, red or flesh-toned and grow beyond the borders of the original pimple. Keloids can “grow larger over time” and may turn darker than your usual skin color when exposed to the sun, according to a report from the University of Michigan Health System.

Color changes

While acne can cause residual discoloration in the form of red or brown marks, those changes are not necessarily scarring. “Patients will commonly refer to [color changes] as scars and we tend to correct that because scars are a lot harder to deal with,” Munavalli said. The good thing is color changes are easier to tread and “respond really well to retinoids,” Farber said. Munavalli noted two main types of color changes:

  • Post-inflammatory hyperpigmentation, which results from the overproduction of melanin after inflammation on the skin.
  • Post-inflammatory erythema, which deals with red or pink patches on the skin that result from inflammation.

How to treat acne scars and hyperpigmentation at home

Dermatologists told us that treating acne is the first and very crucial step to preventing and treating acne scars. This can be done by using OTC acne-fighting ingredients like benzoyl peroxide — which inhibits the growth of the bacteria on the skin — and salicylic acid, which is a chemical exfoliator that helps unclog pores and reduce inflammation. However, “those ingredients don’t do anything to scars once they have formed,” Munavalli said.

Ultimately, the best treatments for acne scarring are to be found in a dermatologist’s office (see below for more info). However, there are some active ingredients available over-the-counter that can be helpful for treating dark spots and color changes left behind by acne, including retinoids, azelaic acid and vitamin C.


Experts told us retinoids are the most effective topical treatments for improving both acne scarring and residual discoloration. “There's evidence that long-term use of prescription retinoids can help acne scarring because they help with collagen remodeling,” Cameron said. However, retinoids can take a long time to work, so it’s a matter of how quickly you want to see results: “If you're committed to using a retinoid over the course of years, some of these scars will improve in appearance over time,” Garshick said.

In terms of OTC treatments, adapalene is the only approved OTC retinoid that can be used to treat acne and scarring over time. “Adapalene is a great, cost-effective option for those with more sensitive skin who can’t tolerate prescription retinoids,” Cameron said.

Retinol is a vitamin A derivative and a type of retinoid that boosts skin exfoliation and prevents acne. It’s usually found over-the-counter and can also promote skin cell turnover and collagen production to help treat post-acne hyperpigmentation and minimize the appearance of current acne scars, according to Garshick. However, since retinol is weaker than prescription retinoids, it’ll work much more slowly. “Since you want to shut things down quickly, I prefer a prescription retinoid first,” said Munavalli.

By prescription, tretinoin (known as Retin-A) and tazarotene have been shown to be effective at reducing the appearance of acne scars, Gmyrek said. She added that EpiDuo, a prescription that combines 0.3% adapalene and benzoyl peroxide, has also been shown to be effective in the improvement of acne scarring.

Azelaic acid

Azelaic acid is a gentle acne-fighting ingredient that can also even out your skin tone and help reduce the appearance of superficial marks and hyperpigmentation, according to Dr. Lindsey Bordone, a board-certified dermatologist and assistant professor of dermatology at ​Columbia University Medical Center.. The ingredient inhibits tyrosinase, an enzyme that creates pigment in the skin and decreases the production of acne-causing bacteria. It can also be a great option for people who are pregnant or for those who have sensitive skin and can't tolerate a retinoid, Garshick said.

Vitamin C

Vitamin C is a powerful antioxidant that can help reduce and prevent the appearance of redness and pigmentation from acne scars. “They can lighten and brighten the skin and reduce some mild hyperpigmentation,” Munavalli said.

Chemical exfoliants

Chemical exfoliants like alpha-hydroxy acids (AHAs) — which include lactic acid and mandelic acid — and beta-hydroxy acids (BHAs), including salicylic acid, can unclog pores, exfoliate skin and event out the skin tone. Experts told us AHA/BHA peels can help reduce acne and fix uneven skin texture, which helps improve mild discoloration on the skin.

How dermatologists treat acne scars

Treating deep acne scars usually requires a series of treatments at the dermatologist’s office over time. Our experts noted a few different in-office treatments that can be the most effective at reducing scarring, including laser resurfacing, microneedling and injectable fillers.

Atrophic scar treatments

Rolling and boxcar scars can be treated with laser resurfacing, micro-needling and micro-needling with radio frequency treatments. Ice pick scars, on the other hand, are the most difficult type of atrophic scar to treat because they’re so deep. They often require a procedure using trichloroacetic acid — called the Chemical Reconstruction of Skin Scars (CROSS) procedure — that’s placed in the base of the ice pick scar, causing a restructuring of scar tissue and new collagen formation. It requires several treatments at least one month apart, according to Gmyrek.

Atrophic scars can also be treated with a procedure called subcision (which lifts the scar tissue upward, decreasing the depression) and injectable fillers, though the latter might only last 1-2 years, said Gmyrek.

Hypertrophic scar treatments

Hypertrophic scars and keloids can be treated with laser resurfacing treatments to remodel the thick scar tissue. This is usually in conjunction with injections that “halt the over-healing process, leading to less collagen formation and a flattening of the scar nodule,” Gmyrek said. This treatment can also decrease inflammation and improve redness.

Hyperpigmentation and discoloration treatments

Munavalli told us that chemical peels — which are performed in-office by dermatologists and aestheticians — can help treat active acne and reduce post-acne pigmentation. Prescriptions that increase cell turnover like retinoids and skin lightening creams like hydroquinone can also help fade red or brown dark spots, according to Cameron.

Meet our experts

At Select, we work with experts who have specialized knowledge and authority based on relevant training and/or experience. We also take steps to ensure that all expert advice and recommendations are made independently and with no undisclosed financial conflicts of interest.

  • Dr. Robyn Gmyrek is a board-certified dermatologist at UnionDerm in New York City.
  • Dr. Michael Cameron is a board-certified dermatologist, founder of Cameron Dermatology and assistant professor at Mount Sinai in New York City.
  • Dr. Michele Farber is a board-certified dermatologist at Schweiger Dermatology Group in Philadelphia. Dr. Farber specializes in skin cancer treatments, as well as general, cosmetic and procedural dermatology.
  • Dr. Marisa Garshick is a board-certified dermatologist at MDCS Dermatology in New York City.
  • Dr. Gilly Munavalli is a board-certified dermatologist and the medical director and founder of Dermatology, Laser & Vein Specialists of the Carolinas in Charlotte, North Carolina. He has nearly 20 years of experience in dermatology and dermatologic surgery.
  • Dr. Lindsey Bordone is a board-certified dermatologist and assistant professor of dermatology at ​Columbia University Medical Center. She specializes in adult general dermatology, managing all conditions of the skin, hair, and nails.

Why trust Select?

Mili Godio is an editor at Select who has written extensively about skin care. Godio previously covered a variety of acne-related topics, including products for acne-prone skin, cystic acne treatments and azelaic acid. She has also reported on various skin concerns ranging from rosacea to dark under-eye circles. For this article, Godio spoke to six dermatologists to narrow down the best treatments for acne scarring and color changes on the skin, and highlighted their recommendations for the best ingredients and products to consider.

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