Lasers for Acne Scars: How They Work and the Best Treatments to Try Right Now

I've dealt with hormonal acne for my entire life. And while the breakouts are definitely annoying, the resulting scars and dark marks they leave behind are even more annoying in my opinion. A breakout lasts a few days, maybe a week, but acne scarring—depending on the type and severity—can last for weeks or even months. Hence why I'm such a fan of professional laser treatments for acne scars.

Sure, topical skincare products (like vitamin C serums, dark spot correctors, and retinol creams) can sloooowly help reduce the appearance of acne scars and dark marks with months and months of consistent use, but if you want to get rid of your acne scars and dark marks quickly, lasers are 100 percent the way to go. Ask any dermatologist and I guarantee they'll agree: Lasers are the most efficient and effective way to treat acne scars, from pitted scars to post-inflammatory hyperpigmentation.

I've had my fair share of personal experience with lasers for acne scars (over the years I've tried Clear + Brilliant, PicoSure, BBL Hero, and Nd:YAG at Skin Laundry and have had impressive results each time), but the science behind these treatments can be tricky to explain, which is why I enlisted the help of four expert dermatologists (shout out to Heather Rogers, MD, Rachel Westbay, MD, Corey L. Hartman, MD, and Arash Akhavan, MD) to help me break down how these lasers works, the best lasers for every type of acne scarring and skin tone, and what to expect from a laser for acne scarring if you decide to try one for yourself.

Which laser is best for acne scars?

We'll dive into the specifics—including the mechanics of these lasers and the types of acne scars they work best on—down below. But for now, use this list of popular laser treatments as a starting point:

• Clear + Brilliant

• LaseMD

• Fraxel

• Halo

• Icon 1540
  

• Erbium

• CO2

• BBL Hero
  

• Vbeam
  

• Excel V
  

• PicoSure
  

What are the main types of acne scars?

The type of laser you use to treat your acne scars will largely depend on the specific types of acne scars and marks that you're experiencing. These are the three main kinds:

Atrophic acne scars

These are the acne scars that look like hollow indents in the skin, says Dr. Westbay. "This concave appearance is due to a sudden loss of collagen, which is a result of inflammation that occurred at the time the acne lesion was active." Atrophic, or pitted acne scars, can be classified into three categories: ice pick scars, boxcar scars, and rolling scars:

• Ice pick scars are small, narrow, and deep

• Boxcar scars are broad and have sharp, well-defined edges

• Rolling scars are similar to boxcar scars but are even more shallow and have smooth, undulating edges that make the skin surface look uneven

In general, all of these types of acne scarring tend to be the result of cystic acne, not your average tiny bump that disappears after a few days.

Hypertrophic acne scars:

These scars appear as raised bumps, like keloids, on the face as a result of scar tissue buildup, says Dr. Hartman. "Most often, hypertrophic scarring occurs in patients with darker skin tones and can be a result from mild acne like whiteheads to more severe like cystic acne." In some cases, patients may experience keloid scars that are more prominent and long-lasting than the acne that caused them.

FWIW, not all keloids can be immediately treated with a laser, says Dr. Rogers. "With keloids, it is safer and more effective to start with injections. I use a combination of medications, including steroids and chemotherapy agents to soften keloids before considering lasering to blend them," Dr. Rogers explains.

Post-inflammatory hyperpigmentation:

These types of acne scars are marks or spots that occur when acne like whiteheads, pustules, and/or cysts triggers an inflammatory response that produces an excess of pigment, resulting in patches and spots that are darker than your natural skin tone, says Dr. Hartman.

"Post-inflammatory hyperpigmentation appears most common in patients with darker skin tones since dark skin has additional melanin in the skin," says Dr. Hartman. These scars and marks are also common in patients who tend to pop their pimples or pick their acne, which triggers and inflammatory response in the skin.