​Here’s How to Get Rid of Your Acne Scars

First, what is a scar? At some point when you picked at that pimple, and scratched off the scab (again and again), the collagen fibers in your skin healed in a new pattern. More rigid, less pliable, and without all the other structures like sweat glands and hair follicles that are usually part of your skin.

To get rid of these areas, you basically need a do-over on the healing. How do you trigger that? By removing a tiny section of the scar, drilling down from the surface—a section so tiny that a common way to do it is with a laser. "An ablative resurfacing laser removes a column of the scar," says Hooman Khorasani, chief of dermatologic and cosmetic surgery at Mount Sinai’s Icahn School of Medicine in New York City. "You literally remove a part of the epidermis and a part of the dermis, and then it heals from the inside out."

Your doctor might discuss ablative lasers like the brand Total FX. Depending on where you live, a treatment might run $2,000-$5,000. There are also nonablative lasers, which heat the tissue without actually destroying it. These go by brand names such as Fraxel Restore. They cost less, and have an easier recovery, but can be less effective. (You can find before-and-after photos of both Total FX and Fraxel treatments on Khorasani’s site.)

Either way, "Your face will look like you got a sunburn," Khorasani says. If you got ablative resurfacing, expect the appearance of a bad sunburn, and redness for a week. Nonablative will leave you with a moderately sunburned appearance, with a shorter period of redness. "You may start peeling a little bit," he says, "as new tissue starts forming."

Of course, there are issues with laser treatment. For one, there's the recovery time before you can take a second pass—and sometimes more than one is needed. Also, in patients with darker skin the laser can affect the skin's pigment. Solution? Micro-needling. In this treatment, you ditch the laser for a very fine needle. Instead of removing a microscopic column of skin, the scar tissue is pricked. "Micro-needling is good because you can use it on all skin types because you're not heating the tissue," Khorasani says. "Because it's not as effective as ablative resurfacing, it's usually combined with something else to make it better."

One of these combos is PRP, or platelet rich plasma. In layman's terms, platelets are a part of your blood rich in ingredients that help cells grow. Your doc can extract some from a sample of your blood, inject them into the scars during micro-needling, and the theory is that they accelerate healing of the tissue. And while it may not be as effective as laser resurfacing, micro-needling is one of the more affordable treatments, in the $300-$800 range (add another $500-$1,000 with PRP). Plus, recovery is just a day or two.

If the first needle option didn't send you running, you may want to consider another: subcision. "Sometimes the reason these scars are depressed is because some of the collagen fibers are oriented in a such a way that they're actually pulling the skin down,” Khorasani says. Solution? Stick a needle underneath the skin to break the ties that pull the scar downward and make that tiny crater in your cheek. "The needle has a sharp blade on it, and you basically windshield-wiper it back and forth under the skin," Khorasani says, "to relieve some of those adhesions." The fine print on this one: It's not as common, so make sure your doc knows what he or she is doing, otherwise it can cause a lot of bruising. Expect to pay $1,000-$1,500 for your full face.

"Sometimes the scars are so deep that the only thing you can do is actually punch them put," Khorasani says. The "punch" in here is a 2- to 4-millimeter circular blade called an excision tool. It removes a column of skin containing the scar, and the tiny wound is closed, usually with a single stitch. Recovery time is more similar to laser resurfacing—your stitches might be in for a week, and you may have to go back to your doc to get them out. Costs can run $1,500-$3,000 depending on how many excisions you need.

But what if your scars aren't deep? What if, like many guys, you have just a few shallow pits on your face? They're not even visible in certain light, but they bother you anyway. Or maybe you've already done laser treatment, but you still need a little push. For this, your dermatologist may recommend a filler. "Lately there's a filler that's been approved by the FDA called Bellafill," Khorasani says. "It lasts for five years, as opposed to most fillers which usually last from eight to 18 months at the most." Bellafill contains bovine collagen, which is meant to improve the appearance of the scar right away. Meanwhile, tiny spheres of a transparent thermoplastic (futuristic, huh?) prop up the tissue until your own collagen can start filling it in. A syringe of filler can cost $1,000-$1,400, but once is typically enough of this treatment.

Bottom line:

If you’re troubled by acne pits or pockmarks, there are ways to make your body tackle them in overdrive. After all, there are parts of your teenage years best forgotten—and the acne is one.

(Still struggling with acne? Here are a few things you can do about it.)