SKN.COACH
Texture & Scars

Acne Scars & Texture

Retinoids and serums have limits. Deep pits require procedures. This guide helps you identify your scar type, understand which treatments actually work, and set realistic expectations for improvement.

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Evidence-based info Realistic expectations 40-80% improvement possible

Find your path

Answer a quick question to find the right guide for your situation.

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What best describes your concern?

Start with identification

Learn how to tell pores from scars and marks from pits. The lighting test is simple and accurate.

Read: Pores vs Acne Scars

Treatment options for pits

Pitted scars need procedures, not just products. This guide covers what works and in what order.

Read: Treating Acne Scars

Understanding procedures

Compare subcision vs microneedling, learn about TCA CROSS for icepicks, and understand the treatment order.

Read: Subcision vs Microneedling

Good news: marks fade

PIH (brown) and PIE (red) marks are flat discolorations that respond to topicals and fade with time. Sunscreen is key.

Read: Marks vs Scars

All guides & resources

Everything in this hub, from fundamentals to specific procedures.

Core Guides

Acne Scars & Pits: What Works Scar types, treatment order, budget paths
Is It Pores or Acne Scars? The lighting tests to tell them apart

Procedures

Subcision vs Microneedling Which to do first and why
TCA CROSS for Icepick Scars How it works, who it's for
Fractional Laser Guide CO2 vs Erbium, what to expect
Derm Hub
Rolling vs Boxcar vs Icepick Visual guide to scar types
Soon

Coming Soon

Post-Acne Marks vs Scars PIH, PIE, and what fades vs what needs treatment
Soon
Microneedling at Home: Risks Why dermarollers can backfire
Soon
How Long Do Acne Scars Take? Realistic timelines for improvement
Soon

Starter routine

A supportive routine between procedures. Focus on healing, not actives.

Morning (AM)

  1. 1 Gentle cleanser — no actives, no foam
  2. 2 Moisturizer — keep barrier strong
  3. 3 SPF 30+ — critical for PIH prevention

Evening (PM)

  1. 1 Gentle cleanser — remove SPF gently
  2. 2 Retinoid (if no procedure within 7 days)
  3. 3 Moisturizer — seal and repair

Ingredients for scar care

What helps, what to be careful with, and what to avoid.

Retinoids ✓

Supports collagen production and cell turnover. Start slow, stop 7 days before procedures.

Sunscreen ✓

Non-negotiable. Sun exposure worsens PIH and can darken healing scars.

Azelaic Acid ✓

Helps with marks (PIH) and inflammation without irritation. Safe for darker skin tones.

Vitamin C ⚠

Good for marks and antioxidant protection, but can irritate if used with too many actives.

AHA/BHA ⚠

Surface exfoliation only. Won't fix pits. Pause 5-7 days before procedures.

DIY Peels ✗

High-strength at-home peels risk burns, PIH, and worsening scars. Leave to professionals.

What not to do

These mistakes can worsen scars or delay improvement.

Expecting serums to fix pits. Topicals can't rebuild lost collagen. Pitted scars require procedures.

DIY dermarolling at home. Infection risk, inconsistent depth, and can worsen scarring. See a professional.

Treating scars with active acne. New breakouts cause new scars. Control acne first.

Skipping sunscreen after procedures. UV exposure causes PIH and can darken healing tissue.

Wrong procedure order. Subcision before lasers for tethered scars—order matters for results.

Expecting one session to fix everything. Most procedures need 3-6 sessions over 12-18 months.

When to see a dermatologist

Some situations need professional evaluation.

Schedule a consultation if:
  • You have pitted scars and want meaningful improvement
  • You're unsure what scar type you have
  • You have a history of keloids or raised scars
  • You have deeper skin and want to minimize PIH risk
  • Active cystic acne is still occurring
  • You've tried at-home treatments for 6+ months with no improvement

Common questions

Quick answers to frequently asked questions about acne scars.

Can acne scars be completely removed?
Most acne scars can be significantly improved (40-80%) but rarely completely removed. Multiple professional treatments spaced over 12-18 months give the best results. Realistic expectations are key—aim for improvement, not perfection.
What's the difference between marks and scars?
Marks (PIH/PIE) are flat discolorations—red or brown spots left after pimples. They fade with time and topicals. Scars are textural changes—pits, indentations, or raised tissue. Scars require procedures to improve. Learn more in our identification guide.
Which treatment is best for icepick scars?
TCA CROSS is the gold standard for icepick scars. It involves applying high-concentration TCA acid into each scar to trigger collagen from the base up. Usually 3-6 sessions are needed. Punch excision is another option for very deep icepicks.
Should I get subcision or microneedling first?
Subcision first if you have rolling or tethered scars. Subcision releases the fibrous bands pulling skin down. Once released, follow-up treatments like microneedling or laser can work more effectively.
Is microneedling or laser better for acne scars?
RF microneedling is safer for darker skin tones with less downtime. Fractional lasers can be more aggressive but carry higher PIH risk for melanin-rich skin. For most people, RF microneedling offers the best balance of results and safety. See our laser guide for details.
How long does it take to see results?
Individual sessions show results in 4-8 weeks as collagen remodels. A full treatment course (3-6 sessions) takes 12-18 months. Final results continue improving for months after the last session. Patience is essential.
Can old scars still be treated?
Yes. Old scars (even decades old) can still respond to treatment. Collagen remodeling can be triggered at any point. Many people with mature scarring see significant improvement with modern procedures.
How much do scar treatments cost?
Costs vary widely. Basic microneedling: $150-300/session. RF microneedling: $400-800/session. Subcision: $300-500/session. Fractional laser: $500-1500/session. A comprehensive treatment plan over 12-18 months typically ranges from $1,500-8,000+.

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Get your personalized routine

A skin scan helps you understand your skin and get a routine that supports healing between treatments.

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