Acne Scar Treatment: Methods, Costs and Results

Acne scars (atrophic, hypertrophic and keloid scars) affect many people long after their acne has cleared. Modern dermatology and aesthetic medicine offer a wide range of effective treatments to significantly reduce the appearance of acne scars — from laser therapy and microneedling to chemical peels and surgical techniques.

Types of Acne Scars

Atrophic Scars (Most Common)

Ice pick scars: Deep, narrow, sharp-edged holes — most difficult to treat
Boxcar scars: Broader, box-shaped depressions with sharp edges
Rolling scars: Broad, wave-like depressions with sloping edges

Hypertrophic Scars

Raised, firm scars that remain within the original wound boundary. Common on the chest and back.

Keloid Scars

Raised scars that grow beyond the original wound boundary. Genetic predisposition, more common in darker skin types.

Treatment Methods

Fractional Laser (CO2 / Fraxel)

Gold standard for atrophic acne scars. Creates thousands of microscopic treatment zones that stimulate collagen production and resurface the skin. 3–5 sessions; 30–50% improvement per session. Best for rolling and boxcar scars.

Microneedling / Dermapen

Creates controlled micro-injuries to stimulate collagen and elastin. Gentler alternative to laser, suitable for darker skin types. Often combined with PRP (vampire facial). 4–6 sessions recommended.

Chemical Peels (TCA, Jessner)

TCA 15–35% or CROSS technique (chemical reconstruction of skin scars) for ice pick scars: high-concentration TCA applied precisely into the scar channel. Multiple sessions required.

Subcision

Needle technique for rolling scars: fibrous bands beneath the scar are severed, lifting the depressed area. Often combined with filler or PRP injection.

Dermal Fillers

Hyaluronic acid or poly-L-lactic acid fillers temporarily lift depressed scars. Duration: 6–18 months.

Punch Techniques (Excision / Elevation)

For ice pick and boxcar scars: the scar is punched out and either sutured or elevated. Often combined with laser resurfacing.

Costs per Treatment

Method	Costs per Session
Fractional CO2 laser	€400–€900
Microneedling + PRP	€250–€500
TCA CROSS	€150–€300
Subcision	€200–€500
Filler for scars	€300–€600

Frequently Asked Questions (FAQ)

Can acne scars be completely removed?

Complete removal of deep atrophic scars is rarely possible, but modern treatments can achieve 50–80% improvement in appearance. A combination of different methods (laser + microneedling + subcision) typically yields the best results. Keloid scars require specialised treatment (cortisone injections, pressure therapy, laser).

What is the best treatment for acne scars?

It depends on the scar type: Fractional CO2 laser for rolling and boxcar scars; TCA CROSS for ice pick scars; subcision for rolling scars with fibrous bands; microneedling for mild to moderate atrophic scars and all skin types.