The Best Facial for Acne Scars: Comparing the Treatments That Actually Work
Acne scar treatment on the face, compared by scar type
Search "best facial for acne scars" and the first page is a tug of war between dermatology clinics selling lasers and skincare brands selling serums. Neither answers the question people actually ask us in the treatment room, which is some version of: I have these marks on my cheeks, which treatment is going to work, and will a facial even help?
The honest answer is that it depends on what kind of mark you have, and most guides never ask. So this one starts there. We separate acne scars from acne marks, walk through the five scar types and what each one needs, compare the treatments (including the ones we do not offer and would send you to a dermatologist for), and share what seven sessions looked like for one of our own clients.
- About half of what people call "acne scars" are marks, not scars. Marks are a color change and fade with the right acids and daily sunscreen. Scars are a texture change and need something that rebuilds collagen.
- Rolling scars and shallow boxcar scars respond well to needling-based treatments. At Mysa that is the MicroGlow Renewal Facial, ProCell microchanneling with growth-factor serums.
- Ice pick scars, deep boxcar scars and raised keloid scars are dermatologist territory. We refer those out rather than take your money for a treatment that will not reach them.
- Plan for a series, not a session. We start with three MicroGlow treatments about four weeks apart. Structural change shows at six to twelve weeks, and scarring usually needs a longer plan than fine lines.
- Nothing takes scars to zero. The realistic goal is scars that are much less noticeable, which matches the American Academy of Dermatology's own wording: treatment can make scars "less noticeable."
First: do you have acne scars or acne marks?
This is the distinction that decides everything else, and it is the one most often missed. Spend ten minutes in any skincare forum and you will see people spending real money on lightening serums for pits that need collagen, and booking collagen treatments for flat brown spots that would have faded with azelaic acid and SPF.
| Looks like | What caused it | What actually helps | Who treats it | |
|---|---|---|---|---|
| Post-acne marks (PIH or PIE) | Flat. Brown or tan on deeper skin tones, pink to purple on lighter tones. Skin is smooth to the touch. | Inflammation left pigment or dilated capillaries behind after the breakout healed. | Time (three to six months), exfoliating acids, azelaic acid, vitamin C, daily sunscreen. Peels and HydraFacial speed it up. | Esthetician. A dermatologist if it is stubborn past a year. |
| Atrophic (indented) scars | A dent, pit or wavy area you can feel with a fingertip, regardless of color. | The breakout destroyed collagen and the skin healed with less tissue than it started with. | Treatments that trigger new collagen: microchanneling, microneedling, lasers, subcision, fillers. Topicals alone will not fill a dent. | Esthetician for mild to moderate rolling and shallow boxcar scars. Dermatologist for ice pick and deep boxcar scars. |
| Raised scars (hypertrophic, keloid) | A firm bump that sits above the skin, sometimes larger than the original spot. | The skin overproduced collagen while healing. | Steroid injections, silicone, laser. Needling-based treatments are not used on these. | Dermatologist only. |
The fingertip test is the quickest sorting tool we know. Close your eyes and run a finger across the area. If you can feel a change in the surface, you have scars. If it feels smooth and you only see it, you have marks. Many people have both, which is why a good plan usually combines a collagen treatment with a pigment plan.
Scar Types
Types of acne scars and what each needs
Dermatologists sort indented acne scars into three shapes, and the shape predicts the treatment better than almost anything else. Roughly 90 percent of acne scars are indented rather than raised, and among those, ice pick scars are the most common, followed by boxcar and rolling scars (Frontiers in Medicine, 2025).
Ice pick scars
Narrow, deep and sharply pointed, as if the skin was punctured with an ice pick. They are the hardest acne scar to improve because they reach deep into the dermis and are too narrow for a surface treatment to remodel. The tools that help, such as TCA CROSS (a very high strength acid applied to the base of each scar) and punch excision, are medical procedures. A facial will not reach an ice pick scar. If most of your scars look like this, start with a dermatologist.
Boxcar scars
Wider, round or oval, with defined edges, like a thumbprint pressed into clay. Depth decides the treatment. Shallow boxcar scars respond to needling-based treatments and resurfacing. Deep boxcar scars usually need fractional laser, subcision or fillers, which again means a dermatologist.
Rolling scars
Wide, soft-edged waves across the cheek that get more visible when you smile or in side lighting. They are caused by fibrous bands pulling the skin down from underneath. These are the scars that respond best to needling-based treatments, because the channels break up those bands while the skin lays down new collagen.
Raised scars (hypertrophic and keloid)
Firm bumps above the skin surface, more common along the jaw, chest and back. These are treated with steroid injections, silicone and vascular laser. We do not treat them, and a history of keloid scarring is on our do-not-treat list for microchanneling, because any controlled injury to the skin can trigger more of the same overgrowth.
Post-inflammatory marks
Not a scar, but the thing most often mistaken for one. Dark marks (post-inflammatory hyperpigmentation) are more common on medium and deeper skin tones. Red or purple marks (post-inflammatory erythema) are more common on lighter tones. Both fade on their own in three to six months if you stop the breakouts, stop picking, and wear sunscreen every day. Acids, azelaic acid and vitamin C speed that up. In our treatment room, pigmentation is the concern that takes longest to shift, so patience is part of the plan.
| Scar type | What helps most | What a facial can do | Typical sessions | See a dermatologist when |
|---|---|---|---|---|
| Ice pick | TCA CROSS, punch excision, fractional laser | Very little. Surrounding texture only. | Not a spa plan | Always, for the scars themselves |
| Boxcar (shallow) | Microchanneling or microneedling, resurfacing | Meaningful softening over a series | 3 to 6 | If edges stay sharp after a series |
| Boxcar (deep) | Fractional laser, subcision, fillers | Minor | Not a spa plan | From the start |
| Rolling | Microchanneling or microneedling, subcision for severe | Best-case scar type for a facial series | 3 to 6, sometimes more | If bands are severe and tethered |
| Raised (hypertrophic, keloid) | Steroid injections, silicone, laser | None. Contraindicated for needling. | Not a spa plan | Always |
| Post-acne marks | Acids, azelaic acid, sunscreen, time | Peels, HydraFacial and microchanneling all speed fading | 2 to 4 | If unchanged after 12 months of consistent care |
Comparing Options
The acne scar treatments compared
Microchanneling for acne scars (what we do at Mysa)
Microchanneling is the collagen treatment behind our MicroGlow Renewal Facial. A handpiece fitted with very fine sterile tips stamps thousands of microscopic vertical channels into the upper skin. The channels close within hours, but opening them is enough to switch on a repair response, and while they are open we apply growth-factor serums that reach the living layer where the repair is happening. No heat, no light, no injections.
For acne scars specifically, that mechanism suits three things well: rolling scars, shallow boxcar scars and post-acne marks. The stamping action is uniform rather than oscillating, so there is less inflammation for a comparable collagen response, and the no-heat part matters if you have a medium or deeper skin tone, where light-based treatments carry a real risk of trading a scar for a dark mark.
What it feels like: a topical numbing cream goes on for about twenty minutes first, while you get a neck and shoulder massage. Most clients describe the treatment itself as a light vibration or scratching. A few of ours have been blunter and called it "a lot of tiny bugs biting," which is fair for the first pass over the cheeks. It is not a spa nap, but it is short and it is tolerable.
What it does not do: it will not reach ice pick scars, it will not lift deep boxcar scars, and it will not replace a laser for severe textural damage. We say so at the consultation. In our experience, scarring responds faster than pigmentation but slower than fine lines, so we plan a longer series for scars than we would for someone chasing a glow.
Downtime is about a day. You leave pink and warm, like an hour in the sun, mineral makeup is fine from two hours after treatment, and some skin flakes lightly around day three. The full day-by-day breakdown is in our microchanneling aftercare guide.
Microneedling vs microchanneling for scars
People use the words interchangeably. They are cousins, not twins. Microneedling, usually done with an oscillating pen like SkinPen, drives needles deeper and creates a controlled wound; the result comes from healing that wound, which is why it bleeds a little and takes three to five days to settle. Microchanneling stamps shallower, uniform channels and leans on growth-factor serums; it does not bleed and takes about a day.
Does the extra depth matter for scars? Sometimes. A 2021 systematic review of nine randomized trials found microneedling to be a well-tolerated and effective treatment for indented acne scars, alone or in combination with other treatments (Sitohang et al., International Wound Journal). For deep, well-established scarring, deeper medical microneedling, especially radiofrequency microneedling, may be the better tool. For mild to moderate scarring in someone who cannot give up a week of looking treated, microchanneling is the practical choice, and that describes most of our clients. We would not call either one universally safer; depth, device, provider and aftercare decide that.
Chemical peels
Peels work on the surface, which makes them excellent for marks and surface texture and limited for depth. Superficial peels (glycolic, lactic, salicylic, mandelic) brighten marks and smooth the top layer with little to no downtime. Medium-depth peels can soften shallow scars but shed visibly for five to seven days. Deep peels and TCA CROSS are medical procedures. At Mysa, peels are built into several of our facial protocols rather than sold as a standalone, and your esthetician chooses the acid and depth for your skin. There is good evidence for pairing: a 2025 meta-analysis found microneedling combined with chemical peeling outperformed either alone for indented acne scars (Advances in Dermatology and Allergology), which is one reason we often pair peel-based facials with collagen-building treatments in a multi-month plan.
HydraFacial for acne scars
A HydraFacial is a maintenance and marks treatment, not a scar treatment. It deep-cleans, exfoliates, extracts (including manual extraction when the skin needs it) and infuses serums, which keeps congestion down so new scars stop forming, and helps marks fade. It does not change texture. Where it earns its place in a scar plan is between MicroGlow sessions: our estheticians often suggest a HydraFacial about a month after each microchanneling session, so the skin stays clear and hydrated while the collagen work matures.
RF microneedling, lasers, TCA CROSS, subcision and fillers
These are dermatologist and medical-provider tools, and we do not offer them. Radiofrequency microneedling adds heat to the needles for deeper remodeling. Fractional CO2 and erbium lasers are among the best-studied options for deeper boxcar and ice pick scars, with downtime measured in a week or more. TCA CROSS spot-treats individual ice pick scars. Subcision cuts the bands under rolling scars. Fillers plump individual indents for a year or so at a time. If your scars are mostly ice pick or deep boxcar, or if a full series of needling-based treatment has not moved them, these are where to go next, and we will tell you that before you book with us.
| Treatment | Scar types helped | Sessions | Downtime | Discomfort | Cost tier (SF) | Deeper skin tones |
|---|---|---|---|---|---|---|
| Microchanneling (MicroGlow) | Rolling, shallow boxcar, marks | 3 to 6+ | About a day | Mild, with numbing | $$ ($398 at Mysa) | Suitable, no heat or light |
| Microneedling (medical) | Rolling, boxcar | 3 to 6 | 3 to 5 days | Moderate | $$ to $$$ | Generally suitable |
| RF microneedling | Rolling, boxcar, some ice pick | 3 to 4 | 2 to 5 days | Moderate | $$$ | Use with care, heat involved |
| Superficial peel | Marks, surface texture | 4 to 6 | None to 2 days | Tingling | $ to $$ | Acid choice matters |
| Medium peel | Shallow boxcar, marks | 1 to 3 | 5 to 7 days | Stinging | $$ | PIH risk, consult first |
| HydraFacial | Marks, congestion (prevention) | Monthly | None | None | $$ | Suitable |
| Fractional laser | Boxcar, ice pick, rolling | 1 to 4 | 5 to 10 days | Moderate to high | $$$ to $$$$ | Higher PIH risk, specialist only |
| TCA CROSS / subcision / fillers | Ice pick, deep boxcar, rolling | Varies | Varies | Varies | $$ to $$$ | Specialist assessment |
Case Study
What one client's seven sessions looked like
Treatment-room observation, not a clinical measurement. Shared with the client's written consent and anonymized. Individual results vary.
A client came to us with moderate-to-severe acne scarring across both cheeks, mostly rolling scars with a few shallow boxcar scars, plus leftover dark marks. The active acne had been under control, which matters: we do not microchannel over a live breakout.
What we would say to anyone reading this and hoping for the same: seven sessions is more than our usual starting series of three, and that is normal for scarring. The improvement was progressive rather than sudden, the marks went first and the texture followed, and the deepest scars improved least.
Home Care
At home: what helps between treatments (and what is a waste)
Home care cannot fill a dent, but it decides how fast marks fade and whether new scars keep forming. Four things do most of the work:
- A retinoid at night. Prescription tretinoin or an over-the-counter retinol. It speeds cell turnover, keeps pores clear and supports collagen. Pause it for the days around a microchanneling session as your esthetician directs.
- An exfoliating acid. Mandelic and salicylic acids for acne-prone skin, glycolic for marks and texture on skin that tolerates it. The Face Reality mandelic products and Jan Marini glycolic cleansers are the two lines we reach for most.
- Azelaic acid or vitamin C in the morning for marks, especially on deeper skin tones where hydroquinone is a conversation for a dermatologist, not a spa.
- Sunscreen every single day. Sun darkens marks and increases the contrast between scar and surrounding skin. Nothing else on this list works without it.
At-home peel kits: be careful. Most are too weak to touch a scar and strong enough to burn or darken skin when overused. If you want acid strength, let a professional apply it. Natural remedies (lemon juice, baking soda, toothpaste, apple cider vinegar) do not fade scars and regularly cause the dark marks people were trying to remove. Scar-fading creams help with marks and do nothing for indents, whatever the box says.
And if you are still breaking out, that comes first. Treating scars while new ones are forming is pouring water into a bucket with a hole in it. Our Face Reality acne care exists for exactly that stage.
Darker Skin Tones
Acne scar treatment for darker skin tones
If you have a medium or deep skin tone, the main risk of any scar treatment is post-inflammatory hyperpigmentation: the treatment itself leaves a dark mark. The risk ranks roughly like this, from highest to lowest: ablative and fractional lasers, medium and deep peels, radiofrequency microneedling, medical microneedling, superficial peels, and microchanneling. Because microchanneling uses no heat and no light, there is no added PIH risk from the energy itself, which is why needling-based treatments are usually preferred over light-based ones for deeper skin tones. It still requires a consultation, a conservative depth on the first session and strict sunscreen afterward. Deeper skin tones are also where azelaic acid and mandelic acid earn their keep for the marks.
Timeline
How many sessions and how long it takes
Microchanneling is a texture treatment, which means the change accumulates rather than arriving all at once. Here is the timeline we give clients:
- Days 1 to 3: mild redness, then skin that looks and feels tighter. Some of that is hydration, not collagen.
- Weeks 2 to 4: marks look lighter and texture starts to shift. Clients usually notice it in photos first.
- Weeks 6 to 12: new collagen matures. This is where scars visibly soften.
- After a series: the cumulative result. One session is a glow; a series is a change.
We start with three sessions about four weeks apart, then reassess. Four weeks is not arbitrary; it is roughly one collagen remodeling cycle, so going more often does not speed anything up. For scarring, expect to extend that series: three to six sessions is typical, and the client above needed seven. Realistically that is a three-to-six-month project, with maintenance every six to eight weeks afterward if you want to hold the result.
San Francisco
Acne scar treatment in San Francisco: what we do and what we refer out
What we do. The Mysa MicroGlow Renewal Facial is $398 for a 60-minute session. Numbing, the neck and shoulder massage, growth-factor serums, the hydrating mask with LED and finishing products are all included, with no add-on charges. We do not sell a discounted package; a recommended starting series of three is $1,194, and we would rather quote the real number than build a bundle around a discount you may not need. Three estheticians perform it, all licensed in California and trained on the ProCell system, and Mysa has been an authorized ProCell provider since 2022. You can request the same esthetician for your whole series, and for scar work we recommend it, because depth and serum choices get adjusted based on how your skin responded last time.
60 minutes, single session
Three sessions, no discount package
Consultation first. Before a first MicroGlow session we look at your skin in person and go through your history. If scars are mostly ice pick or deep boxcar, we will say so and point you to a dermatologist instead.
Not the right treatment right now if you have:
- An active breakout, cold sore, or any open or infected skin in the area
- Active eczema, psoriasis, or a rosacea flare in the treatment area
- Taken isotretinoin (Accutane) in the past six months
- A history of keloid scarring
- A bleeding disorder, or are taking blood thinners
- Pregnancy or nursing
- Ongoing chemotherapy or radiation
What we refer out. Lasers, radiofrequency microneedling, TCA CROSS, subcision, fillers and steroid injections. If a dermatologist is the right first stop, we would rather you hear that from us than find out after a series.
Mysa Day Spa is at 339A W Portal Ave, San Francisco, CA 94127, a few doors from the West Portal Muni station on the K, L and M lines. We see clients from Forest Hill, St. Francis Wood, Parkside, the Sunset and across the city and the Peninsula for this treatment. Open Tuesday to Sunday.
FAQ
Frequently asked questions
What's the best thing for acne scars on your face?
It depends on the scar type. Flat marks respond to acids, azelaic acid and sunscreen. Rolling and shallow boxcar scars respond to needling-based collagen treatments such as microchanneling or microneedling. Ice pick and deep boxcar scars need a dermatologist and tools like TCA CROSS, fractional laser or subcision. Raised scars need steroid injections. The fingertip test tells you which group you are in.
Is microneedling worth it for acne scars?
For indented rolling and boxcar scars, yes. A 2021 systematic review of nine randomized trials found microneedling effective and well tolerated for atrophic acne scars. Microchanneling is the lower-downtime relative of microneedling, uses growth-factor serums by design, and suits mild to moderate scarring. Deep scarring may need medical microneedling or laser.
Can you get rid of acne scars 100 percent?
No. Surface marks can clear completely, but true scars are permanent changes to the skin's structure. The realistic goal with any treatment is scars that are much less noticeable; the American Academy of Dermatology's own wording is that treatment can make scars "less noticeable." Anyone promising to erase scars is overselling.
What is the hardest acne scar to get rid of?
Ice pick scars. They are narrow and deep, so surface treatments cannot reach the base. Dermatologists treat them with TCA CROSS or punch excision, sometimes followed by laser. Keloid scars are also difficult because treating them can trigger more scar tissue.
Are pockmarks treatable?
Yes. "Pockmarks" usually means boxcar and rolling scars. Shallow ones improve with a series of microchanneling or microneedling; deeper ones respond to fractional laser, subcision or fillers with a dermatologist. Most people see meaningful improvement, not complete removal.
How long does it take for acne scars to fade?
Marks fade in three to six months with consistent acids and sunscreen. Scars do not fade on their own; they need treatment, and with microchanneling the visible change comes at six to twelve weeks, building over a series of three to six sessions, sometimes more.
What are effective acne scar treatments for dark skin?
Needling-based treatments over light-based ones. Microchanneling and microneedling use no heat, so they carry less risk of post-inflammatory hyperpigmentation than lasers or deep peels. Pair them with azelaic or mandelic acid and daily sunscreen for the marks, and start with a conservative depth.
Does a facial help acne scars?
A standard facial helps marks and surface texture and prevents new scars by keeping skin clear. It does not fill indented scars. A collagen-induction facial such as microchanneling does improve rolling and shallow boxcar scars over a series. Deep scars need a dermatologist regardless of the facial.
Not sure which scars you have?
Run the fingertip test, then let us look. A consultation is the first step before any MicroGlow series, and it is where we tell you honestly whether a facial series will move your scars or whether a dermatologist should see them first.
Book a Consultation Take the Facial Finder QuizOr call (415) 742-5491 · 339A W Portal Ave, West Portal, San Francisco
Individual treatment results vary. This article is educational and is not medical advice. If you have raised scars, a keloid history, or scarring that has not responded to treatment, see a board-certified dermatologist.
References
Sources
- American Academy of Dermatology Association, Acne scars: Consultation and treatment. aad.org
- Mayo Clinic, Acne scars: What's the best treatment? mayoclinic.org
- Sitohang IBS, Sirait SAP, Suryanegara J. Microneedling in the treatment of atrophic scars: a systematic review of randomised controlled trials. International Wound Journal, 2021. PubMed 33538106
- Connolly D, et al. Acne Scarring: Pathogenesis, Evaluation, and Treatment Options. Journal of Clinical and Aesthetic Dermatology, 2017. PMC5749614
- Advances in the treatment of acne scars. Frontiers in Medicine, 2025. frontiersin.org
- Chemical peeling in combination with microneedling versus chemical peeling or microneedling monotherapy in the treatment of acne scars: a systematic review and meta-analysis. Advances in Dermatology and Allergology, 2025. termedia.pl
