- Chemical peels can be effective in treating certain types of acne scars.
- Professional treatments can produce more immediate results than at-home peels.
- Scars not treatable with peels can benefit from other procedures such as laser therapy.
Chemical peels involve applying an acid or mixture of acids to the face to remove the top layers of skin, revealing new skin underneath and stimulating collagen growth to improve the skin’s appearance. These peels can be used to address a wide number of skin issues, including some forms of scarring due to acne.
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Can Chemical Peels Fade Acne Scars?
Chemical peels fade acne scars by reducing hyperpigmentation and smoothing the surface of the skin. Their effectiveness depends on the type and severity of the scarring.
Types of acne scars
Acne scars can be classified as one of two forms: atrophic or hypertrophic.
Atrophic scars are indents in the skin’s surface. They are a result of new tissue not being created when the acne lesions healed, and are grouped into three broad categories depending on their appearance. These are:
- Icepick (small, deep, narrow; occur after deep infection)
- Boxcar (wider, round or oval; caused by collagen loss after breakouts)
- Rolling (shallow; skin texture appears wavy; caused by fibrous tissues pulling unevenly on epidermis)
Reducing atrophic scarring may require multiple peels over a series of months or years. Depending on the severity of scarring, they may not be possible to fully eliminate, but improvements can be made.
Hypertrophic scars are created by an excess of collagen production during the acne’s healing process and are raised above the skin. A more extreme form of hypertrophic scarring is called a keloid, which continues to grow over time. Hypertrophic scars cannot be treated by chemical peels as the peels aren’t a strong enough treatment.
Another common post-acne issue is hyperpigmentation. Appearing as dark spots, hyperpigmentation isn’t technically a scar but often occurs after an inflammation of the skin such as acne. People with postinflammatory hyperpigmentation are good candidates for chemical peels.
What type of chemical peel is best for acne scars?
Chemical peels are divided into three broad categories: light, medium and deep.
Light chemical peels may be sufficient to reverse hyperpigmentation and smooth mild scarring, especially with multiple treatments. A medium peel may generate quicker results than a light peel and require only one treatment. Deep peels are not generally recommended for acne scarring.
Professional vs. At-Home Chemical Peels
Diligent use of at-home treatments can reduce scarring over time for some people, but professional peels can provide more immediate and dramatic results. While both treatments use the same types of chemicals, licensed clinicians use peels with much higher concentrations than can be sold over the counter (OTC).
What Kind of Chemical Peel Is Best for Acne Scars?
The most common chemicals used for peels work in different ways to reduce scarring. The peel the clinician chooses for you will depend on what kind of scarring you have and its severity.
Other factors include your skin tone and sensitivity: not all peels are safe for darker skin tones, while sensitive skin generally requires lower concentrations of acids to avoid irritation.
Glycolic acid
Glycolic acid is perhaps the most popular chemical peel and can be used to treat acne scars. It can smooth out the skin’s surface to reduce the appearance of atrophic scarring, while also suppressing melanin formation to lighten skin and reduce hyperpigmentation.
Glycolic acid peels are safe for all skin types, but those with darker skin tones should not use them too frequently as they can cause skin discoloration with excessive use.
Mandelic acid
In addition to improving skin texture, mandelic acid can treat postinflammatory hyperpigmentation due to acne scars. This acid is recommended for people with darker skin as its slower mechanism of action makes it less likely to cause skin discoloration. Though it might work more slowly than other acids, it is still capable of delivering significant results.
Lactic acid
Lactic acid can smooth skin and fade hyperpigmentation. It is a weak alpha-hydroxy acid (AHA) that dissolves the uppermost layer of skin to reveal fresh skin beneath and is safe for all skin types, including dry or sensitive skin.
Salicylic acid (SA)
SA is more than an acne treatment – it can reduce post-inflammatory scarring as well. SA is a beta-hydroxy acid (BHA) that exfoliates the skin while promoting collagen production to improve skin texture.
It works well for people with oily skin as it temporarily reduces the production of sebum, the oil produced by the skin. For this same reason, it should be avoided by people with dry skin.
While SA can treat mild scarring, it isn’t very effective for deep atrophic scars.
Trichloroacetic acid (TCA)
A TCA peel can be used to treat atrophic scarring along with hyperpigmentation. When administered professionally, TCA is considered a medium peel requiring up to two weeks of downtime.
To treat ice pick and boxcar scars, TCA can be administered in what is known as the CROSS technique. The procedure involves spot-treating individual depressions in the skin to reconstruct scar tissue.
Before and Afters
Can Chemical Peels Prevent Acne Scarring?
Managing your acne is key to preventing deep acne scarring. Chemical peels can be used as part of your skin care routine to reduce breakouts and the risk of subsequent scarring.
Salicylic and glycolic acid are two peels commonly used to remove dead skin cells and bacteria that lead to acne formation while temporarily reducing sebum production.
Although chemical peels can’t address the hormonal causes of acne, they may help mitigate the damage acne can do to the skin. However, it’s possible that no matter what precautions you take, you will still experience acne scarring.
How to perform a Chemical Peel for Acne Scars at Home
OTC products such as gels, pads and wipes can help fade hyperpigmentation and smooth skin texture. It is advisable to only use products from reputable sources and to avoid buying strong chemicals online, such as TCA, as incorrect application can seriously damage your skin.
OTC chemical peels can work in a variety of ways, often involving multiple steps. Some peels are safe for daily use, while others should only be used once a week or only at night. Be sure to follow the instructions carefully to avoid causing harm to your skin.
Professional Chemical Peels for Acne Scars
If you have severe acne scars you’d like to address, a professional chemical peel may be an effective solution. A dermatologist will be able to evaluate your skin’s needs and prescribe a suitable course of treatment.
Cost
Light chemical peels cost from $100–$300, depending on where you live. Medium chemical peels can cost between $1,000-$3,000.
Alternatives to Chemical Peels for Acne Scars
Options outside of chemical peels can also help fade acne scars. Many of these treatments are better suited to treating deep icepick or boxcar scars that are too deep to be effectively treated by chemical peels.
Topical treatments for acne scars
Topicals that treat post-acne skin issues usually target hyperpigmentation. These include skin-lightening agents such as hydroquinone and arbutin.
In terms of DIY options, lemon juice can be used to lighten hyperpigmentation. However, contrary to popular belief, rubbing vitamin E on acne scars is unlikely to have any effect.
Other treatments and procedures
Techniques such as microdermabrasion and microneedling may be effective at treating mild scarring. For more severe cases of atrophic scarring, ice pick scars can be treated with punch grafting and punch incision, whereas boxcar scars can be temporarily treated with dermal fillers.
Hypertrophic acne scars, which are not treatable with peels, can be addressed instead with cryotherapy, corticosteroid injections or excision.
Lastly, laser treatments (which includes a variety of lasers) can also treat many forms of acne scarring.
Takeaway
While chemical peels cannot treat all forms of acne scars, they can noticeably improve skin texture and appearance for many people. The right chemical peel for you will depend on the type of scarring you are experiencing and your skin type.
There are many OTC chemical peels on the market that you can apply yourself at home, often with good results. However, these peels will never have the same dramatic results as a professional chemical peel. Additionally, it’s important to only use products from a reputable source and follow all instructions to avoid damaging your skin.
For scars not treatable with chemical peels, a variety of at-home and in-office alternative procedures are available.
Sources
- National Center for Biotechnology Information. PubChem Database. Glycolic acid, CID=757, https://pubchem.ncbi.nlm.nih.gov/compound/Glycolic-acid (accessed on July 24, 2019)
- Connolly, D., Vu, H. L., Mariwalla, K., & Saedi, N. (2017). Acne Scarring-Pathogenesis, Evaluation, and Treatment Options. The Journal of clinical and aesthetic dermatology, 10(9), 12–23. ncbi.nlm.nih.gov/pmc/articles/PMC5749614/
- Kontochristopoulos, G., & Platsidaki, E. (2017). Chemical peels in active acne and acne scars. Clinics in Dermatology, 35(2), 179–182. ncbi.nlm.nih.gov/pubmed/28274356
- Agarwal, N., Gupta, L. K., Khare, A. K., Kuldeep, C. M., & Mittal, A. (2015). Therapeutic Response of 70% Trichloroacetic Acid CROSS in Atrophic Acne Scars. Dermatologic Surgery, 41(5), 597–604. ncbi.nlm.nih.gov/pubmed/25899884
- Castillo, D. E., & Keri, J. E. (2018). Chemical peels in the treatment of acne: patient selection and perspectives. Clinical, cosmetic and investigational dermatology, 11, 365–372. doi:10.2147/CCID.S137788