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Acne scars:
what actually works.

Not every mark acne leaves behind is a scar, and not every scar responds to the same treatment. Here's how to tell what you have, what fixes it, and what a realistic timeline looks like.

Journal · Acne · Guide · Updated September 13, 2026

The short answer: Indented (atrophic) acne scars need collagen remodelling, and microneedling with PRF is our first choice: 3–6 sessions, with improvement continuing up to 12 months. Choose Morpheus8 if the skin is also loosening. Flat red or brown marks aren't true scars: they respond to chemical peels and IPL instead. Active breakouts come first, because treating scars on inflamed skin wastes sessions.

First, what are you looking at?

  • Indented scars (rolling, boxcar or ice-pick) form when acne damages the collagen under the skin during inflammation. They are the most common kind and need remodelling treatments. Rolling and boxcar scars respond best; ice-pick scars are narrow and deep, so they're harder, but often still improvable.
  • Flat marks are brown (post-inflammatory pigment) or red and pink (leftover vascular redness). There's no texture change, so they need a treatment that targets colour, not collagen.
  • Raised or keloid scars are a different problem. A history of keloid scarring rules out microneedling and Morpheus8, so tell us at consultation.

The options, side by side.

TreatmentBest forCourseDowntimePrice
DP4 microneedling + PRFIndented scars on otherwise firm skin3–6 sessions, 4–6 weeks apart1–3 days of redness$850 per session with PRF, $2,500 for 3 · $295 without PRF
Morpheus8 RFIndented scars plus loosening skin, all skin types3 sessions, 4–6 weeks apart2–3 days, pinpoint marks for 5–7$800 face
The Skin Renewal TreatmentBrown marks, mild scarring, congestion3–4 sessions, 3–4 weeks apart2–5 days of peeling$175
IPL LumeccaRed and brown marks (not indentations), lighter skin types1–3 sessions, 4 weeks apartMarks darken and flake for 3–7 days$250 face

Why PRF helps.

Microneedling creates thousands of controlled micro-channels that trigger new collagen to fill indentations. Adding PRF, growth factors concentrated from a small draw of your own blood, speeds healing and strengthens that collagen response. For general skin quality PRF is optional, but for scarring it is what we recommend. Our PRP vs PRF guide explains the difference between the two.

Clear skin comes first.

If you're still breaking out, we start there. Active acne usually stabilises within 2–3 months on a consistent medical-grade routine, such as ZO's Complexion Clearing program, alongside gentle salicylic peels or The Clarity Facial. Severe, cystic or treatment-resistant acne belongs with your family doctor or a dermatologist, who can prescribe systemic medication. If you've taken isotretinoin (Accutane), you'll need to wait 6 months after stopping before microneedling, Morpheus8 or a peel.

Peels and microneedling can be alternated (a peel one month, microneedling the next) but not stacked on the same day. More on our acne and scarring page.

Quick questions.

No. Indented acne scars respond to microneedling even when they are years old, because the treatment stimulates new collagen rather than relying on the original healing. Ice-pick scars are the hardest type, but many still improve.
Texture starts to improve around 4–6 weeks after a session, and scars keep improving for 3–6 months as collagen fills the indentations. Remodelling continues up to about month 12, so judge the course as a whole rather than one session.
Sometimes, on a first visit with congested skin. That is temporary purging, not new acne. If we are concerned, we pre-treat with a gentler peel or a ZO regimen first.
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