Updated: 11/1/17. Most everyone will experience some sort of breakouts, blackheads or clogged pores as teenagers. Unfortunately, some people also experience more severe cystic and nodular acne. This is the kind that can permanently damage the skin and cause indented acne scars that last a lifetime. As an esthetician and skin care expert, a common question I get is, “How can I smooth out the indents in my skin from acne scars?”
Fortunately, there are many things you can do at home for depressed acne scars and indents in your skin. If you choose to seek treatment from a dermatologist or cosmetic professional, you have even more options. A home care regimen should focus on exfoliation, collagen regeneration, and sun protection. When used regularly, this combination can dramatically create a smoother texture with fewer visible indentations. The sooner you start it, the better.
Note: For any other types of skin indents other than indented scars from acne, whether it’s lines, wrinkles, large pores or chicken pox scars, the protocol is actually pretty much the same. Regardless of the cause, all skin indentations benefit from smoothing the skin’s texture.
Tips to smooth out indents in skin
Use a retinol product or a prescription retinoid.
I’m a huge believer in what retinol and prescription retinoids can do to heal indented acne scars and smooth the skin. Yes, it’s still important to get professional treatments like chemical peels that work deeper within the skin to affect change (more on that below). However, using an at-home retinol treatment at least five nights a week will dramatically improve the skin’s texture, without a spa or office visit. It’s essentially like giving your skin mini peels at home.
If your skin is sensitive and can’t tolerate Retin A or other prescription retinoids, your skin will likely respond more favorably to a strong over-the-counter version like Advanced Resurfacing Serum. Use it faithfully and you’ll get results. I promise. Like any well-formulated retinol product, you won’t see results overnight. With continued use, though, indented scars in the skin will look better and better. New to retinol or prescription retinoids? Read my beginner’s guide to retinol.
Wear sunscreen every single day—rain or shine.
You’ll never get great results from these suggestions if you do not wear sunscreen every single day. The sun’s UV rays cause damage to the skin by breaking down collagen, which sabotages any attempt to smooth out your skin and lessen indented scars.
In addition, acne can leave behind dark, red or purple scars that can linger for months. UV rays stimulate melanin cells, so anytime your scars are subjected to them they’ll appear darker, redder, and will be visible longer. UV rays don’t just affect you on sunny days spent outdoors; they can easily penetrate the windows in your home, office, or car. Bottom line: wear a sunscreen moisturizer 365 days a year, rain or shine, inside or out.
For acne-prone skin, it’s very important to find a sunscreen formula that doesn’t clog the pores or encourage breakouts. If you want an extremely lightweight sunscreen formulated for breakout-prone, sensitive skin, Daily Protection SPF 30 is perfect for you.
Schedule a professional chemical peel.
Your esthetician or skin care professional should suggest a series of peels appropriate for the severity of your indented acne scars.
What is a chemical peel? During a chemical peel, a professional will apply a chemical solution (acid) to the face. This removes and exfoliates the outer layers of skin. As a result, a clearer, more evenly pigmented, glowing layer of skin appears. The new, regenerated skin is smoother than the old skin, helping to diminish dents in the skin, whether they are from acne or other causes. Peels also work beneath the surface to encourage the stimulation of fibroblasts. These aid in the creation of new collagen.
As you’re going through the peel process, the new skin will temporarily be more vulnerable to the sun. So daily use of sunscreen is especially imperative during this time. Depending on the type of peel, you may need to repeat treatments every 2-6 weeks to achieve desired results. You can also maintain results by using Triple Berry Smoothing Peel. This peel helps both resurface the skin as well as lift away discoloration left over from blemishes.
*Caution: when it comes to chemical peels, it’s extremely important that the person administering the treatment is well-versed and experienced. If the peel isn’t left on long enough, you won’t see results. On the other hand, if it’s left on too long, you may run the risk of potential damage. Be sure to do your due diligence and get a trusted referral. Here are 5 questions you should ask when consulting with a skin professional.
Get injectable fillers, if needed.
Certain cosmetic dermal fillers such as Restylane and Juvederm will help lift the depressed acne scars. The effect is temporary, only lasting anywhere from 6-12 months. Be sure you consult with a reputable nurse or cosmetic dermatologist to see which type of filler may be best for your skin.
For severe indents in the skin from scarring, consider ablative laser resurfacing.
This should be your last resort if your pitted scars are deep and you’re not seeing desired results from chemical peels. With ablative laser resurfacing, a laser destroys the epidermis and heats the dermis. This, then, leads to collagen destruction and subsequent regrowth. You’ll have a wound after this treatment. After it all heals, new smoother and tighter skin forms. Ablative laser resurfacing can be harsh, but results are often dramatic and may last for years.
There is also fractional laser resurfacing, which is a newer technique. This can be nearly as good as non-fractional ablative resurfacing, but it may take more treatments to achieve the same results. If you decide to proceed with skin resurfacing to smooth out your skin, you might need to take a number of preparatory steps.
These include taking an antiviral or antibacterial medication to prevent infection, applying a retinoid skin cream to help prepare the skin and stopping certain medications, such as drugs, to prevent blood clots. You should definitely stop smoking, too, as it can interfere with healing.
Consider gaining weight.
I know this might sound strange, but gaining weight leads to larger fat cells underneath the skin. This gives a natural plumpness to the skin that can fill indents in the skin, such as scars, as well as lines, wrinkles, and pores.
Severe pitted acne scars can be a challenge to improve but if you’re really committed to it, you can definitely significantly smooth out your skin. I also recommend that you read through all of these acne posts to get my expert advice for getting it under control.
Celebrity Esthetician & Skincare Expert
As an esthetician trained in cosmetic chemistry, Renée Rouleau has spent 30 years researching skin, educating her audience, and building an award-winning line of products. Trusted by celebrities, editors, bloggers, and skincare obsessives around the globe, her vast real-world knowledge and constant research are why Marie Claire calls her “the most passionate skin practitioner we know.”