Removing Pitted Acne Scars with Laser: Best Methods, Number of Sessions, Aftercare, and Possible Side Effects

Removing Pitted Acne Scars with Laser

If, after your acne has subsided, there are holes and depressions left on your face that have not improved with creams and a skincare routine, you are not alone. “Pitted acne scars” are actually a type of scar caused by deep damage and inflammation in the skin. The good news is that removing pitted acne scars with laser is one of the most effective medical methods for making the skin smoother and its texture more even; however, it is important to be realistic: laser treatment usually does not provide “100% removal.” Rather, its goal is a significant and natural improvement in the appearance of the skin.

In this guide, we explain exactly how laser improves acne pits, which type of laser is more suitable for each type of scar, how many sessions are typically needed, what pre- and post-treatment care is required, and what helps improve your results while reducing side effects.

Quick Comparison of Common Treatments for Pitted Acne Scars

To give you a clear picture from the start, the table below compares the most common methods in terms of “suitability,” “recovery time,” and “key point.” The final choice should always be made after a physician’s examination and assessment of the scar type.

What Exactly Are Pitted Acne Scars and Why Do They Form?

When a deep, inflamed pimple develops, the inflammation can damage the lower layers of the skin. The body tries to repair the area, but if:

• tissue destruction is extensive,
• insufficient or improperly organized collagen is produced,
• or fibrotic adhesions form beneath the skin,

the result is depressions and unevenness known as “atrophic scars” (depressed scars).

Types of Pitted Acne Scars (and Why Knowing the Scar Type Matters)

Not all acne pits are alike, and this is the main reason why laser results vary from person to person. In simple terms, depressed scars are most often seen in three groups:

• Ice Pick: Narrow and relatively deep holes, similar to needle marks. They usually do not respond ideally to laser treatment alone and may sometimes require more targeted methods.
• Boxcar: Depressions with relatively defined edges. They can respond well to fractional laser and combination treatment.
• Rolling: Broad, wavy unevenness that is typically caused by subcutaneous adhesions. In this case, subcision often plays a key role, followed by laser treatment to improve the surface.

Many people have a combination of all three types. Therefore, a “personalized” treatment plan is usually more effective than a single method.

How Does Laser Improve Pitted Acne Scars?

The main basis of laser treatment for depressed scars is stimulating collagen production and controlled skin resurfacing. With fractional lasers, the beam reaches the skin in numerous tiny columns; in other words, parts of the skin are targeted while other parts remain intact. This design helps:

• speed up healing,
• promote new collagen formation over the following months,
• gradually make the skin texture more organized and smoother,
• improve some post-acne marks along with textural unevenness (depending on the type of discoloration).

What Types of Lasers Are Used to Remove Pitted Acne Scars?

In practice, a range of devices and techniques are used for acne scars. The exact choice depends on the scar type, skin tone, history of post-inflammatory hyperpigmentation (PIH), skin sensitivity, and your lifestyle (for example, whether you can avoid sun exposure).

1) Fractional CO2 Laser

Fractional CO2 laser is one of the best-known options for depressed scars. This method can improve uneven texture while stimulating collagen production to gradually reduce the depth of acne pits. It is commonly used for moderate to deep scars.

A realistic note: Because this laser is relatively powerful, following post-treatment care instructions (especially sun protection and proper use of healing products) plays a decisive role.

2) Erbium Laser (Erbium)

Erbium usually provides more controlled resurfacing and is a good option for some people who want a shorter recovery period or have more sensitive skin. It can be effective for many superficial to moderate scars, while deeper scars may require combination treatment.

3) Non-Ablative Lasers and Light-Based Treatments (such as IPL)

For the actual “depression,” these methods are generally not as powerful as fractional lasers. However, for some people, they can help address post-acne redness or superficial pigmentation alongside scar treatment. If your main concern is discoloration rather than pits, the treatment approach may be different.

4) Fractional RF (as an Alternative or Complement)

For some skin types, especially when the risk of post-inflammatory pigmentation is higher, a physician may suggest fractional RF as a lower-risk option or a complementary treatment. By creating controlled heat in the deeper layers of the skin, this method stimulates collagen production and helps improve skin texture.

Who Is a Good Candidate for Laser Treatment of Pitted Acne Scars?

In general, if you do not have severe active acne and your main concern is “remaining scars,” you are likely a candidate for laser evaluation. The following individuals usually achieve better results:

• People whose active acne is controlled and who are not developing new inflammation.
• People who can avoid sun exposure during treatment and use sunscreen carefully.
• Those with realistic expectations: gradual, step-by-step improvement rather than “flawless skin in one session.”

Who Should Be Cautious or Postpone Laser Treatment?

Under the following conditions, treatment should generally be postponed or an alternative selected:

• Presence of infection, open wounds, or severe active acne in the treatment area
• A history of raised scars or keloids (requiring careful assessment)
• Certain uncontrolled conditions (such as uncontrolled diabetes) or situations that impair healing
• Use of certain medications (especially medications that affect skin healing); these must be disclosed to the physician
• Inability to follow post-laser care instructions (particularly sun protection)

If you have a history of cold sores, be sure to inform your physician before laser treatment so preventive measures can be taken if necessary.

What Are the Steps of Acne Scar Laser Treatment at a Clinic?

The general process of laser treatment for pitted acne scars usually proceeds as follows:

1. Consultation and treatment planning: Your scar type, skin tone, history of pigmentation, and lifestyle are assessed. Photographs may sometimes be taken for before-and-after comparison.
2. Skin preparation: The face is cleansed, and topical numbing cream is used if needed.
3. Laser treatment: The physician adjusts the parameters (intensity, depth, and number of passes) according to your skin.
4. Immediate post-treatment measures: Cooling, soothing creams, or healing products may be recommended.
5. Healing period: Redness, a warm sensation, and sometimes peeling are normal. This period depends on the laser type and treatment intensity.
6. Follow-up sessions and result evaluation: Scar improvement is gradual and is generally seen more clearly over several sessions and months.

How Many Laser Sessions Are Needed and When Will Results Be Visible?

The number of sessions depends on the scar type and the device used. Most people need several sessions of treatment. Additionally, because collagen production takes time, final results are usually seen gradually and may become more noticeable several weeks to months after each session.

Simply put: laser does not provide complete instant results; however, with the right plan, the skin gradually becomes smoother and its texture more even.

Is Laser Treatment Alone Enough? The Role of Combination Treatment for Deep Pits

One point that many superficial articles do not address sufficiently is that for moderate to deep scars, the best results are often achieved with a combination of several methods. The reason is simple: each method targets a different part of the problem.

Common and Logical Combinations

• Subcision + fractional laser: Subcision releases subcutaneous adhesions, while laser resurfaces the skin.
• Microneedling + PRP: For gradual improvement, skin quality, and support for healing (depending on the physician’s recommendation).
• Laser + mild chemical exfoliation: For some people, to help with pigmentation and texture (only under a physician’s supervision).
• Filler + regenerative treatments: For those who need rapid cosmetic improvement, although it usually should be performed alongside foundational scar treatment.

If you would like a more comprehensive perspective on choosing the best method, you can also read the article The Best Treatment for Removing Acne Scars.

Pre-Laser Care to Reduce Side Effects and Improve Results

Proper preparation reduces the risk of pigmentation and inflammation and allows the physician to provide more precise treatment. The most important recommendations (assuming your physician has not given you specific restrictions) include:

• Avoid sun exposure and tanning beds before treatment.
• If your skin is sunburned or irritated, postpone treatment.
• If you use highly irritating products (such as certain exfoliants), you may need to stop them for a period of time based on your physician’s advice.
• If you have a history of cold sores, disclose it in advance.
• At your consultation, provide an accurate list of medications and supplements.

Post-Laser Care: The Most Important Factor in Preventing Pigmentation and Worsening Scars

After laser treatment, your skin is like “controlled injured skin”; it is healing, and during this period, you need to give it an opportunity to regenerate properly.

What You Should Do

• Use sunscreen regularly and correctly (according to your prescription and physician’s recommendations). Light protection is one of the key factors in preventing pigmentation.
• Use the prescribed healing and moisturizing creams.
• Keep the skin clean with a gentle cleanser and avoid touching or picking at it.
• If you have redness and warmth, you may use cool compresses according to your physician’s advice (not direct ice).

What You Should Not Do

• Do not pick peeling skin or scratch the area; doing so increases the risk of pigmentation and scarring.
• Until your physician approves, do not use scrubs, strong exfoliants, retinoids, or fragranced products.
• During the first few days, avoid saunas, very hot showers, and intense exercise that cause heat and heavy sweating.
• Postpone makeup use until your physician says it is appropriate, as it may irritate the skin.

If you are dealing with pigmentation in addition to acne pits, the article Treatment for Dark Acne Marks on the Face may help you understand which approaches are more suitable for dark marks.

Possible Side Effects of Laser for Pitted Acne Scars (and When to See a Doctor)

When performed by an experienced physician using a standard device, laser treatment is generally safe; however, like any medical procedure, it can have side effects. Knowing about them helps you begin treatment with confidence and preparation.

Common and Usually Temporary Side Effects

• Redness and swelling (especially with stronger lasers)
• Burning/warm sensation similar to sunburn
• Dryness and peeling during the healing period

More Significant Side Effects (Less Common but Important)

• Skin darkening (hyperpigmentation), particularly if sun protection is not taken seriously or the skin is prone to pigmentation
• Infection if the skin is manipulated or aftercare instructions are not followed
• Cold sore flare-ups in susceptible individuals

What Symptoms Require Prompt Contact with Your Doctor?

• Severe or unusual pain
• Pus discharge, foul odor, or abnormal crusting
• Fever or signs of infection
• Very severe redness or redness that worsens after several days

Why Do Some People Not Get Results from Laser? (Common Mistakes)

Sometimes the issue is not the “laser” itself, but the treatment pathway. Common reasons for unsatisfactory results include:

• Treating tethered scars without subcision (especially rolling scars)
• Choosing an unsuitable device/intensity for the skin type or scar type
• Unrealistic expectations from a single session
• Failure to follow aftercare (sun exposure, picking, or irritating products)
• Active acne and the formation of new scars during treatment

What Does the Cost of Removing Pitted Acne Scars with Laser Depend On?

The cost of acne scar laser treatment is not fixed and is best determined after an examination. Influencing factors include:

• Laser type and device technology
• Severity and depth of scars and the size of the treatment area
• Number of required sessions
• Need for combination treatment (such as subcision, microneedling, PRP, or filler)
• Physician experience and the clinic’s care and safety protocols
• Geographic location of the clinic

When Can You Return to Work and Daily Life After Laser Treatment?

Depending on the laser type and treatment intensity, you may be able to perform light activities on the same day; however, stronger lasers (such as fractional CO2) usually cause several days of redness and peeling. If your job is outdoors or involves exposure to sunlight and pollution, planning the timing of treatment is very important.

Golden Keys to Getting the Best Results from Laser Treatment for Pitted Acne Scars

• First control active acne, then address the scars.
• Identify the scar type correctly; tethered scars often require subcision.
• View the treatment plan as step-by-step and allow your skin time to produce collagen.
• If your skin is prone to pigmentation, have treatment at a time when sun exposure is lower and take sun protection more seriously.
• Consider post-laser care an “essential part of treatment,” not an additional recommendation.

For Whom Are Home Remedies Not Enough?

Masks and home remedies may help improve skin clarity and calm the skin, but for true pits (depressed scars), they generally cannot correct the deeper skin structure. If the depressions have been present for years or the skin texture looks uneven under light, it is more sensible to seek a clinical evaluation.

Frequently Asked Questions