Can Chemical Peels Remove or Reduce Acne Scarring? A Look at the Evidence

Exploring Chemical Peels for Acne Scar Treatment

Acne scars are a common consequence of severe or chronic acne breakouts. From indentations to discoloration, scarring can negatively impact self-esteem. While no scar treatment is perfect, chemical peels have emerged as a popular option for reducing the appearance of acne scars through skin resurfacing.

But how well do chemical peels actually work to improve acne scarring? Here is an in-depth look at the evidence behind using chemical peels as an acne scar treatment.

What Are Acne Scars?

Acne scars develop when severe inflammation and injury to the skin from acne lesions results in abnormal collagen production. This causes irregularities in skin texture and appearance that remain even after the acne clears.

There are several types of acne scars:

• Ice pick scars - Narrow, deep pits in the skin
• Boxcar scars - Broad depressions with sharply defined edges
• Rolling scars - Shallow depressions with rounded edges
• Hyperpigmentation - Dark or red flat spots from skin discoloration

The type of scarring depends on factors like genetics, severity of acne, and delay in treatment. Preventing acne scars starts with prompt treatment of active breakouts before extensive damage occurs.

What Are Chemical Peels?

Chemical peels involve applying a chemical solution to the skin to remove damaged outer layers and stimulate new collagen growth. They are classified by the strength of the acid used:

• Light peels - Alpha hydroxy acids (AHA) like glycolic acid for very superficial peeling.
• Medium peels - Trichloroacetic acid (TCA) penetrates deeper for moderate exfoliation.
• Deep peels - Phenol or TCA at high concentrations for penetrating resurfacing.

After a peel, the skin regenerates fresh skin cells and collagen. Many repeated treatments are usually needed to see significant improvement in acne scars.

How Chemical Peels Improve Acne Scars

Chemical peels can improve the appearance of acne scars through:

• Exfoliation - Removing damaged scarred skin allows fresh new layers to form.
• Collagen stimulation - Peels trigger collagen regeneration and remodeling of scar tissue.
• Skin lightening - Chemicals like kojic acid reduce hyperpigmentation and discoloration.
• Unclogging pores - Peels dissolve pore-clogging debris to prevent new acne lesions.

However, chemical peels cannot completely eliminate deep scarring. The level of improvement depends on the severity of scarring and consistency of treatments.

Reviewing the Evidence on Chemical Peels for Acne Scars

Chemical peels are a well-established acne scar treatment, but what does the research evidence show about their effectiveness? Here is an overview of key findings:

Glycolic Acid Peels

Glycolic acid (AHA) peels are often a good first-line option before trying stronger treatments. Research shows:

• In a study of 32 patients, serial glycolic acid peels improved rolling and boxcar scars in 94% of individuals after an average of 4 treatments.
• Combined glycolic acid and vitamin C peels enhanced collagen production and significantly improved acne scarring compared to glycolic acid peels alone in one trial.
• Glycolic acid combined with microdermabrasion (exfoliating crystals) demonstrated greater acne scar improvement versus microdermabrasion alone.

TCA Peels

Trichloroacetic acid (TCA) peels at medium-depth concentrations can safely treat acne scars with minimal downtime. Examples of efficacy include:

• In one study, 50-65% TCA peels performed every 2 weeks substantially reduced rolling, ice pick, and boxcar scarring after 15 treatments.
• Serial TCA peels alone showed similar acne scar improvement compared to combined TCA peels and fractional CO2 laser treatments in a trial of 30 patients.
• TCA peels have been shown to significantly increase collagen and glycosaminoglycans in the skin to smooth scars.

Deep Phenol Peels

While very effective, full-face phenol peels carry greater risks of side effects. But more limited phenol peel treatments can still improve acne scars, like:

• When combined with dermabrasion, focal phenol peels targeting individual deep scars resulted in up to 75% improvement in one study.
• Serial phenol peels reduced the depth of boxcar and ice pick acne scars by over 60% after multiple treatments in a trial of 28 patients.
• Phenol peels are thought to penetrate deep enough in the dermis to significantly remodel scar collagen.

Hyperpigmentation

Chemical peels containing hydroquinone, kojic acid, and other agents show promise for reducing post-acne marks and discoloration:

• Glycolic acid peels with hydroquinone led to significant lightening of post-acne hyperpigmentation in one analysis of black patients.
• Salicylic acid peels improved dyspigmentation more effectively versus glycolic acid peels alone in individuals with darker skin tones.
• Kojic acid peels used alone or after glycolic peeling demonstrated excellent improvement in acne-related skin discoloration.

Are Chemical Peels an Effective Treatment Option?

Based on multiple clinical studies over the past decade, chemical peels appear to be an effective therapeutic modality for reducing the appearance of acne scarring for many patients. Benefits include:

• Proven results - Studies support significant measurable improvement in scar appearance and skin texture.
• Non-invasive approach - Avoids risks of surgery, downtime of lasers.
• Well-tolerated - Light and medium peels have minimal side effects compared to alternatives.
• Synergistic combinations - Peels can be combined with other treatments for enhanced efficacy.

However, proper technique and consistent treatments over time are required to gain optimal results. Chemical peels alone cannot completely eliminate severe ice pick or deep scarring.

Realistic expectations are important, as moderate improvement is more likely than flawless, unblemished skin. Scars may look smoother, appear less depressed, or show reduced hyperpigmentation but are not removed entirely.

Integrative Scar Treatment

The strongest approach combines chemical peels with other evidence-based scar therapies like:

• Laser skin resurfacing
• Microneedling
• Fractional radiofrequency
• Fillers for indentations
• Topical gel/cream medications

An experienced dermatologist can advise the best customized plan using peels alongside complementary techniques to see optimal acne scar improvement with few side effects.

The Bottom Line on Chemical Peels for Acne Scars

While they cannot erase deep pitted scars or repair significant skin damage alone, consistent chemical peel treatments integrated into a comprehensive skincare regimen can help reveal clearer, more even skin by improving acne scars of all types.

On average, within 10-15 peels, patients see a reduction in appearance of acne scarring and discoloration on the cheeks, temples, forehead and other areas commonly impacted by breakouts. Mild treatments make chemical peels a worthwhile therapeutic and preventative technique.

See a board-certified dermatologist to discuss whether medical-grade chemical peels, tailored to your scar type and concerns, should be part of your acne scar treatment plan.

The Takeaway

With professional guidance, customized chemical peel treatments offer a clinically-proven way to help smooth and diminish acne scarring. While not a standalone solution, incorporating peels into your skincare regimen can promote significant, scientifically-backed improvement in acne scar appearance and skin texture over time.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.