Which treatment is right for your acne scars?
Acne may be long gone, but the scars it left can stay for years. The good news: today’s in-office treatments can soften scars, smooth texture and rebuild collagen without surgery. The two most effective options are microneedling and fractional CO2 laser resurfacing.
Both work by triggering your skin’s natural healing response, but they differ in depth, downtime and the kind of scars they treat best. This guide explains how each works, compares them side by side, and covers how DermaBlue treats acne scars at its offices in Asheville and Hendersonville.
What causes acne scars, and which type do you have?
Acne scars form when deep, inflamed breakouts damage the collagen beneath the skin. As the skin heals, it either loses tissue, which leaves a depression, or makes too much, which leaves a raised scar. Most people have a mix of types, which is why treatment plans are personal.
- Rolling scars: wide, shallow dips with soft edges that give skin a wavy look. They respond well to collagen-building treatments like microneedling.
- Boxcar scars: broader depressions with sharp, defined edges. These often need deeper resurfacing to soften the edges.
- Ice pick scars: narrow, deep pits. They are the hardest to treat and usually need a series of sessions or a combined approach.
- Raised (hypertrophic) scars: firm, raised tissue, more common on the chest and back. These need a different medical plan from a dermatology provider.
Red or brown marks left after a breakout are not true scars. They often fade on their own or with topical care, laser or peels.
Microneedling for acne scars
Microneedling uses a medical-grade pen with tiny needles to create thousands of microscopic channels in the skin. Those channels trigger your skin’s healing process and boost collagen and elastin, which gradually lifts shallow scars and smooths texture. The channels also help the skin absorb PRP or hyaluronic acid applied right after treatment.
What to expect at DermaBlue:
- Numbing cream is applied first. Most people describe the feeling as light sandpaper moving across the skin.
- A session takes about 30–45 minutes, depending on the area.
- Skin is usually red, like a moderate sunburn, for 12–24 hours. Most people need little or no time off.
- Sessions are spaced 4–6 weeks apart, and most acne-scar plans include a series. Maintenance is typically done 2–4 times a year.
Best for: rolling scars, mild to moderate scarring, uneven texture and enlarged pores, and people who want results with minimal downtime. Medical-grade microneedling is far more effective than at-home rollers, and it’s safe for most skin types when done in a medical setting.
Laser resurfacing for acne scars
Fractional CO2 laser resurfacing is the gold standard for deeper acne scars. DermaBlue uses the CORE fractional CO2 laser, which sends precise microbeams of light into the skin. It removes a fraction of the outer layer and heats the tissue underneath, which triggers new collagen and fresh, smoother skin.
What to expect at DermaBlue:
- Numbing cream is applied before treatment.
- Downtime is typically 5–7 days of redness, swelling and peeling, similar to a sunburn.
- Many patients see a strong result from one treatment; deep scars may need more than one.
- Results keep improving for about six months as collagen rebuilds.
For patients who want less downtime, eCO Tone™ uses lighter settings on the same CO2 laser. It brightens skin and softens scars and fine lines with a shorter recovery, though it usually takes more sessions.
Best for: boxcar and deeper scars, moderate to severe scarring, and patients who also want to treat sun damage, brown spots and wrinkles at the same time.
Firming the skin around scars with XERF™
Scars often look deeper when the surrounding skin has lost firmness. That’s where XERF comes in. XERF is not a laser; it uses dual-frequency radiofrequency energy to heat deeper layers of skin and stimulate collagen, tightening and firming the skin with no needles, no numbing and no downtime.
DermaBlue is one of the top XERF clinics in the nation, with more than 300 treatments performed. XERF doesn’t replace resurfacing for acne scars. But for patients who also have early laxity, crepey texture or a softening jawline, it can be part of a complete skin plan, with results building over 4–12 weeks.
Microneedling vs. laser resurfacing
| Microneedling | Fractional CO2 laser resurfacing | XERF™ (add-on for firmness) | |
|---|---|---|---|
| How it works | Tiny needles create micro-channels that build collagen | Laser removes a fraction of the outer skin and heats deeper layers | Radiofrequency heats deep layers to tighten and firm |
| Best for | Rolling scars, mild to moderate scarring, texture | Boxcar and deeper scars, moderate to severe scarring, sun damage | Mild to moderate laxity and crepey texture around scars |
| Typical sessions | A series, 4–6 weeks apart | Often one; deep scars may need more | 1–3 sessions |
| Downtime | 12–24 hours of redness | 5–7 days of redness and peeling | None |
| Numbing | Yes, topical cream | Yes, topical cream | Not needed |
| When results show | Builds over weeks between sessions | Builds over about 6 months | Builds over 4–12 weeks |
Many patients get the best result from a combination, for example microneedling for texture and laser for deeper scars, timed around their schedule. Your provider will recommend a plan after seeing your skin in person.
Acne scar treatment in Asheville and Hendersonville
DermaBlue offers microneedling, fractional CO2 laser resurfacing and XERF at both western North Carolina offices. Every plan starts with a free 30-minute consultation, where a provider looks at your scar types, skin tone and schedule before recommending a treatment. New patients get $100 off any cosmetic treatment.
DermaBlue Asheville — 1998 Hendersonville Rd, Unit 53, Asheville, NC 28803 · (828) 585-5489
DermaBlue Hendersonville — 120 South Grove Street, Hendersonville, NC 28792 · (828) 685-2917
Because DermaBlue is a full dermatology practice, the same team can also treat active acne, so new breakouts don’t undo the progress you’ve made on your scars.
Frequently asked questions
Is microneedling or laser better for acne scars?
It depends on your scars. Microneedling works well for rolling scars and mild to moderate scarring with almost no downtime. Fractional CO2 laser resurfacing is usually better for deeper boxcar scars and more severe scarring, with about 5–7 days of downtime. Many patients benefit from both.
How many microneedling sessions do I need for acne scars?
Most acne-scar plans include a series of sessions spaced 4–6 weeks apart, followed by maintenance 2–4 times a year. Your provider will suggest a number based on how deep your scars are.
How long is the downtime after CO2 laser resurfacing?
Typically 5–7 days of redness, swelling and peeling. eCO Tone™, a lighter setting on the same laser, has a shorter recovery.
Does XERF treat acne scars?
XERF is a radiofrequency skin-tightening treatment, not a scar-resurfacing treatment. It firms and tightens skin with no downtime, so it pairs well with microneedling or laser for patients who also want firmer skin. DermaBlue has performed more than 300 XERF treatments.
Where can I get microneedling near me in Asheville or Hendersonville?
DermaBlue offers medical-grade microneedling at its Asheville office on Hendersonville Road and its Hendersonville office on South Grove Street. Consultations are free.
How much does acne scar treatment cost?
Cost depends on the treatment, the area and the number of sessions. DermaBlue offers free consultations, discounts for multiple areas, financing, and $100 off for new cosmetic patients.
Book your free skin consultation
You don’t have to figure out your scar type on your own. Book a free 30-minute aesthetic consultation at our Asheville or Hendersonville office, and we’ll build a plan that fits your skin and your schedule. New patients get $100 off any cosmetic treatment. Prefer to talk first? Call (828) 585-5489 or text (844) 994-2744.
Sources
- DermaBlue Microneedling (process, timing, downtime)
- DermaBlue Laser Resurfacing (CORE fractional CO2, eCO Tone, downtime)
- DermaBlue XERF (how it works, sessions, results timeline)
- DermaBlue homepage (locations, $100 new-patient offer)
