Does Accutane Help With Acne Scars?

Some patients taking or interested in taking Accutane (isotretinoin) might also have acne scars, and they’re interested in knowing whether the medication is effective for treating or preventing scars from acne.

Does Accutane Help With Acne Scars?

The simple answer is that while isotretinoin lowers the risk of new scars forming because it treats and can put severe acne into remission, it can’t undo the damage a deep breakout has already started, and it won’t improve the appearance of older, already formed acne scars.

That’s why the American Academy of Dermatology’s guidelines recommend isotretinoin for acne that is already causing scarring, and treat that acne as severe.

Reynolds et al. (2024). Journal of the American Academy of Dermatology

Even so, lowering the risk isn’t the same as removing it: scarring can still happen when acne is being treated well.

Jennings et al. (2024). Journal of the American Academy of Dermatology

Older scars are a different problem, because scars are structurally different things from active acne spots. Things like redness or post-inflammatory hyperpigmentation generally fade over months, sometimes longer, especially once active acne is taken care of. On the other hand, scars are permanent changes to the structure of the skin itself. They usually form where a deep, inflamed breakout has damaged the tissue underneath.

That isn’t limited to severe acne. In a US study of nearly 2,000 patients seeing a dermatologist for acne, 43% had acne scars, and 69% of those had mild or moderate acne at the time they were seen.

Tan et al. (2017). Journal of Drugs in Dermatology

Isotretinoin doesn’t mechanistically act on scar tissue, but rather on the oil production and inflammation in the skin. So you might see improvements in surrounding skin texture and color, but the scar itself isn’t something isotretinoin is used to treat. Some patients also find that dryness during treatment makes texture look more noticeable for a while.

It’s important to set expectations, because without knowing what isotretinoin can help with, and how it works, as well as the timelines involved in treatment with it, the process can feel discouraging at times. For example, some patients on the medication experience a purge phase, a period of time where skin actually temporarily worsens before getting better and clearing up.

Does Accutane Help With Hyperpigmentation?

Indirectly. Red marks (post-inflammatory erythema) and dark marks (post-inflammatory hyperpigmentation) are the flat, discolored spots a breakout leaves behind, and they are often what people mean when they talk about scars. Isotretinoin isn’t a treatment for the marks themselves, but clearing the acne stops new ones from forming, which gives existing marks the chance to fade.

That fading takes patience. A dermatologist consensus on acne-related dark marks describes them as more common in darker skin and often long lasting, and puts early, effective acne treatment first, with a topical retinoid as a first-line option.

Taylor et al. (2023). Journal of the American Academy of Dermatology

On isotretinoin, many patients still have marks around month three even once breakouts have settled. Options like tretinoin for dark marks are worth raising with your provider, since combining products while your skin is already dry is their call.

How Do You Get Rid of Acne Scars, Then?

In order to fix acne scars, the first step of the process should be controlling the current state of the skin, to ensure no future damage is coming in the first place. This likely involves treatment, either with isotretinoin or a topical acne treatment, to stabilize the skin for the long term. There is no point in treating scars if the baseline state of the skin is still bad and able to cause more damage.

It is important to remember that these acne treatments themselves are generally not effective for the treatment of acne scars that have already formed.

Types of Acne Scars

There are various types of acne scars, and treatment will depend largely on scar type and pattern, as well as the individual’s skin sensitivity. The system most dermatologists use sorts pitted (atrophic) scars into three shapes, and each tends to respond to different treatments.

• Icepick scars: narrow, deep pits that look as if the skin was punctured.
• Boxcar scars: round or oval depressions with sharp, defined edges.
• Rolling scars: wider, shallower dips with sloping edges that give skin an uneven, wavy look.

Jacob et al. (2001). Journal of the American Academy of Dermatology

Less commonly, acne leaves raised scars instead: hypertrophic scars, which stay within the original wound, and keloids, which grow beyond it.

The general treatment plan focuses on the limiting factor, or worst aspect of the scarring, and then moves to refining the treatment and recovery with things like texture blending and tone improvement. Beyond scar type, the number of scars, your skin type and how much downtime you can take all shape the plan.

Renzi et al. (2024). Journal of the American Academy of Dermatology

Treatment is done with a long-term mindset and is paced to ensure proper recovery between different procedures.

What Can Be Done for Acne Scars?

Most of the treatment options for acne scars are going to be centered around more involved, in-person clinical procedures.

Think things like:

• Subcision, which releases the bands pulling rolling scars down
• Punch excision and TCA CROSS, mainly for icepick scars
• Steroid injections, for raised scars
• Fillers
• Laser resurfacing, fractional or fully ablative
• Chemical peels
• Microneedling, including radiofrequency microneedling
• Dermabrasion

A Cochrane review of 24 trials found the research too weak to back any single scar treatment as the first choice, and fillers were the only option with moderate-quality evidence behind them.

Abdel Hay et al. (2016). Cochrane Database of Systematic Reviews

More recent trials point toward combining treatments. A 2026 analysis of 56 randomized trials found that combinations generally did better than single treatments for moderate to severe pitted scars, with fractional CO2 laser paired with subcision or PRP showing the most consistent benefit. Most of those trials were small, so the right combination for your skin is one to plan with a dermatologist.

Ou et al. (2026). Aesthetic Plastic Surgery

How Soon After Accutane Can You Get Scar Treatment?

The standard guidance on skin treatments during or after isotretinoin has been to wait 6 to 12 months, and the FDA label still says to avoid waxing and skin resurfacing, such as dermabrasion and laser, during treatment and for at least 6 months afterward.

US Food and Drug Administration (2002). Accutane (isotretinoin) prescribing information

However, a 2017 systematic review and expert consensus, covering 32 publications and 1,485 procedures, found that there wasn’t enough evidence to support delaying treatments like superficial peels, laser hair removal, fractional lasers, or minor surgery, although mechanical dermabrasion and fully ablative lasers were still not recommended during treatment.

Spring et al. (2017). JAMA Dermatology

The label and the review don’t agree yet, so timing is a decision for the dermatologist treating you, who may consider starting some procedures sooner than the old rule suggests.

How to Get Prescribed Isotretinoin (Accutane) Online

If you’re wondering how or where to get isotretinoin, Happyglow connects you with US-licensed physicians who decide whether starting isotretinoin is right for you, entirely online.

1. Start your visit. Answer a few questions about your health and goals (~5 min).
2. A physician reviews. They determine whether isotretinoin is appropriate for you or recommend a better fit.
3. Delivered to your door. If approved, your prescription ships free, with refills coordinated with your monthly check-ins.

See if isotretinoin is right for you→

Not approved? You’re refunded in full.