Acne Scar Treatment at a Med Spa: Lasers, Microneedling and Peels

Acne scar treatment is not one procedure but a group of them.

Some resurface or remove scarred skin, some stimulate the skin to make new collagen, and some fill or cut out individual scars.

The American Academy of Dermatology (AAD) lists these options for depressed (sunken) acne scars: chemical peels, fillers, laser resurfacing, topical retinoids or salicylic acid for mild scarring, microneedling, platelet-rich plasma as an add-on, radiofrequency, RF microneedling and scar surgery (excision, subcision or dermabrasion).

One familiar spa treatment is not on that list: the AAD says microdermabrasion does not treat acne scars.

Laser resurfacing shows the mechanics most clearly.

Cleveland Clinic describes it as removing the outer layer of skin (the epidermis) while heating the dermis underneath to stimulate new collagen.

Ablative lasers remove layers of skin; non-ablative lasers create heat without injuring the skin surface.

Fractional lasers work differently — Cleveland Clinic describes fractional CO2 as drilling numerous narrow columns into the skin while the surrounding skin remains untreated and intact.

ASDS, the dermatologic surgeons' society, names CO2 and erbium as the two most common resurfacing lasers: CO2 for wrinkles, scars, warts and other conditions, and erbium for superficial and moderately deep lines on the face, hands, neck and chest.

CO2 lasers are 510(k)-cleared medical devices, not FDA-approved.

One fractional CO2 system, the Candela CO2RE (K181523), is cleared for dermatological procedures requiring ablation, coagulation and resurfacing of soft tissue including skin.

Our CO2 laser guide follows that device class in depth.

Peels and microneedling sit on the same AAD list.

The AAD's example plan for a mild peel is 3 to 5 treatments given every 2 to 4 weeks.

Our chemical peels guide covers the three peel depths, and our microneedling guide covers what microneedling devices are authorized for and what they cost.

These treatments address scars — the textural changes acne can leave behind.

The AAD describes the depressed types: ice pick scars, the most common type, which look small but go deep into the skin; rolling scars, which are wide and shallow; and boxcar scars, which are round or oval depressions wider than ice pick scars.

The raised types — hypertrophic, keloid and papular scars — form when the skin makes too much collagen while healing, and the AAD says they are more common in people with darker skin tones.

Keloids may begin 3 to 12 months after acne clears.

One look-alike is not a scar at all.

The AAD says the flat discolored spots acne leaves behind — post-inflammatory hyperpigmentation — are usually not scars.

That distinction matters when you read any treatment list: the AAD's list of options is a list for scars, and the flat spots are not scars.

Timing comes first.

The AAD says scar treatment usually begins after active acne is under control, and that patients should tell the dermatologist about every acne treatment used in the last two years, because some scar treatments can cause side effects during or soon after certain acne medicines.

Candidacy then depends on the modality.

Cleveland Clinic lists acne and chickenpox scars among the concerns laser resurfacing suits well.

ASDS and Cleveland Clinic both say people with active acne or very dark skin usually are not good candidates for ablative resurfacing, and Cleveland Clinic adds that darker skin carries a greater risk of healing with hyperpigmentation, with erbium possibly the better choice.

Raised scars are their own case: the AAD says hypertrophic scars may be treated with lasers, corticosteroid or other injections, or prescription topicals, and that keloids often need combined treatments and can return.

For which laser suits which scar type, see laser resurfacing for acne scarring.

Two cost facts frame everything else.

The AAD says medical insurance does not cover acne scar treatment, and it says insurers treat laser scar treatment as cosmetic, so the full bill is out of pocket.

How the bill is built depends on the modality and on how the provider prices it — ask whether a plan is quoted per session, per area or as a package, and remember that a plan can span several appointments.

There is one national anchor, and it is specific to resurfacing.

ASPS, the plastic surgeons' society, puts the average cost of skin resurfacing procedures like laser skin resurfacing at $1,829, according to its latest statistics.

That is a plastic-surgeon fee, not a med spa price, and ASPS says it excludes related costs such as facility, anesthesia and prescriptions.

We could not confirm a national average price for acne scar treatment across all of these modalities, so treat any single all-modality figure you see as a question to ask about, not an answer.

What moves the price is mostly the plan itself.

The AAD says ice pick scars need different treatment than rolling scars, so the scar type shapes the modality, and the modality shapes the session count: the AAD's mild-peel example runs 3 to 5 treatments every 2 to 4 weeks, non-ablative lasers often require a series of treatments, and a 2023 review notes non-ablative fractional lasers need more sessions than ablative ones in skin of color.

Ask any provider what a quote includes — which device, what settings for your skin type, and how many visits — before you compare prices.

Session counts follow the modality, and the sources give ranges rather than a single number.

The AAD's example plan for a mild chemical peel is 3 to 5 treatments given every 2 to 4 weeks.

It says non-ablative lasers often require a series of treatments and that results can take months to appear.

For skin of color, a 2023 review describes non-ablative fractional lasers as first line but notes they are less effective and need more sessions than ablative lasers.

Longevity is equally scoped.

Cleveland Clinic says skin may keep improving for up to a year after resurfacing and that results may last several years, though normal aging brings new wrinkles.

Keloid scars are the exception on durability: the AAD says keloids often need combined treatments and can return.

And the honest ceiling is improvement, not erasure.

The AAD's wording is that laser treatment can make a scar less noticeable but cannot get rid of it.

Pain and downtime track each other.

A 2018 systematic review of energy-based acne scar treatments found ablative lasers achieve the highest efficacy but with significant pain, downtime and a risk of long-term pigment change, while RF and RF microneedling were slightly less effective than non-ablative fractional lasers, with an even safer profile.

Resurfacing is done as an outpatient procedure: Cleveland Clinic describes local anesthesia, often plus oral or IV sedation, with a partial face taking 30 to 45 minutes and a full face 1.5 to 2 hours.

In a 2026 review of RF microneedling, the reactions reported were mostly redness, swelling and transient pain.

Recovery figures differ by laser and by source.

Cleveland Clinic gives up to two weeks for traditional CO2 resurfacing, one full week for erbium and one full week for fractional resurfacing, with treated areas generally healing in 5 to 21 days.

ASDS says healing takes 3 to 10 days depending on the depth of resurfacing and the type of laser, with daily soaks, ointment and re-dressing.

Cleveland Clinic says redness generally fades in 2 to 3 months, but in some cases it can persist for 6 months to a year, and it goes on longer in people with blonde or red hair.

Before laser scar treatment, the AAD advises a short list of preparations:

Cleveland Clinic lists the complications of laser resurfacing as milia (which can appear up to a month after treatment), hyperpigmentation and, rarely, hypopigmentation, cold sore reactivation (especially around the mouth), bacterial infection, swelling and, very rarely, scarring.

It notes antivirals are often started before treatment.

ASDS adds a burning sensation, itching and bumps from blocked sweat glands.

The largest recent summary puts the risks in rank order.

A 2026 systematic review of facial laser complications (13 studies, 2,010 cases treated from 2019 to 2025) found post-inflammatory hyperpigmentation was the most common complication, particularly in Fitzpatrick skin types IV to VI, and that ablative lasers (CO2, Er:YAG) carried the highest risks of scarring and infection.

Ocular injuries were less common but among the most severe.

For acne scars specifically, a 2023 review of treatment in skin types IV to VI says the pigment-change risk depends on the skin type, the device and its settings, including the density of treatment.

RF microneedling has its own serious-risk record.

On October 15, 2025 the FDA issued a Safety Communication warning that serious complications — burns, scarring, fat loss, disfigurement and nerve damage, sometimes needing surgical repair — have been reported with RF microneedling used for aesthetic skin procedures.

The evidence ranks these options by the trade they make: the treatments that change scars most ask the most of your skin.

Two expert signals run through that table.

A 2022 international consensus of 24 dermatologists and plastic surgeons from 12 countries concluded energy-based devices are a first-line treatment for many acne scar types, with ablative fractional lasers, non-ablative fractional lasers, vascular lasers and RF devices preferred by most of the panel.

A 2018 systematic review of 59 articles reached the same trade from below: efficacy rises together with pain, downtime and pigment risk.

Which option fits which scars is a question for a licensed provider who has examined them.

Device specifics matter too: InMode's Morpheus8 applicators are cleared only for dermatologic procedures needing coagulation or contraction of soft tissue or hemostasis, and use above 62 mJ/pin is limited to Fitzpatrick skin types I to IV — acne scars are not on that clearance, so ask what the device and settings a provider plans to use are expected to do for your scars.

Start with the scar types, because the AAD says ice pick scars need different treatment than rolling scars.

A provider who can name your scar types and explain which modality they would use for each — and why — is showing you the thinking the rest of the price quote depends on.

Who may perform a treatment is not answered by FDA clearance.

For ablative laser resurfacing, it is a question of state law, set through the state medical and nursing boards — and for injections, AmSpa, the med spa trade association, says injecting a prescription drug such as botulinum toxin falls under the practice of medicine, under rules that vary by state.

Ask who will perform your treatment and what that person's license and training is, and check the answers against the rules where you live.

Ask about the plan's honest ceiling as well.

The AAD says laser treatment cannot get rid of a scar, so a promise to erase scars completely goes beyond what the source says the treatment can do, and results can take months to appear.

Insurance will not cover the treatment, so ask for the total plan cost — sessions, areas and any package terms — before you book.

Our how to choose a med spa checklist covers the questions worth asking any provider: the medical director, who treats you, training on the specific device, and how pricing works.