Pockmarks are typically caused by old acne marks, chickenpox, or infections that can affect the skin, such as staph. The results are often deep, dark-colored scars that don’t seem to go away on their own.

There are scar-removal options that can help remove pockmarks or minimize their appearance. Read on for 10 options to discuss with your skin care specialist.

1. Over-the-counter (OTC) scar treatment cream

From traditional creams to silicone-filled bandages, OTC treatments primarily work by hydrating your skin and minimizing overall scar appearance. They can also help ease any itching and discomfort you might have.

Examples include:

• Mederma
• Murad Post-Acne Spot Lightening Gel
• Proactiv Advanced Dark Spot Correcting Serum
• Peter Thomas Roth Acne Discovery Kit

OTC scar treatments are readily available without a prescription. However, these can take months to work and require persistent use for best results. In some cases, continuous use can also increase the risk of side effects, such as rash and irritation.

2. Facial massage

A facial massage doesn’t directly remove scars. But it can complement other scar therapies you’re already using. It’s thought that facial massage can reduce inflammation and improve skin circulation, while also removing toxins. In turn, you might notice overall improvements in skin texture and tone.

Facial massages don’t carry any side effects, but their efficacy against pockmarks isn’t widely studied. If anything, a weekly or monthly massage could reduce stress and inflammation.

3. Chemical peels

Chemical peels are used for a variety of cosmetic concerns, including wrinkle and scar minimizing. They work by removing the top layer of skin (epidermis) to help new cells regenerate. This process is called exfoliation.

Rather than actually removing pockmarks, chemical peels have the potential to minimize their appearance. These peels tend to work best for flattened surface scars only.

Chemical peels can use:

• glycolic acid
• pyruvic acid
• salicylic acid
• trichloroacetic acid (TCA)

Common side effects include peeling, redness, and burning.

Chemical peels remove the outer layer of skin only, so you’ll have to get them on a regular basis in order to achieve maximum results. Your skin care specialist may recommend them every two to four weeks, depending on your individual tolerance and the type of ingredients used.

4. Microdermabrasion

Microdermabrasion is another type of resurfacing treatment that removes the epidermis. Instead of using acids like those used in a chemical peel, microdermabrasion consists of abrasive ingredients to remove skin cells.

This process is traditionally conducted by a skin care specialist, though there are also at-home kits. Microdermabrasion doesn’t typically cause side effects, but it tends to work best when done regularly. It also works best for smaller surface scars.

5. Dermabrasion

Dermabrasion is another type of skin resurfacing treatment. Unlike its sister treatment microdermabrasion, dermabrasion removes both the epidermis and middle layer of skin (dermis).

It’s done in a physician’s office and might require general anesthesia. Your dermatologist uses a sanding machine against the skin to remove the epidermis and parts of your dermis to reveal smoother, toned-looking skin.

Dermabrasion isn’t as effective for deeper scars. It also carries the risk of side effects, such as:

• new scars
• enlarged pores
• blotchy skin coloring
• infection

6. Microneedling

Microneedling is also called “collagen-induction therapy” or simply “needling.” This is a gradual treatment that involves needles that puncture your skin.

The idea is that once the pockmark wounds heal, your skin will produce more collagen to naturally fill them and reduce their appearance. Side effects include bruising, swelling, and infection.

For maximum results, the American Academy of Dermatology (AAD) recommends follow-up treatments every two to six weeks. You’ll likely start seeing significant results within nine months.

7. Fillers

Skin fillers such as collagen or fat-based substances are injected into the area of concern. Rather than removing scars completely, skin fillers aim to plump up your skin to improve their appearance.

According to the AAD, results can last anywhere from six months to indefinitely, depending on which filler is used. Fillers also carry a few risks such as skin irritation, infection, and allergic reactions.

8. Ablative laser resurfacing

For pockmarks, ablative laser resurfacing works by removing thin layers of your skin. This is considered the most invasive form of laser resurfacing, and you’ll need one to two weeks of recovery time. However, the results tend to last for years without additional treatment.

For acne scar-related pockmarks, your skin care specialist may recommend focal acne scar treatment (FAST).

Side effects of ablative laser resurfacing include:

• further scarring
• pigmentation changes
• redness and swelling
• acne
• infections

9. Non-ablative laser resurfacing

Non-ablative laser resurfacing is less invasive than ablative resurfacing, and it doesn’t require the same down time. In fact, you can resume your normal activities immediately after treatment as long as there aren’t any complications.

Although this may be an advantage for some people, this also means that it’s not as effective as ablative laser resurfacing.

This type of laser therapy stimulates the skin by increasing collagen instead of simply removing the affected layers of skin. The overall effects come on gradually, but they may not last as long as ablative laser therapy.

Though not as invasive, non-ablative laser resurfacing still carries the risk of side effects.

These include:

• new scars
• blisters
• redness
• dark skin spots, especially if you already have darker skin

10. Punch excision

With punch excision, your skin care specialist removes the pockmark with a tool called a punch. The punch itself is designed to be larger than the scar being removed. Although this process removes the pockmark, it will leave behind a lighter surface-level scar. This one-time treatment doesn’t carry any other side effects.

See your skin care specialist

Although it may be tempting to try all the options at hand, it’s best to talk to your skin care specialist before trying to get rid of pockmarks. You’ll also need to consider the current health of your skin.

For example, if you still have acne on top of pockmarks, your skin care specialist will need to treat the acne before you can move on to scar removal.

Getting a skin exam from your skin care specialist is the first step toward finding the right treatment for pockmarks.

You should also check with your insurance provider to find whether the procedures are covered. Most of these procedures are considered “cosmetic,” which can result in steep out-of-pocket costs.