Does Tretinoin Help with Acne Scars? Here's Everything to Know

Acne can be relentless. But for many the frustration only continues after breakouts stop. 

It’s a reality for millions of women who’ve done the hard work of managing breakouts, only to be left with a lasting reminder of what their skin’s been through. These marks aren't just cosmetic, acne scarring can really affect how you feel about yourself.

If you’ve been searching for an effective way to treat post-acne marks and scarring, you’ve likely come across tretinoin. But does tretinoin actually help with acne scars? Or is it just another overhyped ingredient?

Let’s break down what the research really says about tretinoin and acne scarring, what types of scarring it works best for, and how to approach treatment in a way that’s strategic, results-driven, and dermatologist-approved.

First Off, What Kind of Acne Scars Do You Have?

Before we chat solutions we need to get a handle on the problem we’re trying to solve. Not all acne scars are the same, and understanding what you're dealing with is the first step toward effective treatment. Tretinoin cream can be incredibly effective, but how well it works depends on the type of scarring you're targeting.

Here are the most common types:

1. Post-inflammatory hyperpigmentation (PIH)
These are flat, dark marks that linger after a breakout has healed. They’re more common in medium to deep skin tones and are caused by excess melanin during the skin’s healing process. These are not true scars, but they can be just as frustrating. 

2. Post-inflammatory erythema (PIE)
Usually seen in lighter skin tones, PIE appears as pink or red discoloration after inflammation. It’s caused by dilated blood vessels beneath the surface of the skin. These are also not true scars but can be hard to get rid of.

3. Atrophic scars
These are true acne scars that affect the texture of the skin. They form when inflammation destroys collagen during a breakout. Common types include:

• Ice pick scars: Narrow, deep pits
  
• Boxcar scars: Broad depressions with sharp edges
  
• Rolling scars: Shallow, wave-like indentations
  

Each type may require a slightly different treatment plan. 

Pigmentation and erythema tend to respond well to topical treatments like tretinoin, while more severe texture changes may benefit from a combination approach that includes procedures like microneedling, lasers, or chemical peels.

If you're not sure what kind of scars you have, you're not alone. Many people have more than one type. 

What’s nice is, tretinoin does play a central role in improving all three, by increasing cell turnover, brightening discoloration, and stimulating collagen repair.

How Tretinoin Works For Acne Scarring

‍Tretinoin, a derivative of vitamin A originally formulated for acne treatment.  As a retinoid, it binds to specific receptors in skin cells, triggering a cascade of beneficial changes that directly address the root causes of acne scarring.

1. Accelerated cell turnover

The most significant way tretinoin helps with acne scars is through accelerated cell turnover. Normal skin cell renewal takes about 28 days, but tretinoin can speed this process up significantly. 

This rapid turnover helps shed damaged surface cells more quickly while bringing fresh, healthy cells to the surface. 

This means hyperpigmented cells are removed faster for those dealing with this type of post-inflammatory scarring. 

2. Stimulates collagen production

Tretinoin also stimulates collagen production deep within the dermis. Collagen is the protein that gives skin its structure and firmness. 

For acne scars, this increased collagen helps fill in depressions from beneath, gradually making them less noticeable. 

The improved skin structure also helps fade hyperpigmentation more evenly as the skin becomes healthier overall. New collagen supports can also support the healing of damaged blood vessels while strengthening the surrounding tissue. 

While this process takes time– often 6-12 months to see significant improvement– the results can be dramatic across all types of scarring.

3. Still Dealing with Breakouts? Tretinoin Handles That Too

Many people trying to treat acne scars are still actively breaking out. That’s exactly why tretinoin is so effective: it doesn’t make you choose between managing acne or improving scars. It works on both, at the same time.

Tretinoin has been a dermatologist go-to for decades. Originally developed to treat acne, it remains one of the most studied and effective topical treatments available today. 

Why Tretinoin Works So Well for Acne-Prone, Post-Acne Skin

Tretinoin doesn’t just clear breakouts, it helps prevent the kind of damage that turns into long-term scarring and discoloration. Here’s how:

• It prevents clogged pores. Tretinoin speeds up skin cell turnover, preventing dead skin cells from building up and blocking pores — the main cause of blackheads, whiteheads, and deeper acne.
  
  
• It reduces sebum production. Excess oil is a major contributor to acne. Tretinoin helps regulate and reduce sebum levels, making the skin less oily and less prone to breakouts.
  
  
• It indirectly calms inflammation. By clearing pores and disrupting the ideal environment for Cutibacterium acnes (the bacteria linked to acne), tretinoin helps reduce bacterial overgrowth and the inflammation that causes red, irritated pimples.
  
  
• It fades post-acne marks. Increased cell turnover speeds up the fading of dark spots (post-inflammatory hyperpigmentation) and redness (post-inflammatory erythema), improving skin tone and texture.
  
  
• It boosts collagen production. This helps heal and smooth the skin, reducing the appearance of acne scars over time.
  

When Tretinoin Isn’t Enough: Deeper Scars May Need Extra Help

While tretinoin is highly effective for improving skin texture and fading discoloration, some types of acne scars run deeper than topical treatments can reach.

If you're dealing with ice pick scars, deep boxcar scars, or severe rolling scars, you may need to combine tretinoin with in-office procedures for the best results. These treatments include:

• Microneedling – stimulates collagen deeper in the dermis.
  
  
• Chemical peels – resurfaces damaged skin and smooths uneven texture.
  
  
• Laser treatments – like fractional CO2 or erbium lasers, which target deep scarring and improve overall skin tone.

If you’re not sure what kind of scars you have, a consultation with a dermatologist or a telemed provider (like us) can help you figure out the right plan for your skin.

Common Questions About Tretinoin & Acne Scarring:

Q: “How long does it take to see results?”
A: For pigmentation, you may start seeing fading in 4–8 weeks. For texture, results can take a few months with consistent use. Progress builds over time.

Q: “Will it irritate my skin?”
A: Some dryness or peeling is normal at first. We formulate our creams to be as gentle as possible while still effective. Start slow (every 2–3 nights), then build up.

Q: “Do I need to use SPF with tretinoin?”
A: 100% yes. Your skin will be more sensitive to sun, and UV can worsen scars. Daily SPF is non-negotiable. Go for SPF 50. 

Q: “Which is better for acne scars: tretinoin or retinol?”
A: Tretinoin. It’s prescription strength, more potent, and clinically proven to treat acne scars better than retinol. 

Q: What percentage of tretinoin should I use for acne scars?

A: Start with 0.025% or 0.05%. Higher strengths like 0.1% may work faster but can be more irritating. However, this is up to the discretion of your doctor.

Bottom Line: Does Tretinoin Help With Acne Scars?

Yes, tretinoin is one of the most dermatologist-recommended ingredients for fading post-acne marks and smoothing the look of indented scars over time. 

While it isn’t a quick fix, consistent use can help visibly improve tone, texture, and clarity, especially when paired with the right routine.

Want to try our prescription tretinoin-containing acne formulas?

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