What's best for acne scars... otc creams like mederma or scarfade, or rx like tretinions?

Scar improvement: Scar improvement can be achieved, but it takes patience. An overnight improvement is simply impossible. There is no clinical evidence to support Mederma. You need a long peel. This is achieved with tretinoins. Also, microdermabrasion and/or dermabrasion depending on scar depth. A chemical peel is also an otpion, Tretinoins, abrasions, and peels all achieve the desired skin slough. Good luck