Types of Acne Scars and how to treat them

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Many of us have had acne at least once in our lives, however the severity and type of acne can differ between each of us.

Getting rid of the acne is one thing, dealing with the scars left over is another. There are many types of scarring from acne which all require different treatments.

Pitted Acne Scars

This is the most common type of acne scarring. All depression scars (pitted acne scars) rest on top of fibrous, collagen rich scar tissue. The fibrous tissue anchors the scar to the subcutaneous tissue, resulting in the depression and preventing re-growth of healthy tissue.

Rolling Scars

Rolling scars can be differentiated by depressions with rounded, sloping edges. This is because they are not just one scar but several, resulting in a rolling appearance. This type of scar is normally seen on individuals who have suffered from acne long-term. As you get older this scarring gets worse due to your skin naturally losing it’s elasticity and fullness.

Chemical peels can treat these scars as well as laser resurfacing procedures, and phototherapy.

Boxcar Scars

These scars are like rolling scars, however they are steeper and have more defined edges. Because of this, they are harder to treat than rolling scars. However, they do take up less surface area on the skin.

Laser treatments are also good for treating boxcar scars, as well as chemical peels, and other cosmetic fillers (the latter two are not effective for deep scars).

Icepick Scars

This type of scar resembles large pores and is the most difficult scar to treat without surgery, due to its depth.

Chemical peels and laser therapies are effective treatments for icepick scars as well as punch-out excisions (a mildly invasive treatment technique that is growing in popularity).

Raised Acne Scars

Raised acne scars are less common than depressed scars but are more noticeable and trickier to treat. This is due to an absence of healthy skin on the surface, meaning a bumpy, uneven surface that is hard to cover up.

Keloid Scars

These scars are common in individuals with dark skin. They are formed when scar tissue forms on the skin in excess because of an over-production of collagen. This can be caused when acne hasn’t healed properly and the skin is still broken, making the collagen gather around the wound and seal over it resulting in the bumpy, uneven scar.

Treatments for keloid scars include steroid injections, chemical peels, laser therapy and sometimes surgery followed by radiotherapy.

Hypertrophic Scars

Hypertrophic scars are similar to keloid scars, however instead of the collagen forming around the wound, it fills up the wound. The appearance is normally a dark or red colour on the skin but within a few years the scars flatten and become paler.

As Hypertrophic scars are raised, these can be treated effectively with laser resurfacing, micro-dermabrasion and the scars can even be surgically removed.

Discoloration and Pigmentation Scarring

Tissue damage by acne can cause a range of abnormal conditions in the skin alongside fibrous scar tissue. Discolouration is the most common form of long-term acne scarring in individuals.


This is a condition where there are high levels of the melanin pigment accumulated in the skin. This causes freckle-like spots/blotches of skin.

Hyper-pigmentation can be treated by IPL (Intense Pulsed Light) therapy, prescription medications such as hydroquinolone and laser treatment.


This is the opposite condition to hyper-pigmentation. Instead of a dark discolouration of the skin due to too much melanin, the appearance is a light pinkish colour caused by a lack of melanin. The condition vitiligo is a severe case of hypo-pigmentation.

Unlike hyper-pigmentation, hypo-pigmentation can be difficult to fix, as there are few treatments currently available. However chemical peels and laser therapy can be helpful for some individuals suffering from this condition.

Erythema (permanent redness)

This is a condition where small capillaries near the skin’s surface become damaged and displays as a region of redness in the skin. This is very common in individuals with lighter skin tones.

Erythema is commonly treated with prescription medications to decrease vasodilation, although these medications aren’t known to have a lasting effect for this condition. For a more permanent solution, laser treatments and other light therapies can lead to effective results for some individuals suffering from erythema.

Whilst there are a variety of different acne scars, each requiring specialist treatment, the most common non-intrusive treatments are chemical peels and prescription medication taken orally and/or cutaneously.

Laser treatments and light therapies such as IPL therapy, whilst more intrusive, are often the most effective solution for severe cases of scarring. However this all depends on the individual, which is a good reason to see a dermatologist before starting any treatments.

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