Different Types of Acne Scars & The Best Acne Scar Treatments

Different Types of Acne Scars & The Best Acne Scar Treatments Part I

Flare ups of adult acne are bad enough, but when bad breakouts lead to acne scars, it’s easy to become discouraged.  Fortunately professional acne treatment can offer a variety of therapies that can help diminish acne scars. And with 30% of people who suffer from moderate to severe acne developing acne scars, many men and women ask what is the best acne scar treatment that provides the best results in the shortest amount of time?

Before you can answer what is the best acne scar treatment available, it is important to identify which type of acne scars you have, because different scars respond differently to various acne scar  treatments.

Typically, acne scars fall into one of three categories:

  1. Depressed Acne Scars
  2. Raised Acne Scars
  3. Pigmentation Acne Scars

How Do Acne Scars Form?

In short, acne scars are caused when inflammation damages surrounding skin tissue. Acne results when hair follicles become filled with sebum (the skin’s oil,) dead skin cells, and/or bacteria. When filled with this debris, hair follicles may become engorged and inflamed.

Sometimes this inflammation gets so big that the wall of the hair follicle bursts under the pressure allowing some of the bacteria that is clogging the hair follicle to seep into surrounding tissue, causing deeper, wider lesions.

Once a breakout is under control and the acne starts to clear up the body begins the healing process, producing collagen and elastin to repair the damage tissue and fill in the recesses that were filled with bacteria. If the body produces too much collagen or too little collagen, scars form.

What are Depressed Acne Scars?

Depressed acne scars are the most prevalent type of scarring with inflammatory acne. Also called “pitted acne scars,” they are a type of atrophic scarring (scars caused by a loss of tissue) and include ice pick scars, boxcar scars, and rolling scars. These types of acne scars typically occur in the check area, but can be found all over the face and neck and any other area of the body that is prone to acne breakouts.

How Do Depressed Acne Scars Form?

Depressed acne scars are thought to form when the body does not produce enough collagen during the healing process.

Ice pick scars

Ice pick scars are very narrow and deep pitted scars that extend down into the dermis, as if the skin has been punctured by a sharp object like an ice pick.  Ice pick scars may also resemble large, open pores.

How do Ice Pick Scars Form? Ice pick scars form when the infection that engorges a hair follicle makes its way to the surface of the skin. The bacteria of the infection destroys skin tissue leaving a long, narrow column of scar tissue in its wake, outlining the path the infection took as it worked its way to the skin’s surface.

Boxcar Scars

Box car acne scars are broader than ice pick  scars, but have sharp, angular edges. They are typically round or oval in shape and often form on the cheeks and down the neck.

How do Boxcar Acne Scars Form? When acne becomes inflamed, the bacteria in the infection breaks down the collagen in the surrounding tissue. Collagen is a protein that helps give skin its structure. When it is broken down that area of tissue remains unsupported. During the healing process the body tries to replace the collagen that was lost during the infection. If the body does not produce enough collagen to efficiently fill in the depression, a depressed scar forms.

Boxcar scars may be mild or severe, depending on the amount of collagen breakdown and the body’s ability to replace that lost collagen.

Rolling Scars

Rolling scars are broader than boxcar scars, but have rounded, sloping edges, creating waving undulations that roll across the skin.  Rolling scars often form when an area of skin is afflicted with long term acne.

How do rolling acne scars form? Rolling scars are formed when fibrous, band like tissue develops in between layers of skin, connecting the top layer of skin to the lower subcutaneous tissue. The bands pull  on the top layer of skin, creating wave like undulations on the surface of the skin.

Acne scars can be improved with professional acne treatment. Learn More >>

Different Types of Acne Scars Part II: Raised Acne Scars >>

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