What are different type of acne scars?

Acne can range from mild to severe, and can be classified as pimples, cysts, whiteheads, blackheads, and nodules. Severe acne causes painful, pus-filled bumps known as nodules that develop beneath the skin. 

Moderate acne causes less painful, pus-filled pimples. Whiteheads or blackheads with or without a few red bumps or pimples are less irritating.

After mild acne is healed, the pale red or brown marks usually disappear over time on their own. However, severe acne, particularly cystic acne, is likely to leave lasting scars. If you squeeze or pick at your acne instead of treating it or letting it heal, permanent scarring is more likely to happen.

Depending on the type of acne scars you have and how you manage it, you might witness different types of scarring.

Types of acne scars

Atrophic acnes scars can be categorised into 3 different types – Ice pick, boxcar and rolling acne scars. 

type of acne scars

Acne scars with atrophy

Flat bumps, known as atrophic scars, heal beneath the epidermis. Severe cystic acne is a common cause of these scars. However, they can also be brought on by other forms of acne. Depending on a person’s acne history, atrophic acne scars can look different. Atrophic scars come in different kinds:

Ice pick scars

Smaller, more angular scars that point down into the skin’s surface are known as ice-pick scars. These commonly occur on the cheeks. Ice pick scars are notoriously difficult to cure and frequently need intensive, persistent care.

Boxcar scars

Boxcar scars are large, commonly box-shaped, with distinct edges. Boxcar scars are caused by severe acne, chickenpox, or varicella, a virus that results in a red, itchy, and blistering rash. The areas where the skin is quite thick are the lower cheekbones and jaw, where boxcar scars commonly develop.

Rolling scars

Rolling scars have a wave-like appearance on the skin’s surface. They are not clearly defined and instead give the skin’s surface a rough, uneven appearance. When collagen tries to heal the wound left by the pimple, rolling scars are created. Strings of protein stretch between the skin’s topmost layer (the epidermis) and its deeper layers as the body attempts to repair the wound (the subcutaneous tissue). The epidermis is forced downward and joined to a deeper level where it has no business being. The rolling appearance of rolling acne scars is produced as a result.

ice pick acne scar
boxcar acne scar
rolling acne scar

Inflammation-induced hyperpigmentation

Inflammation-induced hyperpigmentation frequently leaves behind a darker or discoloured skin patch after your acne has healed. It is not a scar and will go away on its own with proper sun protection.

Hyperpigmentation might happen when the skin is injured by severe acne or if you’ve picked at your acne. However, with the right sun protection, your skin will eventually change back to its normal colour in any circumstances. People with darker skin and those who squeeze or pick at their pimples are more prone to develop post-inflammatory hyperpigmentation.

Principles of Acne scar Treatment

The following basic principles have proven effective in acne scar:

The best treatment of acne scar is prevention: Early onset of adequate local and systemic acne treatment.

If acne scars cannot be prevented, they must be treated early: Reduce/stop any residual acne disease activity (→ Dermatology)

Once acne scars are established, the aim is to make them less noticeable: Rule out any residual acne disease activity before starting invasive local scar treatment (reduction of infection risk).  Lines of treatment are Subcesion, LASER, injections, Biostimulator, Peeling, Micro-needling, Plasma, Growth factors, Stem cell, fillers, fat injection, RF.

In severe cases, autologous fat cell transfer (Lipofilling) has proven to be a reliable acne scar treatment in Dubai to improve the appearance of scars significantly.

Consult an expert for acne scar treatment

Prof Dr Robert Hierner is the most distinguished Plastic Surgeon in Dubai with an excellent international reputation and experience of over 30 years at renowned universities and institutions worldwide. Dr Robert has helped several people with various acne scars and treatments.