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Acne scar is a common skin problem, which is faced by people of different age groups. Choosing the best possible treatment is important so that it does not worsen with age.
Acne scars refer to the outcome of inflamed blemishes that are caused by skin pores. These are engorged with bacteria, dead skin cells, and excess oil. A break in the follicle wall is caused by the swelling of pores.
Acne is present among 5.6 million people in Canada. This high prevalence indicates the need for effective acne scars treatment so that people can obtain clear skin. This blog evaluates different types of acne scars and the probable treatments.
Acne scars occur when acne inflammation results in damage to the deeper layer of the skin. This leads to the breakdown of the pore wall, thereby releasing inflammatory content into surrounding tissues.
Skin produces collagen naturally to repair the damage. Well, scars result when too little collagen is produced. Acne scars can also form via picking at blemishes, delayed acne treatment, and genetic predisposition.
Before knowing how to remove acne scars, you should know their various types. Let’s check out the main types of acne scars.
Atrophic scars refer to indented scars that heal beneath the normal layer of skin tissue. This scar is seen when your skin fails to contribute to tissue regeneration. This results in leaving an imbalanced scarring.
Any severe acne or chickenpox can result in atrophic scars. This type of scar degrades the subcutaneous fat below the skin. The different types of atrophic scars are boxcar, icepick, and rolling. This acne scar is the most prevalent one compared to the other types.
Hypertonic and keloid scars are abnormal responses to wound healing, where an extra connective tissue is formed in the actual wound area. This type of scar is formed from the buildup of scar tissue, often from previous acne spots.
The size of a hypertrophic scar is the same as the acne that caused it. But a larger scar is created than the one caused by acne in the case of keloid scars. This grows beyond the sides of the main spot.
A darker skin patch is common after healing an acne. This indicates post-inflammatory hyperpigmentation (PIH). This shows the creation of extra melanin in the skin after injury.
PIH can affect your dermis or epidermis. This is severe among people with darker skin tones. The patches in PIH range from tan to black.
| Scar Type | Appearance | Depth/Severity | Common Locations | Best-Suited Treatments |
|---|---|---|---|---|
| Ice Pick Scars | Deep, narrow, “punctured” holes (like small pits) | Severe, extends into the dermis | Cheeks, forehead | Punch excision, TCA CROSS, laser resurfacing |
| Boxcar Scars | Broad, round or oval depressions with sharp edges | Moderate to severe | Cheeks, temples | Microneedling, fractional laser, dermal fillers |
| Rolling Scars | Wave-like, undulating appearance, less defined edges | Moderate, caused by tethered skin | Lower cheeks, jawline | Subcision, microneedling, fillers |
| Linear Scars | Long, thin scars that look like lines or scratches | Mild to moderate | Forehead, cheeks | Microneedling, laser therapy, resurfacing peels |
| Widespread (Atrophic) Scars | Large flat depressions, skin appears thinned out | Mild to moderate | Broad areas of face and body | PRP therapy, dermal fillers, laser resurfacing |
Table 1: Comparative Evaluation of the Different Types of Scars
Do acne scars go away? If this question sparks in your mind, then the answer is yes. Well, there are specific treatment procedures for different scar types. Let’s find out the best treatments for acne scars.
Acne scars are treated by microneedling, by the creation of controlled micro-injuries in the skin. Your skin produces new elastin and collagen via these micro-injuries. These fill in depressed scars by remodelling the present scar tissue.
Microneedling is considered for treating atrophic scars. This results in the stimulation of the natural healing process of the body. The renewal of skin cells is also encouraged by this treatment procedure. Microneedling is also applicable to treat hypertrophic and keloid scars. The average duration is 3-6 months.
In laser therapy, focused light beams are used for the stimulation of new collagen production. This results in lowering the visibility of a scar, along with the improvement of its texture. This acne scars treatment procedure can be ablative or non-ablative, which depends on the type of laser.
Nowadays, fractional lasers are used that treat a tiny skin portion while leaving the surrounding area to aid healing. Laser treatment for acne scars helps in growing new skin cells while replacing the scar tissue. This treatment process is effective in treating hypertonic and keloid scars. Atrophic scars can also be treated via laser therapy. This treatment process is considered for few weeks to months.
This treatment procedure destroys the damaged layer of the skin by the application of chemicals on its surface. Hence, your skin peels, and a fresh layer is created below it. Here, dermatologists provide acidic solutions to control skin damage.
This treatment process accounts for exfoliating damaged layers, which stimulates collagen production. This lowers scar depth, thereby making your skin smoother. Also, this evens skin tone. Chemical peels are effective in treating atrophic scars and post-inflammatory hyperpigmentation. The overall duration is 4 to 6 months.
Acne scars are treated by dermal fillers, which are injected into the indented areas. This plumps the skin instantly while matching the surrounding skin area. This lowers the visibility of a scar.
The natural healing process of the skin is triggered by needle penetration. This results in boosting collagen production while improving the overall skin texture. Dermal fillers treat atrophic scars (except icepick scars), but it is inapplicable to hypertrophic scars. This treatment procedure works for 6 months to 2 years.
Does retinol help with acne? Yes, it does. This is your option if you want to treat acne scars without undergoing any major therapy. Retinol helps in preventing the buildup of dead skin cells in the skin pores. This keeps the skin fresh, whereas new blemishes are not formed.
While considering retinol to treat acne scars, you must use it with sunscreens and moisturisers to avoid side effects. This is suitable for treating post-inflammatory hyperpigmentation.
Well, most of the treatment procedures for acne scars generate positive outcomes. Here is a representation of acne scars before and after treatment. The average treatment duration is 3 to 6 months.
Here are some of the combined approaches to treat different types of acne scars.
| Combination Approach | Components | Mechanism / How It Works | Ideal Scar Type | Key Benefits |
|---|---|---|---|---|
| Laser + Microneedling | Fractional CO₂ or Erbium laser + Microneedling | Laser resurfaces skin; microneedling stimulates collagen and enhances absorption of topical serums | Ice pick, boxcar, rolling | Enhanced collagen remodeling, reduced downtime compared to multiple laser sessions |
| Chemical Peel + Microneedling | Medium/deep chemical peel (TCA, glycolic) + Microneedling | Peel removes damaged surface layer; microneedling triggers collagen regeneration | Superficial to moderate scars | Improves skin texture, tone, and scar depth |
| Laser + PRP (Platelet-Rich Plasma) | Fractional laser + PRP injections | Laser triggers controlled injury; PRP accelerates healing and boosts collagen | Atrophic scars, widespread scars | Faster recovery, improved skin quality, reduced redness |
| Subcision + Filler | Manual subcision + Hyaluronic acid or collagen fillers | Subcision breaks tethered scar tissue; filler elevates depressed areas | Rolling and deep boxcar scars | Immediate cosmetic improvement + long-term collagen stimulation |
| Punch Excision + Laser | Surgical excision of deep pits + fractional laser resurfacing | Removes severe scars; laser smooths surrounding tissue | Severe ice pick scars | Complete removal of deep scars and improved overall texture |
| Chemical Peel + PRP | Medium/deep chemical peel + PRP application | Peel resurfaces skin; PRP promotes faster healing and collagen regeneration | Shallow boxcar and widespread scars | Enhanced skin rejuvenation and pigmentation correction |
Table 2: Combination Therapies to Treat Acne Scars
To prevent acne scars, you ned to follow certain aspects.
To ensure optimal results after any treatment process, you must follow a definite aftercare process. Here are some key tips.
The various types of acne scars are atrophic scars, hypertrophic and keloid scars, and post-inflammatory hyperpigmentation. You can treat them via dermal fillers, microneedling, etc. Use sunscreen every day to prevent acne scars.
Are acne scars troubling you? Don’t ignore it. We possess an experienced team of dermatologists. Book an appointment to find the best treatment process for you.
