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Acne Scarring Treatment in Campbell

Also known as: Acne Scars, Post-Acne Scarring, Atrophic Acne Scars, Post-Inflammatory Scarring, Acne Pitting, Ice Pick Scars, Boxcar Scars

4 min readLast updated: 2026-04-07Reviewed by Dr. Kamakshi R. Zeidler, MD, FACS

Acne scarring refers to permanent changes in skin texture and appearance that result from inflammatory acne. When severe acne damages the deeper layers of the skin, the body's wound healing response can produce too little or too much collagen, leading to depressed (atrophic) or raised (hypertrophic) scars. Atrophic scars, including ice pick, boxcar, and rolling types, account for the majority of acne scars. Treatment options include laser resurfacing, microneedling, subcision, dermal fillers, and chemical peels, often used in combination for optimal results.

At a Glance

  • A meta-analysis of 37 studies found the pooled prevalence of acne scars among acne patients is approximately 47%[5]
  • Atrophic (depressed) scars account for approximately 80-90% of acne scars, with ice pick, boxcar, and rolling subtypes[4]
  • Risk factors for acne scarring include acne severity, delayed treatment, family history, and male gender[5]
  • Modern acne scar treatment typically uses a multi-modal approach combining several techniques for different scar types[3]

Affected Anatomy

  • Epidermis (skin surface layer)
  • Dermis (deeper skin layer where collagen is disrupted)
  • Subcutaneous tissue (in severe tethered scars)
  • Collagen and elastin fibers
  • Facial skin (cheeks, temples, forehead most commonly affected)

What are the symptoms of Acne Scarring?

  • Depressed or pitted areas in the skin (atrophic scars)
  • Small, deep, narrow depressions resembling puncture marks (ice pick scars)
  • Broad, rectangular depressions with well-defined edges (boxcar scars)
  • Shallow, wide depressions giving skin a wavy or undulating appearance (rolling scars)
  • Raised, firm areas of excess scar tissue (hypertrophic scars)
  • Uneven skin texture or roughness in areas of prior acne
  • Discoloration or pigmentation changes at scar sites

When should you seek care for Acne Scarring?

  • Acne scars that affect self-confidence or quality of life
  • Active acne that has not responded to over-the-counter treatments
  • New raised or thickened scars that continue growing
  • Desire for professional evaluation of treatment options
  • Worsening appearance of existing scars

If any of these apply to you, don't hesitate to reach out for help.

What causes Acne Scarring?

Causes

  • Severe inflammatory acne (cystic or nodular acne)
  • Disruption of the dermis during the acne healing process
  • Insufficient collagen production during wound repair (atrophic scars)
  • Excessive collagen production during wound repair (hypertrophic or keloid scars)
  • Picking, squeezing, or manipulating acne lesions
  • Delayed or inadequate treatment of inflammatory acne

Risk Factors

  • Severe or cystic acne
  • Family history of acne scarring
  • Delayed treatment of inflammatory acne
  • Male gender
  • Repeated or relapsing acne episodes
  • Picking or squeezing acne lesions
  • Darker skin tones (higher risk of post-inflammatory changes)
  • Smoking

How It's Diagnosed

  • 1Visual examination by a dermatologist
  • 2Classification of scar types (ice pick, boxcar, rolling, hypertrophic)
  • 3Assessment of scar depth and severity
  • 4Evaluation of active acne that may need treatment first
  • 5Review of prior acne history and treatments
  • 6Assessment of skin type and tone for treatment planning

How is Acne Scarring treated?

At Aesthetx, we offer several approaches for acne scarring:

Injectable Dermal Fillers

Injectable dermal fillers are FDA-approved medical devices used to restore facial volume, smooth wrinkles, and enhance facial contours. Board-certifie...

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Microneedling

Microneedling, also known as collagen induction therapy, is a minimally invasive dermatological procedure that uses fine sterile needles to create con...

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Laser Treatment

Laser treatment uses focused light energy to address a variety of skin concerns including scars, acne, acne scarring, hyperpigmentation, melasma, red ...

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Scar Revision

Scar revision is a dermatologic or surgical procedure designed to improve the appearance, texture, and function of existing scars. Techniques include ...

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Prognosis and Recovery

  • Most acne scars can be significantly improved with appropriate treatment
  • Combination treatments typically produce better outcomes than single modalities
  • Multiple treatment sessions are often needed over several months
  • Complete elimination of deep scars may not be possible, but substantial improvement is typical
  • Treating active acne first is essential to prevent new scarring
  • Results depend on scar type, depth, skin type, and treatment approach

Frequently Asked Questions

Acne scarring refers to permanent changes in skin texture caused by inflammatory acne that damages the deeper layers of skin. The most common types are atrophic (depressed) scars, including ice pick, boxcar, and rolling scars. Raised hypertrophic scars can also occur. Scars develop when the skin's healing process produces too little or too much collagen.
Acne scars vary in appearance by type. Ice pick scars are small, deep, narrow pits. Boxcar scars are broader depressions with defined edges. Rolling scars create a wavy, uneven skin surface. Hypertrophic scars appear as raised, firm bumps. Many people have a mix of scar types, particularly on the cheeks, temples, and forehead.
Acne scars form when inflammatory acne damages the dermis, the deeper layer of skin. During healing, the body may produce too little collagen (creating depressed scars) or too much collagen (creating raised scars). Picking or squeezing acne and delaying treatment of severe acne can increase the risk of scarring.
Consider seeing a dermatologist if acne scars affect your confidence or quality of life, if you have active acne that is not responding to over-the-counter treatments, or if you want to explore professional treatment options. A dermatologist can classify your scars and develop a personalized treatment plan.
Dermatologists often use a combination of treatments tailored to each patient's scar types. Common approaches include laser resurfacing, microneedling, subcision for tethered scars, dermal fillers for volume loss, and chemical peels for texture improvement. Multiple sessions over several months are typically needed for optimal results.
While most acne scars can be significantly improved with treatment, complete removal of deep scars may not always be possible. Modern multi-modal treatments can substantially reduce the appearance of scars over a series of sessions. Results depend on scar type, depth, skin type, and the treatment approach used.
The most effective way to prevent acne scars is to treat inflammatory acne early and effectively. Avoid picking, squeezing, or manipulating acne lesions, as this increases the risk of scarring. Using sunscreen on healing acne helps prevent post-inflammatory hyperpigmentation. If over-the-counter treatments are not controlling your acne, seek professional care promptly.

Your Physicians

Dr. Kamakshi R. Zeidler

Dr. K. Zeidler

MD, FACS

Dr. Dino Elyassnia

Dr. D. Elyassnia

MD, FACS

Dr. Jane Weston

Dr. J. Weston

MD, FACS

Dr. Bao Tran

Dr. B. Tran

MD

Dr. Shirley Liu

Dr. S. Liu

MD, MHS

Dr. Michele Koo

Dr. M. Koo

MD, FACS

Dr. Rick Lehman

Dr. R. Lehman

MD, FACS

Dr. Jean Gillon

Dr. J. Gillon

MD, FACS

Dr. Amelia K. Hausauer

Dr. A. Hausauer

MD, FAAD

9 board-certified physicians across 4 locations

Medically reviewed by Dr. Kamakshi R. Zeidler, MD, FACS · Last reviewed: 2026-04-10