Concern
Acne Scarring Treatment in Campbell
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]
Signs & symptoms
- 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
What causes Acne Scarring
- 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 assessed
- Visual examination by a dermatologist
- Classification of scar types (ice pick, boxcar, rolling, hypertrophic)
- Assessment of scar depth and severity
- Evaluation of active acne that may need treatment first
- Review of prior acne history and treatments
- Assessment of skin type and tone for treatment planning
How is Acne Scarring treated
Several approaches can address acne scarring:
Treatment
Learn moreInjectable Dermal Fillers
Injectable dermal fillers are FDA-approved medical devices used to restore facial volume, smooth wrinkles, and enhance facial contours.…
Treatment
Learn moreMicroneedling
Microneedling, also known as collagen induction therapy, is a minimally invasive dermatological procedure that uses fine sterile needles to…
Treatment
Learn moreLaser Treatment
Laser treatment uses focused light energy to address a variety of skin concerns including scars, acne, acne scarring, hyperpigmentation,…
Treatment
Learn moreScar Revision
Scar revision is a dermatologic or surgical procedure designed to improve the appearance, texture, and function of existing scars.…
Treatment
Learn moreHALO Laser
HALO is a hybrid fractional laser that combines ablative (2940 nm erbium) and non-ablative (1470 nm) wavelengths in a single treatment…
Treatment
Learn moreProFractional Laser
ProFractional laser is an ablative fractional resurfacing treatment that uses a 2940 nm erbium:YAG wavelength to create microscopic…
Treatment
Learn moreChemical Peel
A chemical peel is a skin-resurfacing procedure in which a chemical solution is applied to the skin to remove damaged outer layers,…
Recovery & outlook
- 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. K. Zeidler
MD, FACS
Dr. D. Elyassnia
MD, FACS
Dr. J. Weston
MD, FACS
Dr. B. Tran
MD
Dr. S. Liu
MD, MHS
Dr. M. Koo
MD, FACS
Dr. R. Lehman
MD, FACS
Dr. J. Gillon
MD, FACS
Dr. A. Hausauer
MD, FAAD
9 board-certified physicians across 4 locations
Sources & references
This article draws on 6 sources, including peer-reviewed research.
Government & research
Medically reviewed by Dr. Kamakshi R. Zeidler, MD, FACS · Last reviewed: 2026-06-09