Treatment for Acne Scarring

Frequently Asked Questions

• What is acne scarring?
  Acne scarring is a permanent change in skin texture caused when inflammatory acne damages the deeper layer of skin. If healing produces too little collagen, depressed scars form; if it produces too much, raised scars can develop. The most common scars are the atrophic types: ice pick, boxcar, and rolling scars.
• What do acne scars look like?
  Ice pick scars look like small, deep, narrow pits. Boxcar scars are broader depressions with well-defined edges, while rolling scars create a shallow, wavy, or uneven surface. Hypertrophic scars appear as raised, firm areas of scar tissue. Many people have several scar types at once, particularly on the cheeks, temples, and forehead.
• What causes acne scars?
  Acne scars form when inflammatory acne damages the dermis, the deeper layer of skin. During healing, too little collagen creates depressed scars and too much collagen creates raised scars. Severe acne, delayed treatment, and picking or squeezing acne lesions can increase the risk of scarring.
• When should I see a doctor for acne scars?
  See a dermatologist if acne scars affect your confidence or quality of life, if active acne is not responding to over-the-counter treatments, or if you want to explore professional treatment options. A clinical evaluation can identify the scar types present and guide a personalized treatment plan.
• How are acne scars treated?
  Treatment is typically tailored to the scar types present and combines several methods. Options 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.
• Can acne scars be completely removed?
  Most acne scars can be significantly improved, although complete removal of deep scars may not always be possible. Modern multimodal treatment can substantially reduce their appearance over a series of sessions. Results depend on the scar type and depth, skin type, and treatment approach.
• How can I prevent acne scars from forming?
  The most effective way to prevent acne scars is to treat inflammatory acne early and effectively. Avoid picking, squeezing, or otherwise manipulating acne lesions, since this increases the risk of scarring. Sunscreen on healing acne helps prevent post-inflammatory hyperpigmentation. If over-the-counter treatments are not controlling the acne, seek professional care promptly.
• Why do acne scars need more than one kind of treatment?
  Acne scarring describes several different shapes of damage. A rolling scar is normal-thickness skin pulled downward by fibrous strands beneath it, so it responds to subcision that cuts those tethers and to methods that add volume underneath. A boxcar scar is a crater with defined shoulders, and resurfacing lowers the surrounding skin toward its base. An ice pick scar is a narrow tract that runs deep into the dermis. A laser strong enough to reach its bottom would damage everything around it, so ice pick scars are excised or treated with a focused acid technique. At Aesthetx, we write the plan by naming the particular scars present and matching a method to each.
• How long after acne clears should scar treatment start?
  Active inflammation should be controlled first. Resurfacing skin that is still breaking out risks new scars in the healing tissue. Pigment left by recent lesions often fades on its own over six to twelve months, so treating too early can mean spending money on marks that were going to resolve anyway. Distinguishing residual discoloration from true textural scarring is done by touch as much as sight: a flat mark is pigment, while a contour change is a scar. This requires a dermatologic assessment. We offer dermatology and surgical scar revision within the same practice, so we can care for either finding here.