Treatment for Acne Scarring

Frequently Asked Questions

• What is acne scarring?
  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.
• What do acne scars look like?
  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.
• What causes acne scars?
  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.
• When should I see a doctor for acne scars?
  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. An in-person evaluation can classify your scars and guide a personalized treatment plan.
• How are acne scars treated?
  A combination of treatments is typically used, 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.
• Can acne scars be completely removed?
  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.
• 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 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.
• Why do acne scars need more than one kind of treatment?
  Because the word describes three 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 anything that adds volume underneath. A boxcar scar is a crater with defined shoulders, and it responds to resurfacing that lowers the surrounding skin toward the base. An ice pick scar is a narrow tract running deep into the dermis, and a laser strong enough to reach the bottom of it would damage everything around it, so those are excised or treated with a focused acid technique. What you should get from us is a plan naming your particular scars and the method for each, and that is how we write them.
• How long after acne clears should scar treatment start?
  Active inflammation should be controlled first. Resurfacing skin still breaking out risks new scars in the healing tissue, and pigment left behind by recent lesions often fades on its own over six to twelve months, which means treating too early spends money on marks that were going to resolve anyway. Telling residual discoloration apart from true textural scarring is done by touch as much as by sight, because a flat mark is pigment while a contour change is a scar. That is a dermatologic assessment, and we offer dermatology and surgical scar revision in the same practice, so whichever it turns out to be, we can take care of it here.