Back to concerns

Acne Scars

Acne scars are lasting reminders of breakouts, caused by inflammation, collagen disruption, and improper healing of the skin. They can appear as depressions, raised areas, or discoloration. Fortunately, a wide range of advanced treatments now target acne scarring; helping restore smoother skin texture and improving long; term confidence.

Find a Provider

Overview

What Are Acne Scars?

Acne scars are changes in skin texture or pigmentation that develop after acne lesions heal. They form when inflamed blemishes damage the skin and underlying tissue, leading to abnormal collagen production during healing. Scars may appear as depressions, raised tissue, or dark marks; often persisting long after breakouts have resolved.

While acne scars can affect anyone who has experienced moderate to severe acne, they are more likely in individuals who delay treatment or manipulate pimples. The type of scar; whether depressed, raised, or pigmented; depends on the depth of inflammation, genetic predisposition, and skin type. Treatments are tailored to each scar type for the best results.

Find a provider

Matt Taranto

Owner | Managing Partner
Matt Taranto

TL;DR Summary

Acne scars are permanent changes in skin texture caused by inflammation and damage to the deeper layers of the skin during active acne. They can appear as depressions, raised areas, or uneven texture and often do not improve with topical products alone. Treatment focuses on stimulating collagen, resurfacing the skin, or restoring volume depending on the type and severity of scarring. Results vary based on scar type, skin characteristics, and the expertise of the provider performing the treatment.

Common Types of Acne Scarring

Acne scars vary in depth, size, and appearance. Some are shallow and improve over time; others are deep or raised and require professional treatment. Identifying the type of acne scar is essential for selecting the most effective therapy; as different scar patterns respond to different procedures.

Ice Pick Scars

Narrow, deep scars that extend into the dermis; creating a “pitted” appearance.

Boxcar Scars

Wide, angular depressions with sharp edges; often seen on cheeks and temples.

Rolling Scars

Shallow, wave; like indentations caused by tethered bands under the skin.

Hypertrophic Scars

Raised, firm scars from excessive collagen buildup at the healing site.

Keloid Scars

Thick, overgrown scars extending beyond the original acne lesion.

Post-Inflammatory Hyperpigmentation (PIH)

Dark spots left after acne heals; not true scars but common concerns.

What Causes Acne Scarring

Acne scars form when inflamed pimples damage skin tissue, triggering irregular collagen repair. Factors like picking, delayed treatment, and genetics increase risk. Scars may appear as indentations from tissue loss or raised areas from excess collagen.

Inflammatory acne

Severe inflammation damages skin and underlying tissue; increasing scar risk.

Popping or picking pimples

Disrupts healing and worsens tissue damage.

Delayed acne treatment

Prolonged inflammation raises chances of permanent scarring.

Excess collagen during healing

Overproduction creates thick, raised scars.

Genetic factors

Family history increases likelihood of acne scars.

Repeated skin trauma

Chronic irritation disrupts normal healing; leading to scarring.

Treatments That Remedy Acne Scarring

A variety of treatments improve acne scars by resurfacing skin, stimulating collagen, or releasing tethered scar tissue. Options range from chemical peels and microneedling to laser therapy and fillers. The right treatment depends on scar type, skin tone, and patient goals; with many requiring a series of sessions for optimal outcomes.

Microneedling / Collagen Induction Therapy

Controlled micro-injuries trigger collagen remodeling that gradually lifts shallow rolling and boxcar scars. Because it uses no heat, it carries a lower risk of pigment change in deeper skin tones. Most patients need three to six sessions spaced four to six weeks apart.

Microneedling / Collagen Induction Therapy

Microneedling with Radiofrequency (RF)

Adding radiofrequency energy delivers heat at a controlled depth beneath the surface, which reaches denser scar tissue that standard microneedling cannot. This suits thicker skin and deeper atrophic scarring. Surface disruption stays minimal, so downtime is typically two to three days per session.

Microneedling with Radiofrequency (RF)

Ablative Fractional Resurfacing

Fractional CO2 and erbium lasers remove columns of tissue to soften the sharp shoulders of boxcar and icepick scars, which is where these scars catch shadow. Results build over three to six months as new collagen fills in. Downtime runs five to ten days.

Ablative Fractional Resurfacing

Chemical Peel

Medium-depth peels address the discoloration that often outlasts the scar itself, along with mild surface irregularity. Post-inflammatory pigmentation responds well. Peels do a fraction of what lasers do for scar depth, but they carry less risk and less recovery time.

Chemical Peel

Bellafill

Bellafill is FDA approved specifically for distensible rolling acne scars, meaning scars that flatten when the skin is stretched. Injection lifts the depression immediately, and the collagen matrix maintains correction long term. Providers typically confirm scar distensibility before recommending it.

Bellafill

Laser Acne Treatment

Scar revision is usually staged after active breakouts are controlled, since new inflammatory lesions create new scars faster than resurfacing can correct old ones. Laser acne treatment reduces active lesions and oil production, which stabilizes the skin before scar-focused work begins.

Laser Acne Treatment

Related Concerns to Acne Scarring

Acne scarring often coexists with other skin concerns such as discoloration, uneven texture, or enlarged pores. These issues can affect skin’s appearance and confidence. Addressing related concerns alongside scar treatment often produces the most comprehensive results; leading to smoother, more even skin tone and improved self; esteem.

Acne

Active acne and acne scarring are treated on different timelines. Controlling inflammation first protects the results of any scar revision and prevents the cycle of correcting old scars while new ones form.

Acne

Uneven Texture

Scarring changes how light falls across the skin, which reads as roughness even where individual scars are shallow. Resurfacing treatments address scar depth and overall texture in the same session.

Uneven Texture

Scarring

Acne scars sit within a broader category that includes surgical, traumatic, and hypertrophic scarring. Treatment principles overlap, though raised and keloid scars require a different approach than depressed acne scarring.

Scarring

Hyperpigmentation

Dark marks left after a lesion clears are pigment, not scar tissue, and many fade on their own within six to twelve months. Distinguishing the two matters because pigment responds to entirely different treatments than depressed scarring.

Hyperpigmentation

Enlarged Pores

Enlarged pores and icepick scarring are commonly confused, and both concentrate across the cheeks and nose. Patients seeking pore refinement often find that what they are seeing is fine atrophic scarring.

Enlarged Pores

Redness or Rosacea

Newer acne scars often retain a pink or red tone from residual vascular activity. This discoloration typically responds to vascular-targeted treatment rather than the resurfacing used for scar depth.

Redness or Rosacea

Frequently Asked Questions

Acne scars include ice pick, boxcar, rolling, hypertrophic, keloid scars, and post; inflammatory hyperpigmentation.

Some scars can be significantly improved; complete removal is rare. Treatments aim to smooth texture and lighten discoloration.

Best treatment depends on scar type; lasers, microneedling, and subcision are often most effective in combination.

Improvements are visible after a few sessions; full results often appear over several months as collagen rebuilds.

Most treatments are safe; providers customize techniques to match skin type and minimize risk of pigmentation issues.

Contact

Sources & studies

The information presented on this page is supported by data and insights from the following trusted sources:

American Academy of Dermatology (AAD) ;

Clinical guidance on acne causes, scarring, and treatment options.

Mayo Clinic ; Acne Scars ;

Patient education on scar types and management.

The Aesthetic Society ;

Evidence; based insights on lasers, fillers, and advanced scar revision techniques.

All sources are reviewed for accuracy and credibility to ensure the content remains reliable and up to date.

Find a Treatment near you

Discover trusted, world-class clinics verified for safety, expertise, and patient experience.

Explore Directory