Understanding Different Types of Acne Scars and How to Treat Them

Before going to the nearest drugstore or skin clinic, knowing what type of acne scar you have would be best. Staying well-informed about your condition can help you find the right treatment.

Types of Acne Scars and How to Treat Them

Not all acne scars are alike. Therefore, the treatments differ for each type. There are two main categories: atrophic scars and hypertrophic or keloid scars.

Atrophic Scarring

Atrophic scars are depressions caused by the loss of skin tissue. Here are three types of atrophic scars:

Boxcar Scars

This type of atrophic scarring is not exclusively caused by pimples. These "box-like" skin depressions could be caused by a wide variety of skin concerns, from severe acne to chicken pox. Boxcar scars may come with discoloration. But in some cases, they look the same as the skin color.

Ice Pick Scars

These atrophic scars may seem like small dots at the skin's surface but are quite deep. Ice pick scars are named as such since they look like they were made using the narrow and sharp tool. These acne scars can be commonly seen in the cheeks and forehead.

The scars' size and depth depend on how an individual's skin heals. But when not treated well and persistently, these scars can cause an infection or inflammation that can rise to the skin's surface.

Rolling Scars

Rolling scars are also atrophic scars. They make broad, sloping, and uneven edges on the skin. The depression caused by rolling scars may be shallow or deep. Again, it depends on the acne's severity and how one's skin heals.

Treatment for Atrophic Scars

Here are some common treatments for atrophic scars. Keep in mind, though, that these are not one-off treatments. They won't magically undo your atrophic scars with just one session. You should consult your skincare provider on the best treatment plan and schedule to help address your skin concerns.

  • Chemical peels using glycolic or salicylic acid can be used to remove the damaged outer layers of the skin. This step helps accelerate the skin's normal exfoliation process.
  • Dermabrasion addresses uneven skin caused by atrophic scars. A dermatologist uses a device that smoothens or "sands down" the outer layer of the skin.
  • Laser therapy is another common procedure used to address shallow atrophic scarring. Dermatologists use high-energy light to stimulate collagen production, which is critical in cell growth regeneration. More collagen means there will be more new cells to restore the damaged skin tissue.
  • Punch Excision is a process that involves cutting out the acne scar. The skin is then stitched back together to form a smaller, less noticeable scar.
  • Punch grafting is usually done to address deeper atrophic scarring like ice pick and boxcar scars. In this treatment, the dermatologist punches out the scar and replaces it with skin from a different part of the body (e.g., skin behind the ears). This treatment will require you to keep a dressing for up to a week to keep it clean and minimize infection.

Hypertrophic and Keloid Scars

This type of scarring is characterized by raised scar tissue on the spot where the acne has healed. An acne scar is hypertrophic if the size is similar to the acne that caused them. On the other hand, a scar is considered a keloid if the raised lump of tissue grows beyond the original pimple or acne spot. You can find this type of scarring along the jawline, chest, or shoulders. 

Treatment for Hypertrophic and Keloid Scars

Since hypertrophic and keloid scars are raised instead of flat atrophic scars, they may need more medical attention to correct.

  • Steroid injections can help flatten or soften this type of acne scarring. Like other treatments, only a medical professional must accomplish steroid injections. This treatment should also be scheduled at suitable intervals to make it more effective.
  • Surgical removal is another scar removal option. However, you must consult with your dermatologist first if this is the proper treatment for you because, in some cases, keloid scarring grows back post-surgery.

Post-inflammatory Hyperpigmentation

You may notice flat, dark spots even after a pimple has healed. These spots are called post-inflammatory hyperpigmentation. They're more of a discoloration than an actual scar. Depending on your skin type and skin tone, the color of these spots may range from pink or red to brown or black.

Treatment for Post-inflammatory Hyperpigmentation

If you're wondering how to treat hormonal acne scars, the best move is to let them heal themselves. But to help avoid further discoloration, you need to protect your skin from the sun's harsh rays. It’s best to always apply (and reapply!) sunscreen with SPF 30 or higher, even on cloudy days. Plus, remember that hydration is an essential part of skincare. Your skin will thank you by staying hydrated and properly moisturized.

To speed up your skin's recovery, you can opt to undergo chemical peels or laser therapy. However, it's important to note that you should consult with your dermatologist before undergoing any treatment requiring medication or a medical procedure.

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Knowing what type of scars you have is important before jumping into any treatment. Buying the wrong skin treatment can be a waste of money at best and exacerbate your skin concerns at worst.

But just like with any health concern, prevention is better than cure. Keep your skin clean by maintaining a simple yet effective skincare routine and maintaining a well-balanced diet. Work on taking care of your overall well-being, including your skin's health, and make treating scars your last resort.



Katie Pierce


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