Acne is a widespread skin condition that affects the face, neck, chest, and back and is caused by different factors such as bacteria and hormones. The worst part is that you can never expect when they will appear on your skin. You can wake up in the morning and find white bumps, black pores or even red skin, and then a week after, you find a dark spot or a small indent in the same area, which we call acne scars.

If you have acne scars, dermatology clinics like Sozo Clinic can help you assess your scars and recommend the best treatment for them.

Acne Scars

Types of Acne Scars

You may think that acne scars are the same since they occur due to skin damage during the healing phase of active acne. These acne scars have their classifications.

Generally, these acne scars classify into Atrophic and Hypertrophic Scars.

Atrophic Scars

Atrophic acne scars are related to a loss of collagen during the healing phase. These scars have an indented appearance, mostly found on the face. They are divided into three subtypes:

Atrophic Scars
Ice PickThese are narrow and deep with a wider opening, forming a “V” shape. This represents 60-70% of total scars.
RollingHave a wave-like appearance to the skin or show an “M” shape. These scars are usually wider than 4 to 5 mm in size and represent 15-25% of total scars.
BoxcarHave wide bases and openings. They form a “U” shape. They can be deep or shallow and represent 20-30% of total scars.

Keloids and Hypertrophic Scars

Hypertrophic and Keloidal scars occur due to excess collagen deposition and a decline in collagenase activity. This results in lumps of tissues in the original site where the acne is. These scars are more prevalent in darker-skinned individuals and occur in the torso.

Hypertrophic scars are typically pink-coloured, firm and thick, raised bundles of tissue that remain in the area where the acne has been. It is similar to other types of scars.

Keloidal scars are reddish-purple-coloured papules and nodules that spread and form beyond the original site of the acne.

Level of Post Acne Scarring

You may have noticed that some people with acne who get treatments improve after a short period. In contrast, others get treatment for longer sessions. The reason behind this is that there are also different levels of scarring.

Levels of Post-Acne Scarring
MacularThis level does not present a problem in the shape of skin but instead shows the colour of the affected area. The scar is flat but shows redness and hyper- or hypopigmentation. This level is for the dark marks that you see.
MildThis level needs to be evident near distances (50 cm or greater); makeup can sufficiently cover it. In the case of men, the normal shadow of shaved beard can guise it or normal body hair if extra facial.
ModerateThis level is noticeable (50 cm or greater). Makeup and even the shadows of a beard for men cannot easily cover the scarring. However, if the scar is atrophic, it is still possible to flatten it by manually stretching the skin.
SevereThis level is obvious at greater distances (more than 50 cm). Even with makeup, this scar is still noticeable. This severe scarring is not possible to flatten by manually stretching the skin.

Treatment For Acne Scars

If you have acne scars, do not worry since treatments are available to reduce the appearance of these scars. 

Facial Treatment

Atrophic Scar Treatment

Chemical Peels

This treatment applies chemicals such as glycolic acid and salicylic acid to the skin to remove the damaged outer layers of the skin and accelerate the repair process.

Dermabrasion/ Microdermabrasion

This technique mechanically removes damaged skin. It promotes re-epithelialisation or the emergence of a wound with a new epithelium. The only difference between the two is that dermabrasion completely removes the outer part to penetrate the inner layer of the skin. Meanwhile, microdermabrasion only removes the outer layer and accelerates the natural exfoliation.

Laser Treatment

Those with boxcars or rolling scars are candidates for laser treatment. This treatment removes damaged scar tissue through melting, evaporation, or vaporisation. Some lasers do not remove the scar tissue but stimulate new collagen formation. This then causes the tightening of the skin resulting in the scar rising to the surface.

Skin Needling

A new technique that uses a sterile roller with a fine and sharp needle to puncture the skin to initiate collagen production in the skin.

Hypertrophic Scar Treatment

Silicone Gel

It is a common and effective prevention and treatment for hypertrophic acne scars that are usable throughout the year. 

Intralesional Steroid Therapy

This treatment involves injecting steroids into the scar to reduce its volume, thickness and texture.


This is known as cold therapy, where extremely low temperatures destroy abnormal or damaged tissue. Pain, hypo and hyperpigmentation are possible adverse reactions associated with this treatment.

Pulsed Dye Laser

This treatment uses heat to target the blood vessels redness, lessening the scar’s colour. This treatment is advisable for light-skinned individuals since less melanin is present to compete with the haemoglobin laser energy absorption.

Talk To The Experts

Not all acne leads to scarring. Others disappear when taken care of properly or cause a slight discolouration that will eventually fade with time and with enough sunscreen. 

In cases where you can already notice indentations in your skin and start to feel conscious about it, then visit your dermatologists for advice and possible treatments for your scars. Do not try to experiment on your own because it may worsen your scars.

Take Away

Acne will always be part of people’s life. Along with that, acne is the possibility of acne scars or hypopigmentation. However, you don’t have to worry since treatments are available now to reduce or remove these scars. All you have to do is visit your dermatologist and get to know your acne.