Types of Acne Scars and How to Treat Them
Find the best treatment for your unique skin.
Acne is frustrating enough on its own—but for many people, the marks left behind can feel even more discouraging. The key to effective treatment isn’t just choosing the “best” procedure. It’s correctly identifying the types of acne scars you have first. Different scars form for different reasons, and each responds differently to treatment.
In this guide, we’ll break down the most common types of acne scars, explain why they form, and briefly review acne scar treatment options that may help improve their appearance. Understanding your scar type is the first step toward creating a personalized plan that actually works.
Types of Acne Scars
Not all acne scars are created equal. Some represent changes in pigment, while others involve permanent texture changes in the skin. Broadly speaking, acne scarring falls into two categories: discoloration and structural scars.
Hyperpigmentation
Technically, post-inflammatory hyperpigmentation (PIH) isn’t a true scar—but it’s often confused with one. These are flat dark spots left behind after a breakout heals. They may appear pink, red, brown, or purple depending on your skin tone.
Hyperpigmentation occurs when inflammation triggers excess melanin production. The good news? Because the skin’s structure isn’t damaged, these marks can fade over time.
According to the American Academy of Dermatology, discoloration from acne is common and often improves with sun protection, topical treatments, and certain in-office procedures.
If your skin is smooth but uneven in tone, you’re likely dealing with pigmentation rather than a true textural scar.
If this might be you, a series of IPL Photo Facials might be right for you.
Atrophic Scars
Atrophic scars are the most common of all acne scar types. These form when inflammation damages collagen, and the skin cannot fully repair itself. The result is a depression or indentation in the skin.
These scars sit below the surface and are typically permanent without professional treatment.
Atrophic scars include:
Ice pick scars
Boxcar (pitted) scars
Rolling scars
Because they represent a loss of tissue, treatment typically focuses on stimulating collagen production to rebuild support under the skin. Often, we recommend Microneedling or Secret RF Microneedling, depending on the patient.
Hypertrophic Scars
Hypertrophic scars are raised, thickened scars that develop when the body produces too much collagen during healing. Unlike atrophic scars, these sit above the surface of the skin.
They are more common on the chest, back, shoulders, and jawline. While less common on the face, they can still occur—especially after deep, cystic acne.
These scars may feel firm and appear pink or flesh-toned. Treatment approaches here differ significantly from depressed scars, which is why proper identification is critical.
Ice Pick Scars
Ice pick scars are narrow, deep, and sharply defined. They look as if the skin has been punctured with a small, pointed tool—hence the name.
These scars extend deep into the dermis and are among the most challenging to treat. Because they are so narrow and deep, surface-level treatments often don’t provide significant improvement.
If your scars resemble small holes or pinpoint indentations, you’re likely dealing with ice pick scars.
Pitted (Boxcar) Scars
Pitted scars, often called boxcar scars, are wider depressions with clearly defined edges. Unlike ice pick scars, they are broader and may appear round or oval.
They vary in depth. Shallow boxcar scars may respond well to resurfacing treatments, while deeper ones often require more advanced collagen-stimulating procedures.
When evaluating types of acne scars, boxcar scars are one of the most commonly misidentified forms—many people assume all depressions are the same, but depth and edge definition matter when choosing treatment.
Rolling Scars
Rolling scars create a wave-like or uneven skin texture. They typically have sloping edges rather than sharply defined borders.
These scars occur when fibrous bands form between the skin and underlying tissue, pulling the surface downward. The result is a subtle but noticeable unevenness—especially in certain lighting.
Rolling scars often respond best to treatments that release these tethered bands while stimulating collagen.
The Best Treatment Options
When it comes to acne scar treatment options, the most effective plan depends entirely on the type of scarring present. A thorough consultation allows a provider to assess scar depth, skin tone, and overall skin health before recommending a customized approach.
Here’s a brief overview:
For Hyperpigmentation
Medical-grade skincare
Chemical peels
IPL (Intense Pulsed Light) for residual pigment
Microneedling for overall skin renewal
For Atrophic Scars (Ice Pick, Boxcar, Rolling)
Microneedling with regenerative boosters
Radiofrequency microneedling
Subcision (for rolling scars)
Biostimulatory injectables to restore volume
For Hypertrophic Scars
Corticosteroid injections
Laser treatments designed for raised scar tissue
At SKN WTR, treatment plans are tailored based on scar type rather than taking a one-size-fits-all approach. Because many patients have more than one scar type, combination treatments are often the most effective solution.
It’s important to remember: no single treatment works for all types of acne scars. The correct diagnosis is what determines success.
Why Proper Identification Matters
Choosing the wrong treatment can lead to frustration—or minimal improvement. For example:
Treating ice pick scars with surface-level peels alone may not produce meaningful results.
Attempting to “lighten” rolling scars won’t address the underlying structural issue.
Using aggressive resurfacing for hypertrophic scars could worsen inflammation.
That’s why identifying the specific types of acne scars you have is essential before investing time and money into treatment.
A professional evaluation ensures your treatment plan targets the true cause of the scar—whether that’s pigment, collagen loss, or excess scar tissue formation.
The Next Step
If you’re unsure which types of acne scars you’re dealing with, the best next step is a personalized consultation. During your visit, your provider will assess:
Scar depth and pattern
Skin tone and sensitivity
History of acne and previous treatments
Overall skin goals
From there, a strategic plan can be created to improve texture, tone, and long-term skin health.
Ready to take the first step toward smoother, clearer-looking skin?
Book your consultation here and let’s create a treatment plan tailored specifically to your skin.
Understanding your scars is the foundation of successful treatment—and the right plan can make all the difference.