Acne scarring, a permanent and largely avoidable complication of acne, and most often is a source of significant psychological distress. The prevalence of post-acne scarring is in the region of 10-14% in the general population.
Acne scars are either hypertrophic or atrophic, depending upon whether they are elevated or depressed in relation to the skin surface. Depending on the shape and depth, the atrophic scars are divided into the following main morphological types: ice-pick pitted scars, superficial or deep boxcar scars, and rolling scars. The majority of people have a mixture of these types of acne scars.
- Rolling Scars – These are the most common type of acne scar. Shallow and wide, they have sloped edges, which gives them their “rolling” appearance. They are commonly found on the cheeks.
- Boxcar Scars – These scars appear angular with distinct, sharp-looking edges. This type of acne scars resembles chicken pox scars and can generally be found on the cheeks and temples of the face. Boxcars can be shallow or deep in appearance.
- Ice Pick Scars – These scars are formed as deep pits on the surface of the skin that are commonly narrow in width and extend deep into the skin, appearing like “holes”. Ice-pick scars are usually the most challenging scars to improve, related to their depth.
- Hypertrophic Scars – are less common forms of acne scarring. However, they can occur anywhere on the body. Hypertrophic scars are caused by aggressive forms of cystic acne that cause deep structural damage to the skin and can create unevenness on the surface of the skin by appearing raised and lumpy.
- Hyperpigmentation Scars – Hyperpigmentation commonly occurs on darker-skinned individuals. These scars are usually flat red or dark marks on the skin after the pimple has healed. These dark marks can take months or even years to fade away and can become darker with chronic sun exposure.