Acne Scarring

Types of Acne Scarring

Although acne eruption is temporary, the disfigurement persists for life and the prevention of acne scarring and improvement of unsightly acne lesions is the most common reason for patients to seek medical attention.  Early and appropriate acne therapy is needed to prevent long-term sequelae (scarring, dyspigmentation, and psychological impact) from occurring.  Once acne scarring is present, both patient and I are left with a number of therapeutic alternatives that can improve scar appearance.  Over the past two decades, great advances have been made in conventional surgical therapy, filler substances, as well as laser phototherapy.  These therapies, alone or in combination, can be used to significantly improve the appearance of acne scarring.

Prior to proceeding with any treatment, an appropriate classification of the scarring type is necessary. 

Acne scars can be divided into ice-pick, rolling, and boxcar scars.

  In brief summary:

  1. Ice-pick scars are deep scars 1 to 2 mm in diameter that tend to taper at the bottom
  2. Rolling scars are generally caused by adhesive bands from the dermal subcutaneous junction [junction between skin and the fat layer] to tougher tissues close to the muscle layer.
  3. Boxcar scars are wider than ice-pick scars, measuring more than 3 mm in diameter and having vertical sides producing chicken pox-like scars

All these scars can be further divided into shallow and deep.  In addition to these three basic types of scars, the patient can present with hypertrophic [thick] scars either of a keloidal or non-keloidal type.  Decreased and increased pigmentation as well as persistent scar redness are also a frequent feature of post-acne sequelae.

Treatment of acne scars must be individually directed for each patient depending on the types of scars present.  Frequently, several procedures may need to be performed either at the same time or on multiple visits.  When surgical procedures require separate visits, a minimum of four to six weeks between the treatments is needed for adequate healing to occur. 

The good news is that most acne scarring can be improved with different treatment methods. There is hope for improving skin scarring once the active acne eruptions are controlled.

If you are concerned about acne or acne scarring, please call at at 780-424-4440 ext. 2 or email us. We will be glad to assist.

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The information provided on this website is for Canadian patients only and is meant for information and education that is based on experience and research.


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