There are two basic types of scar depending on whether there is a net loss or gain of collagen (atrophic and hypertrophic scars). Eighty to ninety percent of people with acne scars have scars associated with a loss of collagen (atrophic scars) compared to a minority who show hypertrophic scars and keloids.
Ice-pick scars – these are deep, narrow, pitted scars. Rolling scars – broad depressions with a sloping edge. Boxcar scars – broad depressions with sharply defined edges. Atrophic scars – flat, thin scars or depressed scars (anetoderma)
Grade 4: This grade of acne scar is defined as severe disease whereby the acne scars are not flattened by stretching the skin. It includes deep divots, severe boxcar scars, ice pick scars, and hypertrophic/keloid scarring.
Acne scars do not go away entirely on their own. Depressed acne scars often become more noticeable with age as skin loses collagen. However, there are a variety of treatments that can make acne scars less noticeable. Post-inflammatory hyperpigmentation or redness may lighten on its own within several months.
The most difficult type of acne scars to treat is icepick acne scarring. Ice pick scars are narrow, V-shaped scars that go deep into the skin. They often look like small oval holes, similar to a chicken pox scar. Because of these characteristics they are the most difficult acne scars to treat.
Surface scars may be completely removed, and deeper acne scars may appear less noticeable. Potential severe side effects include scarring and changes in skin color. Chemical peel. Your doctor applies a chemical solution to the scar tissue to remove the top layer of skin and minimize the appearance of deeper scars.
What Is Abnormal Scarring? When skin is cut or injured, the body heals itself by forming scar tissue. If the body makes too much scar tissue, abnormal scarring results. “Hypertrophic scars” are usually raised, red fibrous lesions, and keloid scars extend beyond the edges of the original cut or wound.
Acne scars can be sunken (depressed) due to the loss of tissue. They may look like ice pick pits. They can be rolling, creating a wavy texture in the skin or they may also be boxlike. These are sometimes called boxcar acne scars and are often on the face.
In other cases, the broken blood vessels from a popped lesion leave a mark on your skin. These are what we usually call “dark marks” or hyperpigmentation. Even if you don't pop your acne, you may still see dark red or brown marks appear on your skin from especially deep or inflamed cases.
Fundamentally, acne marks are flat, brown, or red. They can be removed by applying some creams or they tend to go away on their own, naturally. On the other hand, acne scars lead to skin irregularities. They are raised or indented and often stay with the person forever.
These “look like tiny holes, but, in profile, they go deep into the skin like an ice pick or V shape.”
Popping, picking, or squeezing your pimple does nothing but increase the risk of scarring and discoloration. Scratching or touching a blemish can also transfer bacteria from your hands and create inflammation. It can also prolong the healing process.
"Women may have rated scarring as an attractive quality for short-term relationships because they found it be a symbol of masculinity, a feature that is linked to high testosterone levels and an indicator of good genetic qualities that can be passed on to offspring.
When a scar first develops on lighter skin, it's usually pink or red. Over time, the pinkish color fades, and the scar becomes slightly darker or lighter than the color of the skin. In people with dark skin, scars often appear as dark spots. Sometimes scars itch, and they may be painful or tender.
Hypertrophic scars are one of the most common forms of scarring. Although they look similar to keloid scars, hypertrophic scars are caused when there is too much collagen in the skin, giving it a raised appearance.
Ice-pick scars are a common type of scarring that can occur as a result of the acne healing process. They appear as small, sharp indentations that are wider at the skin's surface and narrow into a point as they reach down into the skin.
It usually takes 3-6 months for the marks to disappear. However, if you have a scar, you're dealing with permanent skin damage that needs treatment in order to disappear.
Salicylic acid
It's considered to be one of the best treatments for acne scars. You can add products with salicylic acid into your daily routine, or your skin care specialist may use it for less frequent chemical peels. It might take a few weeks to see a difference when using salicylic acid.
Most rolling scars will soften a bit eventually. But you'll probably need treatment to get your skin back to its original state. The good news is, since rolling scars are so shallow and soft, they're the easiest to treat.
Depending on the location of the scar, acne scars can appear more severe as you grow older because of collagen depletion in the skin. Depressed acne scars or atrophic acne scarring will usually look worse as your skin loses natural volume as part of the natural aging process.