Acne scars, different shapes and how to get rid of them?

Acne scars are a common problem that can be caused by acne. Acne is a skin condition characterized by inflammation of the sebaceous glands. These inflammations can lead to pimples, blackheads and cysts. When acne is not treated properly or is very inflamed, it can leave scars. Acne scars can come in different shapes and sizes. They can be red, brown or purple in color and they can be raised or sunken. The scars can appear on the face as well as on other parts of the body.

More about acne, its different forms, causes and treatments.

Acne Scars Keloid Atrophic

Scars, factors influencing it

There are several factors that can contribute to the appearance of acne scars. These factors include:

  • The severity of the acne, the more intense and extensive the inflammation, the more chance of scarring.
  • The way acne is treated: severe acne treatment is not effective with a cream
  • Genetic predisposition, plays a role in about 80-90% of acne. A twins study revealed that a quarter of twins with acne reported that one or both parents also had acne in the past. Unlike only 4% of twins without acne.
  • Age, acne is more common in adolescents than adults. This is because hormones play a major role in acne. The hormones testosterone and estrogen stimulate the sebaceous glands to produce more sebum.
  • The hormonal status, 44% of women with acne worsened in the premenstrual period.

Acne scars are often more serious when treated too late or improperly. It is unknown how many people in the general population suffer from acne scars, but studies show that 40-95% of people with severe acne get scars. Unfortunately, only 1 in 3 of these seek treatment. The scars can have a negative impact on people’s quality of life. They can lead to shame, lower self-confidence and social isolation. It is important to treat acne scars in a timely manner to prevent further damage.

Different forms of scars

There are three main types of acne scars: atrophic scars, hypertrophic scars and keloidal scars. The specifics of each type are determined by changes in collagen in the skin.

In atrophic scars, there is a decrease in collagen, while in hypertrophic scars and keloidal scars, there is an increase in collagen.

Acne scars mainly manifest in three different forms, which arise from an insufficient production of skin tissue during the healing process. Atrophic scars, also called “ice pick,” “boxcar” and “rolling” scars, can vary in shape and depth.

The “ice pick” scars are the most common atrophic scars (60-70%) and are characterized by small, deep point-shaped pits in the skin, where the opening is wider than the depth, creating a V-shape.

“Boxcar” scars are round or oval scars with sharp vertical edges. They are wider on the surface compared to “ice pick” scars and often have a U-shape with a wide base. These scars can be either superficial or deep.

“Rolling” scars are characterized by deep or superficial indentations in the skin, often in a band-like structure and with a width of more than 4 to 5 mm. They often show an M-shaped pattern.

Acne Scars

These different forms of atrophic scars are caused by variations in the healing process and result in the distinctive scars often seen in people with acne.

The majority of people (about 80%) with acne scars mainly deal with atrophic scars, while the minority (about 10-20%) develop hypertrophic scars and keloids.

Acne Scars Atrophic Keloid

Treatment Acne scars

There are several treatments available for acne scars. The best treatment depends on the type and severity of the scars. Some common treatments include:

Chemical peels: Peelings use acids to remove the top layer of the skin. This can help improve the appearance of acne scars by making the skin smoother and more even. Chemical peels are available in different strengths depending on the severity of the scars. Treatment is usually carried out in a number of sessions, at intervals of several weeks. More about Peelings

Microdermabrasion: It uses tiny crystals to exfoliate the skin. This can help improve the appearance of acne scars by renewing the skin and stimulating collagen production. Microdermabrasion is a non-invasive treatment usually performed in a series of sessions, at intervals of several weeks.

Laser therapy: CO2 fraxel lasers can help reduce scarring. This is a more invasive treatment than chemical peels or microdermabrasion, but it can be more effective for severe scarring. Laser therapy is usually performed in a number of sessions, at intervals of several weeks.

Fillers: These are injectable gels containing hyaluronic acid that can be used to fill sunken scars. This is a temporary treatment, but it can be a good option for people who want to quickly improve the appearance of their scars. Fillers are usually performed in a single treatment.

Surgical procedure: This approach involves surgery to remove deep or severe acne scars. This treatment is more invasive than other options, but can be very effective for severe scarring. The surgical procedure is usually performed in one session. This involves the use of a bioppler, a special instrument used to take tissue samples (biopsies). The procedure is performed as follows:

  1. Preparation: The skin is cleaned and locally anesthetized to ensure that the patient remains comfortable during the procedure.
  2. Biopsy: The doctor uses the biopsy to remove the damaged tissue from the scar. This is done with extreme precision so as not to damage the surrounding healthy tissue.
  3. Sutures: After the damaged tissue is removed, it may be necessary to suture the skin, depending on the size and depth of the scar. Sutures help to pull the skin back together and promote proper healing.
  4. Aftercare: A bandage is applied after the procedure to protect the treated area and prevent infection. The patient is instructed on how to care for the treated area during the recovery period.

This surgical treatment is effective in removing deep or severe acne scars, but it is important to note that it is a more invasive option and may involve a recovery period.


Here are some tips for preventing acne scarring:

  • Start treating acne as early as possible.
  • Avoid squeezing pimples!
  • Use a gentle cleansing gel and moisturizer.
  • Protect your skin from the sun. This is to reduce dark spots and use a mineral sunscreen
  • Drink plenty of water.
  • Eat a healthy diet. More on nutrition and acne
  • Reduce stress. More about stress and rashes on your skin

Did you know that?

Cleanse your skin twice a day with a mild facial cleanser

A 2006 randomized study investigated the effect of facial cleansing on acne vulgaris in men.

Conclusion: acne exacerbation showed a strikingly significant difference in the group that cleansed once daily. On the other hand, a significant improvement in acne was seen in the group that used a mild cleanser twice a day before washing the face.

Advice: for both men and women, clean your skin twice a day with a mild facial cleanser.

Acne Scars Facial Cleansing Lotion Cleansingmilkd

Natural remedies can soothe milder symptoms of acne scars, but they are generally less effective than medical treatments. Medical treatments such as laser therapy, chemical peels, or microdermabrasion offer targeted, intensive methods that work deeper into the skin to reduce scars.

Some superficial acne scars may fade slightly over time, especially with good skin care and sun protection. However, deeper or more extensive scars often require professional treatment to see good improvement.

There is no direct evidence that diet can cause or cure acne scars, but a healthy diet can support overall skin health. Maintaining a balanced diet rich in vitamins and minerals can help promote skin healing and possibly reduce the formation of new scars.

Stress and sleep deprivation can lead to hormonal fluctuations and inflammation, which can worsen acne and increase the risk of scarring. Managing stress and getting enough sleep can help reduce acne outbreaks and support skin healing.

While many treatments can significantly reduce the appearance of acne scars, it is sometimes difficult to remove them completely. Treatment effectiveness may vary depending on the severity of the scars, skin type and how well the skin responds to the treatment.

While you are here

Acne is a common skin problem that causes a lot of stress and frustration. Despite having many proven treatment options, people often opt for home remedies. In the blog below, the 8 most common home remedies are reviewed and advice is given to make an informed choice for your skin care. It is important to know that home remedies may not be effective in treating acne and that professional treatments and advice from a dermatologist are often the best option. More on 8 Popular home remedies for acne – what doesn’t make sense!

Picture of Dr. Francis Wu

Dr. Francis Wu

Dr. Francis Wu, een vooraanstaande dermatoloog, is de drijvende kracht achter Iconic Elements. Hij heeft sinds 2004 zijn expertise ingezet om een veilige en effectieve huidverzorgingslijn te creëren, geschikt voor zowel gezonde huid als huidproblemen. Iconic Elements, opgericht in 2016, is de eerste brede skincare lijn in Nederland ontwikkeld door een dermatoloog. Als medisch specialist streeft Dr. Wu naar het bevorderen van het welzijn van mensen door hoogwaardige en effectieve huidverzorgingsproducten te bieden. De proefdiervrije en vegan producten vermijden schadelijke chemicaliën en bevatten natuurlijke ingrediënten.
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