Understanding the Different Types of Acne Scars and How to Treat Them

Acne scars are not all the same, and the right treatment depends entirely on the type you have. However, choosing a treatment without understanding your scarring is one of the most common reasons people feel let down by their results. However, here, MediZen explains types of acne scars in clear, practical terms.

In addition, at MediZen, understanding your scarring is the first step to improving it. As a result, this guide explains the main types of acne scar and how we treat each.

Acne Scars vs Marks

For example, it helps to separate true scars from marks. Importantly, scars are changes in the skin’s texture, where the surface is indented or raised. In addition, while flat red or brown marks are post-inflammatory pigmentation.

As a result, marks often fade over time and respond well to treatments that target tone. Whereas textural scars need treatments that rebuild and resurface the skin. Also, most people have a mix of both.

Atrophic (Indented) Scars

That said, atrophic scars sit below the surface of the skin and are the most common type of acne scar. What is more, they fall into three kinds.

Ice pick scars

On top of this, narrow, deep scars that look like small punctures in the skin. Of course, they are the most challenging to treat and often need targeted or combined approaches.

Boxcar scars

In short, broader scars with defined edges, similar to the marks left by chickenpox. Crucially, they respond well to resurfacing and collagen-stimulating treatments.

Rolling scars

Then, wide, shallow scars with sloping edges that give the skin a wavy appearance. Likewise, they respond well to microneedling and collagen induction.

Hypertrophic and Keloid Scars

For example, less common in acne, these raised scars form when the skin produces too much collagen during healing. They sit above the surface rather than below it and need a different approach to indented scars, assessed on an individual basis.

Post-Inflammatory Pigmentation and Redness

These are the flat brown marks or lingering redness left after a breakout. They are not true scars and usually respond well to peels, laser and good skincare. Along with diligent sun protection to stop them darkening.

How Each Type Is Treated

Scar type	Typical treatment
Ice pick	Targeted resurfacing, sometimes combined approaches
Boxcar	Laser resurfacing, RF microneedling
Rolling	Microneedling, RF microneedling
Raised (hypertrophic)	Specialist approach, assessed individually
Brown marks / redness	Chemical peels, laser, skincare

Why Identifying the Type Matters

Because each type responds to different treatments, an accurate assessment is essential. Treating a textural scar as though it were a mark, or vice versa. Simply will not work and can waste both time and money. This is exactly why we begin with a proper consultation and skin analysis.

Combining Treatments for the Best Result

Because most people have more than one type of scar, a combined plan usually works best. For example using microneedling to rebuild collagen and peels or laser to even out tone. You can read more in our guide comparing acne scar treatments, which explains how the main options work.

What Causes Acne Scars to Form?

Scars form when a breakout damages the deeper layers of the skin and something disrupts the body’s healing process. When the skin produces too little collagen during healing, the skin stays indented. Where too much is produced, a raised scar can form.

Deep, inflamed breakouts such as cysts are the most likely to scar. This is why treating acne early and effectively is the best way to limit long-term scarring.

Can Acne Scars Be Prevented?

The most effective way to prevent scarring is to treat active acne promptly and resist the urge to pick or squeeze breakouts. This pushes inflammation deeper. A good skincare routine and daily sun protection also help, as sun exposure can darken marks.

Where scarring has already formed. Prevention shifts to keeping acne under control so that no new scars develop while we treat existing ones.

How Long Does Treatment Take?

Because scar treatments such as microneedling and laser work by stimulating collagen. Results build gradually over weeks and months rather than appearing immediately. Most patients have a course of treatment, with improvement continuing after the final session as new collagen develops. We will give you a realistic timeline at your consultation.

Living with Acne Scars and Why Treatment Helps

Acne scars can have a real impact that goes well beyond the skin itself. Having lived through the breakouts, many people find the lasting reminder on their skin affects their confidence in photos. In social situations and at work, long after the acne itself has settled. It is a genuinely common concern, and you are far from alone in wanting to do something about it.

The encouraging news is that modern treatments can make a significant difference, even to scarring that has been there for years. While the goal is improvement rather than perfection, most patients love their smoother. More even skin and the confidence that comes with it. The first step is simply an honest assessment of your scarring and what is realistically achievable.

Do Acne Scars Get Worse Over Time?

Acne scars themselves do not generally get worse once they have formed, but they can become more noticeable with age. As the skin naturally loses collagen and firmness over the years, indented scars can appear slightly more pronounced. Sun exposure can darken any accompanying marks.

This is one reason many patients choose to treat their scarring sooner rather than later. While the skin still has good natural collagen to work with. Treating scars earlier, alongside good sun protection, can help keep the skin smoother for longer.

Types Of Acne Scars at MediZen

MediZen is a CQC-registered, Save Face-accredited medical aesthetic clinic in Sutton Coldfield, just a short drive from Birmingham. A qualified doctor or nurse practitioner performs every treatment, never a beautician. Dr David Eccleston founded the clinic in 1999. The Times has named him one of the UK’s best anti-ageing doctors. With more than 30 years of experience, he leads a team committed to safe, natural-looking results.

Every treatment begins with a full consultation, and our skin consultations include a VISIA skin analysis. This lets us see beneath the surface of your skin and build a plan around your specific concerns rather than a one-size-fits-all package. Book a consultation today and we will assess your scarring and recommend the right plan. Finance and payment options are available to help make treatment more accessible. Our skin memberships and packages help you maintain your results over time. To find out more about types of acne scars, book a consultation with our Birmingham team.

Frequently Asked Questions