No matter how meticulous your acne treatment, you may still find yourself victim to acne scars. But scars take shape in different ways. Usually, they come in two types: those that are caused by tissue loss (atrophic), or those that are caused by an excess of tissue (hypertrophic). Included in these two categories are more specific varieties, such as ice pick, boxcar, rolling and keloid scars.

Discolorations are not truly scars. Rather they are a type of hyper pigmentation that will fade over time.

Types of Acne Scars

Ice Pick Scars

*Appearance: Ice pick scars are narrow and deep. The name relates to the skin's appearance as though it's been stabbed by a sharp picked edge. The scars cause long narrow deep holes that might look like a large open pore.

*Development: Ice pick scars develop due to infections within cysts or other deeply inflamed blemishes. In the case of ice pick scars, skin tissue is lost leaving the deep hole.

*Common treatments: Punch excision or punch grafting is the normal treatment for ice pick scars.

Boxcar Scars

*Appearance: Boxcar scars are rounded impressions that have deep vertical sides. They are wider than ice pick scars which gives the skin more of a pitted appearance.

*Development: These scars are the result of an inflammatory breakout that kills collagen and creates tissue loss. The lack of collagen means that the skin no longer has support and therefore a depression is developed. Boxcar scars can be small to severe, depending of the loss of tissue.

*Common treatments: Treatments include punch excision or elevation, and well as dermal fillers or laser resurfacing.

Rolling Scars

*Appearance: Rolling scars are characterized by wave like undulations across the skin.

*Development: The development of these scars is due to the production of fibrous tissue bands between the skin and subcutaneous tissue below. These tissues pull the skin, binding it to deeper structures of the skin. It is this reaction that causes the rolling appearance of this type of scarring.

*Common treatments: Rolling scars are most often treated with subcision.

Hypertrophic or Keloid Scars

*Appearance: A hypertrophic scar is a raised mass of scar tissue. These types of scars usually develop to a larger size than the original wound. Men are most prone to this type of scarring, usually in the area of their torso.

*Development: Hypertrophic scars are unique in that they are formed by an overproduction of collagen.

*Common treatments: These scars are most effectively treated with steroid (cortisone) creams, tapes, or injections that flatten or reduce the area of raised scar tissue. Interferon injections are also given to soften the scar tissue.