Classification of Acne Scars in Edmonton – Know Your Scar Type

Each scar type responds differently to treatment. Depressed scars may benefit from procedures that stimulate collagen or release tethered tissue, whereas raised scars often require therapies that reduce excess collagen. Our team at Albany Cosmetic & Laser Centre assesses your scar pattern and skin type to recommend the most appropriate combination of laser therapy, microneedling, fillers or subcision. A personalised approach leads to smoother results and fewer treatment sessions.

Types of Acne Scars

Atrophic Scars (Indented)

Atrophic scars result from a net loss of collagen and appear as depressions or pits in the skin. They are the most common form of acne scarring, affecting the majority of patients. Atrophic scars are further divided into three subtypes.

Ice Pick Scars

These narrow, deep scars look like tiny punctures. They extend vertically into the dermis, creating a V‑shaped tract. Ice pick scars tend to be less than 2 mm in diameter and may be resistant to superficial treatments. Procedures such as microneedling, chemical peels and TCA CROSS can help break down scar tissue and promote collagen formation.

Boxcar Scars

Boxcar scars are round or oval depressions with sharply defined vertical edges. They are wider than ice pick scars but shallower, resembling varicella (chickenpox) scars. Boxcar scars may be shallow or deep and are often located on the cheeks or temples. Fractional lasers, dermal fillers and subcision can improve their appearance by filling the depression and stimulating collagen.

Rolling Scars

Rolling scars create a wavy, undulating appearance to the skin. These broader scars result from fibrous bands tethering the dermis to the underlying tissue. Subcision is a common treatment that releases these bands. Combination therapies with microneedling, radiofrequency or fillers can further smooth the skin surface.

Raised Scars

While most acne scars are indented, some develop due to excess collagen production during healing. Raised scars are more common on the chest, back and shoulders and may be itchy or firm. They include hypertrophic scars, keloids and papular scars.

Hypertrophic Scars

Hypertrophic scars are raised but remain confined to the boundary of the original lesion. They often appear within a few months of an acne breakout and feel firm. Treatment typically involves corticosteroid injections, silicone gel sheets or laser therapy to flatten the scar and reduce redness.

Keloids

Keloid scars extend beyond the original wound edges. They form thick, irregular lumps that may continue to grow over time. Keloids are more common in people with darker skin tones and often require combination therapy, such as steroid injections, cryotherapy or laser treatment, to reduce size and prevent recurrence.

Papular Scars

Papular acne scars present as small, skin‑coloured or lighter‑coloured bumps on the nose, chin or jawline. They may resemble acne but are a type of raised scar. Treatment options include intralesional corticosteroids, microneedling or radiofrequency to flatten the bumps and improve texture.

Flat Pigmentation (Post‑Inflammatory Hyperpigmentation)

After acne clears, you may notice flat, pigmented spots called post‑inflammatory hyperpigmentation (PIH). These marks are not true scars because they do not alter the skin’s texture and usually fade over time. Sun protection, topical lightening agents and gentle chemical peels can help accelerate fading. It is important to differentiate PIH from atrophic or raised scars when planning treatment.