Acne Scar Classification Guide
Understanding your scar type is the fastest way to choose the right treatment plan. This acne scar classification guide explains what dermatology terms like “ice pick,” “boxcar,” “rolling,” and “hypertrophic” really mean—and why two people with “acne scars” may need completely different approaches. If you’re ready to move from identification to action, see your options for smoothing acne-scar texture and book a skin assessment.
How To Identify Your Acne Scar Type
Determining your scar type requires close examination. Icepick scars look like small pinholes, while boxcar scars appear broader with defined edges. Rolling scars have a wave-like appearance, making the skin look uneven. In contrast, hypertrophic and keloid scars are raised and can sometimes feel firm. Identifying the type will help your skincare provider suggest the most effective treatment method.
Acne Scar Classification: In-Depth Guide
Acne scars are broadly grouped into atrophic (indented) scars—caused by collagen loss—and raised scars—caused by excess collagen. Atrophic scars include ice pick (narrow/deep), boxcar (wider with sharp edges), and rolling scars (wavy texture from tethering). Raised scars include hypertrophic scars (stay within the original acne boundary) and keloids (extend beyond it). It’s also important to separate true scars from post-inflammatory hyperpigmentation (PIH), which is flat pigment and treated differently.
Clinically, severity can be graded (for example, from mild to severe based on visibility and whether the scar flattens when skin is stretched). This matters because the same device can perform very differently depending on scar depth and tethering. If you’re treating mostly texture and pores, collagen-induction treatments designed for acne-scar texture may be a good fit. For deeper textural change with a clearer downtime window, fractional CO2 laser resurfacing options may be considered as part of a staged plan.
| Scar type | Common best-fit approach |
|---|---|
| Ice pick | Focal techniques + collagen support |
| Boxcar | Fractional resurfacing + collagen support |
| Rolling | Release tethering + combination therapy |
| Hypertrophic | Flatten thickened scar tissue |
| Keloid | Combination plan to reduce regrowth risk |
| PIH (flat pigment) | Pigment care + strict sun protection |
