You could find yourself with acne scars even with the most comprehensive skin care routine. But scars take shape in different ways. There are two common categories of scars caused by acne: atrophic, or caused by tissue loss, and hypertrophic, or caused by excess tissue. These two categories encompass four distinct types: ice pick, boxcar, rolling, and keloid scars.

Red marks left by acne are not scars, they are merely a type of hyper pigmentation that will lessen and disappear with time.

Types of Acne Scars

Ice Pick Scars

*Appearance: Ice pick scars are thin and profound. Its name comes from the skin's appearance as if it's been stabbed by an ice pick. The scars create a small but deep hole in the skin's surface somewhat similar to what a large, open pore might look like.

*Development: Ice pick scars develop due to infections within cysts or other deeply inflamed blemishes. In this case, skin tissue is destroyed and leaves a thin deep scar.

*Common treatments: The most common medical treatment for this type of scar is punch excision or punch grafting.

Boxcar Scars

*Appearance: Boxcar scars are rounded impressions that have deep vertical sides. They are bigger and not as narrow as ice pick scars, therefore giving the skin a pitted appearance.

*Development: Boxcar scars are created when an inflammatory breakout destroys collagen and tissue is lost. The skin in this affected area no long has support because of the lack of collagen and a depression is created. Boxcar scars can be small to severe, depending of the loss of tissue.

*Common treatments: Punch excision or elevation are the most common treatments for boxcar scars, as well as dermal fillers or laser resurfacing.

Rolling Scars

*Appearance: Rolling scars have a wave like appearance that run across the skin.

*Development: These scars are created when fibrous bands of tissue is produced between the skin and subcutaneous tissue below. These tissues bind the skin to more profound structures. This reaction creates the rolling characteristic of this type of scar.

*Common treatments: Subcision is the most common treatment for rolling scars.

Hypertrophic or Keloid Scars

*Appearance: A hypertrophic scar is a hard mass of 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: These scars are unique in that they are caused by an excess of collagen and therefore tissue.

*Common treatments: Keloid scars can be treated with tapes, injections, and steroid (cortisone) creams that lessen or flatten the excess tissue. Interferon injections soften scar tissue and are also a frequent treatment when dealing with hypertrophic scars.