Types of Acne Scars, Boxcar, Rolling & Icepick scars

Acne scars occur when the skin’s natural wound-healing response produces an inappropriate amount of new collagen, either in excess or insufficient levels, to repair damage caused by inflammation. Atrophic acne scars, including boxcar scars, icepick scars, and rolling scars, are depressions in the skin’s surface that develop when too little collagen is produced. A hypertrophic scar is a raised scar that forms when too much new collagen is produced, resulting in a thick, growth-like lesion known as a keloid scar. Acne scars can often be even more challenging to treat than the initial breakouts themselves and, for many, may cause feelings of self-consciousness or low self-esteem. Consulting with an experienced board-certified dermatologist, such as Dr. Green in NYC, is the best way to develop a safe and effective acne scar treatment plan.

No two individuals will develop scars in the same manner, and most patients with acne scars have a mixture of several types of acne scars, requiring a unique combination treatment approach to reduce their appearance successfully. There are many non-invasive acne scar treatment options, including traditional and radiofrequency microneedling, subcision with dermal fillers, laser resurfacing, punch excision, steroid injections, and chemical peels. Since no two individuals will develop acne scars identically, the best way to determine which treatment options would be most beneficial for your particular type of acne scars is by consulting with an expert, such as Dr. Green in NYC.

Dr. Michele Green is a board-certified cosmetic dermatologist and world-renowned expert in non-invasive treatment options, including acne and acne scar treatment. In her boutique dermatology office in the Upper East Side neighborhood of Manhattan, she utilizes the most cutting-edge techniques and innovative technologies to reduce the appearance of acne scars in patients of all skin types and skin tones, providing long-lasting rejuvenation results. Castle Connolly, New York Magazine, Super Doctors, and the New York Times consistently identify Dr. Green as one of NYC’s best dermatologists for her dedication to her patients and expertise. Whether your acne scar treatment plan includes subcision with dermal fillers, chemical peels, microneedling, specially formulated skincare products, or laser resurfacing, Dr. Green will work with you to create a personalized treatment protocol that aptly addresses your unique concerns and leaves you with a clear, smooth, beautiful complexion that lasts.

Types of Acne Lesions and Breakouts

Acne is the most common medical skin condition in the United States, with the American Academy of Dermatology reporting that up to 50 million Americans are affected annually. One in every five individuals with breakouts is estimated to develop some type of acne scars. Active breakouts can be categorized from mild to severe acne. Mild acne is mostly non-inflammatory and consists of blackheads and whiteheads. Moderate acne breakouts are more extensive and consist of blackheads, whiteheads, papules, and pustules. Breakouts of large, inflamed, painful nodules and cysts characterize severe acne. Severe acne is the most likely to result in acne scarring due to the amount of inflammation involved.

• Blackheads are comedones with an opening at the surface of the skin. Their characteristic dark color is due to the oxidization of sebum, debris, and dead skin cells in the pores.
• Whiteheads are closed comedones that form when a pore is clogged with dead skin cells and sebum. These cells are not exposed to air but instead are covered with skin, preventing the oxidization of the material inside the pore.
• Papules are acne lesions that appear as raised bumps on the skin, typically 1 centimeter or smaller in diameter. Papules are lesions that do not contain pus but are composed of a solid material. Papules can develop into pustules if they later become filled with pus.
• Pustules are acne lesions, usually less than 1 centimeter in diameter, filled with pus and appear as an inflamed, red bump on the skin.
• Cysts are a type of inflammatory acne lesion that develops deep below the skin’s surface and do not come to a “head” like other pimples. Cysts are typically large, inflamed, pus-filled, and painful.
• Nodules, like cysts, are larger and more painful than many other types of acne. These lesions form deep below the skin’s surface, too, and do not form a “head” but instead look like a firm red bump. The biggest difference between cystic acne and nodular acne is that cysts are pus-filled, whereas the material within nodules is a harder, firmer substance.

Not all acne breakouts will result in scarring. Inflammatory acne is the most likely type of lesion to cause scarring; however, any acne lesion may potentially result in acne scars. Acne scars develop due to inflammation, causing irreparable damage to underlying skin tissue, so breakouts of cysts and nodules should be treated by a dermatologist as soon as possible. Popping pimples significantly increases the likelihood of acne scarring, as it exacerbates inflammation. To obtain the best cosmetic results from acne scar treatment, it is important to start by managing any active acne breakouts. Expert dermatologist Dr. Michele Green in NYC will work with you to eliminate your acne and reduce the appearance of scars to provide a healthy, smooth, clear, and radiant complexion that lasts.

How many types of acne scars are there?

There are two main categories of acne scars: atrophic and hypertrophic. Based on these two main categories, different acne scars can be divided into four subcategories. These subgroups of acne scars include ice pick, boxcar, rolling, and keloid scars. Acne scars can also vary in severity, ranging from macular to mild and moderate to severe.

I – Atrophic Acne scars

Atrophic acne scars are the most common type of acne scar. They develop when the skin’s natural wound-healing response produces insufficient new collagen. Depressions in the skin’s surface characterize these types of acne scars. Inflammatory acne lesions, such as nodules and cysts, are the most likely to cause atrophic acne scars. Icepick, boxcar, and rolling scars are the three types of atrophic acne scars.

II – Hypertrophic scars

Hypertrophic scars are thick, firm, raised scars that occur when the skin’s natural wound-healing response produces too much new collagen. Hypertrophic scars commonly develop in response to a deeper wound. Hypertrophic scars typically affect areas of the body such as the chest, back, shoulders, and jawline. Raised, growth-like lumps of scar tissue the same size as the initial wound are called hypertrophic scars. Raised scars that are larger than the initial wound and may continue to grow after healing completely are called keloid scars. Hypertrophic scars may eventually regress, whereas keloid scars do not.

What are the different types of acne scars?

I – Ice Pick Acne Scars

Ice pick acne scars are a type of atrophic scar with deep, narrow, v-shaped indentations on the skin’s surface. Ice pick scars are typically 2 mm wide or smaller, often resembling enlarged pores. This type of acne scar appears as though the skin was punctured with a sharp tool, such as an icepick. Icepick scars extend deep into the dermal layers of skin and are often caused by severe inflammation associated with nodular or cystic acne lesions. An infected, inflamed cyst or nodule can cause irreparable damage to the underlying skin tissue, resulting in skin perforation. This causes the appearance of a deep and narrow hole, characteristic of an ice pick scar. 

Ice pick scars are the most difficult acne scars to treat effectively. Luckily, several viable ice-pick acne scar treatment options are available at Dr. Green’s private dermatology office in the Upper East Side of NYC, including punch excision and punch grafting. Punch excision is a technique that involves performing a small excision of the scar, utilizing a punch biopsy tool. After the scar is surgically removed, the wound is sutured or glued together and allowed to heal. Punch grafting is a procedure that entails taking a skin graft from behind the ear and using it to close the defect in the skin. This type of procedure, however, is usually reserved for deeper and larger scars. In your consultation, Dr. Green will evaluate your scars and help you determine the most appropriate treatment options. 

II – Boxcar Scars

Boxcar scars are atrophic acne scars with a round or oval-shaped appearance, well-defined edges, and deep vertical sides. Boxcar scars range from superficial to deep, depending on the amount of skin atrophy caused by inflamed and infected acne lesions. Boxcar acne scars resemble chicken pox scars, usually wider than icepick ones.

Internationally renowned, board-certified dermatologist Dr. Green often recommends a unique combination of treatment options for reducing boxcar scars. Among the most popular options are subcision with dermal fillers, microneedling, chemical peels, and laser treatments. During your consultation with Dr. Green regarding boxcar acne scar treatment, she will work with you to create a customized plan that leaves you with smooth, beautiful skin that lasts.

III – Rolling Scars

Rolling scars are a type of atrophic acne scar that appear wavy, uneven, and rough-looking on the skin’s surface. Rolling scars, unlike boxcar scars, do not have sharply defined borders but rather sloping edges. Rolling scars have the appearance of rolling across the skin, wave-likely due to bands of scar tissue and fibrous tethers developing between the surface of the skin and the underlying subcutaneous tissue. The fibrous bands pull down on the epidermis, creating the rolling, wavy appearance of rolling scars. Rolling scars are typically several millimeters wide and most commonly affect areas of the face such as the jawline and cheeks.

Effective treatment of rolling scars typically requires a combination approach. Most patients with rolling scars benefit from combining treatment options such as subcision with dermal fillers, microneedling, chemical peels, and laser resurfacing treatment. When you work with Dr. Green, she will help you develop a personalized acne scar treatment plan and timeline that best suits your specific concerns and unique needs.

Keloid Scars

A keloid scar is a specific type of raised scar that occurs when the skin’s natural wound-healing response produces too much new collagen. Keloid scars tend to be larger than the original wound and can continue to grow long after the skin has been repaired. With keloid scarring, it is almost as if the skin does not recognize that a wound has healed; thus, the process of repairing the wound is overextended. Some individuals are more prone to developing keloid scars than others. It has been found that keloid scars run in families, with some individuals having a genetic predisposition for keloid scarring. Additionally, patients with darker skin tones are more susceptible to developing keloids than those with lighter skin tones.  

Patients are advised only to treat keloid scars in a medical setting with a board-certified dermatologist or plastic surgeon to avoid exacerbating the keloid, which can ultimately worsen the scar. Dr. Green has treated thousands of diverse patients who struggle with the appearance of keloid scars and often recommends a combination treatment approach for the best cosmetic results. Effective treatment of keloid scars often includes silicone gels, V-Beam laser therapy, and steroid injections. 

Post-inflammatory hyperpigmentation

Post-Inflammatory hyperpigmentation (PIH) refers to the dark spots that may be left behind after an acne lesion or other inflammatory skin condition (such as a wound or a rash) heals. The color of the dark spots associated with post-inflammatory hyperpigmentation varies, appearing as brown, black, red, pink, or purple patches of skin- depending on the patient’s skin tone. During the natural healing process of the skin, there is potential that skin cells involved with healing the area are also contributing to the overproduction of melanin, leading to areas of concentrated hyperpigmentation. Although this type of hyperpigmentation may fade on its own, it can take a significant amount of time. Reducing the appearance of post-inflammatory hyperpigmentation is much more effective and efficient when consulting with an experienced board-certified dermatologist, such as Dr. Michele Green, in New York. Dr. Green has over two and a half decades of experience providing some of the most discerning individuals around the globe with the best non-invasive treatment options for post-inflammatory hyperpigmentation, including chemical peels, V-Beam laser treatment, specially formulated skincare products, and more.

Why does acne cause scars?

Acne scars develop when inflammation associated with acne lesions causes irreparable damage to the underlying skin tissue. The skin undergoes a natural wound-healing process to try and repair the damage. Part of the wound healing process entails the formation of new collagen fibers. Hypertrophic and keloid scars develop when too much new collagen is produced, resulting in a thick, firm, raised scar above the skin’s surface. Atrophic acne scars, including icepick, boxcar, and rolling scars, develop when too little new collagen is produced. Atrophic acne scars are characterized by depressions or indentations in the skin’s surface.

Not all acne breakouts will result in acne scars. Some patients are more prone to developing acne scars than others. It is estimated that one in every five individuals who suffer from acne breakouts will develop acne scars. Inflammatory acne lesions are far more likely than non-inflammatory acne lesions to cause acne scars. Any acne lesion can, however, result in acne scarring. It is essential to start treating acne breakouts with a board-certified dermatologist like Dr. Green as soon as possible. Preventing an acne scar by treating the breakout is often much easier than reducing the appearance of an acne scar after it has formed. In addition, picking at or popping pimples exacerbates inflammation, increasing the likelihood of acne scarring.

What do permanent acne scars look like?

Unfortunately, most types of acne scars are permanent. Permanent acne scars are atrophic or hypertrophic, appearing either as depressions or thick, raised, growth-like lesions on the skin’s surface. Reducing the appearance of atrophic and hypertrophic acne scars requires professional treatment, such as from board-certified dermatologist Dr. Michele Green in NYC.

Smooth, pigmented lesions that remain on the skin’s surface following a breakout may eventually resolve independently. These pigmented marks left behind after an acne breakout heals are known as post-inflammatory hyperpigmentation (PIH). Although PIH can resolve on its own, it can take a significant amount of time to diminish. Treatment by a board-certified dermatologist can expedite the healing process and quickly result in a clear, even-toned complexion. 

Are there any home remedies for acne scars?

The most effective treatment for acne scars is typically a combination approach, including various non-invasive cosmetic procedures and specially formulated skincare products. It is always recommended to consult with a board-certified dermatologist, such as Dr. Michele Green in NYC, for acne scar treatment. Whether depressions or raised growth-like lesions, reducing the appearance of textural acne scars requires professional treatment from an experienced board-certified dermatologist, such as Dr. Michele Green in NYC. Dark spots associated with post-inflammatory hyperpigmentation may respond well to active ingredients in skincare products that can be found over the counter, such as salicylic acid, retinoids, niacinamide, and vitamin C, among others. Before adding any skin care product to your regular regime, it is important to consult with Dr. Green to ensure that the selected products are appropriate, safe, and will deliver the desired effects.

What type of acne scar do I have? How to know what type of acne scars you have

There are several types of acne scars; no two individuals with acne scars will identically develop them. Most patients have some combination of different types of acne scars. The most common type of acne scar is atrophic. Atrophic acne scars are depressions or indentations in the skin’s surface, including ice picks, boxcars, and rolling scars. Hypertrophic scars are thick, firm, raised scars that form above the skin’s surface. Keloid scars are a specific type of raised scar that grows larger than the initial wound and may continue growing after the skin has healed. Hypertrophic scars may eventually regress independently, whereas keloid scars do not.

The best way to understand which types of acne scars you have and how to treat them properly is by consulting with an experienced board-certified dermatologist, such as Dr. Michele Green, in New York City. Dr. Green is a world-renowned dermatologist with over two and a half decades of experience providing the best non-invasive acne scar treatments for all types of acne scars. When you consult with Dr. Green at her private dermatology office in Manhattan’s Upper East Side neighborhood, she will work with you to create a customized acne scar treatment plan that best suits your unique needs and aesthetic goals.

What type of acne scars the most?

The most common type of acne lesion to cause scarring is nodular or cystic acne. These types of acne lesions are associated with a significant amount of inflammation that penetrates the skin at a great depth. Acne scars form when inflammation causes irreparable damage to the underlying skin tissue. Mild acne breakouts that are non-inflammatory, such as blackheads and whiteheads, typically do not lead to acne scarring. Larger, more inflamed lesions like cysts and nodules are more likely to cause permanent damage to skin tissue, leaving scars. The most common type of acne scar is the atrophic acne scar, characterized by depressions in the skin. Not all acne breakouts will result in scars; some individuals are more prone to developing acne scars than others.

What is the hardest type of acne scar to treat?

The hardest type of acne scar to treat is the icepick scar. Ice pick scars are a type of atrophic acne scar. Ice pick scars are deep, narrow, v-shaped scars that develop when the skin does not produce enough new collagen during the natural wound healing process following a breakout. Icepick scars are most likely to develop from cystic acne. The unique characteristics that define an icepick scar make them the most difficult type to treat. Successfully reducing the appearance of icepick scars typically requires a combination treatment approach and a series of sessions with an experienced, board-certified dermatologist, such as Dr. Michele Green in NYC. Some of the most popular icepick acne scar treatment options include punch excision, laser treatments, and chemical peels.

Which types of acne scars are permanent?

Unfortunately, most types of acne scars are permanent. Permanent acne scars are atrophic, hypertrophic, or sometimes even a combination of the two. However, the permanence of an acne scar does not mean its appearance can not be significantly improved. For many who have struggled with acne, the presence of acne scars can be a painful reminder of their breakouts. Acne scars frequently cause feelings of self-consciousness and low self-esteem, and many patients seek cosmetic treatment to achieve a smoother complexion and regain self-confidence. By implementing a customized acne scar treatment plan unique to you and the types of acne scars you have, Dr. Green can significantly diminish the appearance of your scars and provide you with a smooth, clear, beautiful complexion that lasts. 

How do you tell what an acne scar is?

An acne scar falls into one of two categories: hypertrophic or atrophic acne scars. Hypertrophic scars are thick raised scars that develop when too much new collagen is produced during wound-healing. Atrophic scars include ice pick scars, boxcar scars, and rolling scars, and they develop when insufficient collagen is produced during the wound healing process. An acne scar can be identified by observing either of these types of lesions after a pimple ha

Do all pimples leave scars?

No, not all pimples leave scars. Inflammatory acne lesions, such as nodules and cysts, are far more likely to leave scars than non-inflammatory types of acne. This is because acne scars form when inflammation causes irreparable damage to underlying skin tissue. Nodular and cystic acne is severe acne accompanied by a significant degree of inflammation. When these breakouts are left untreated, patients will likely develop acne scarring. In addition, picking at and popping pimples can exacerbate the inflammation associated with acne, significantly increasing the likelihood of scarring. Acne scarring can be even more challenging to treat than the initial breakouts. Always consult with an experienced board-certified dermatologist to treat cystic acne breakouts promptly. And remember, never pop your pimples!

What type of acne is most likely to scar?

Any acne lesion can potentially leave acne scars, depending on the inflammation associated with the breakout and the propensity of an individual to scar. However, some breakouts are more likely than others to cause acne scarring. Inflammatory acne breakouts that present as cysts, pustules, or nodules are more likely to leave behind scars than non-inflammatory acne, such as blackheads. This is because cystic and nodular lesions penetrate greater depths of skin tissue, causing irreparable damage to underlying layers. Untreated acne can result in significant acne scarring, which can be even more challenging to treat than the initial breakouts themselves. The best way to prevent and treat acne scars is by consulting an experienced board-certified dermatologist, such as Dr. Michele Green in NYC. This is especially important for those who know that there is a family history of acne scars since there is an increased likelihood of acne scars if you have siblings or parents with acne scars. 

Additionally, any acne lesion may lead to an acne scar if picked at or popped. Whatever you do, do not squeeze your pimples! Attempting to perform your extractions at home can exacerbate or cause inflammation and may even force the trapped sebum, debris, and dead skin cells deeper into the pores. The majority of acne scars that patients seek treatment for form from attempting to pop their pimples. Instead of risking causing damage to the skin tissue and creating an acne scar, schedule a consultation with Dr. Green, who will develop with you a personalized acne and acne scar treatment plan to help you achieve and maintain a healthy, smooth, clear complexion.

Are acne scars common?

Yes. The American Academy of Dermatology reports that acne is the most common skin condition in the United States, affecting up to 50 million individuals annually. It is also estimated that one in every five individuals affected by acne breakouts will develop acne scars. While most types of acne scars are permanent, their appearance can be significantly reduced through the utilization of various non-invasive cosmetic procedures and specially formulated skincare products, many of which are available at board-certified dermatologist Dr. Michele Green’s private office in NYC.

What type of acne scars the most?

The most common type of acne lesion that causes scarring is nodular or cystic acne. These types of acne lesions are associated with a significant amount of inflammation that penetrates the skin at a great depth. Acne scars form when inflammation causes irreparable damage to the underlying skin tissue. Mild acne breakouts that are non-inflammatory, such as blackheads and whiteheads, typically do not lead to acne scarring. Larger, more inflamed lesions like cysts and nodules are more likely to cause permanent damage to skin tissue, leaving scars. The most common type of acne scar is the atrophic acne scar, characterized by depressions in the skin. Not all acne breakouts will result in scars; some individuals are more prone to developing acne scars than others.

What is the hardest type of acne scar to treat?

The hardest type of acne scar to treat is the icepick scar. Ice pick scars are a type of atrophic acne scar. Ice pick scars are deep, narrow, v-shaped scars that develop when the skin does not produce enough new collagen during the natural wound healing process following a breakout. Icepick scars are most likely to develop from cystic acne. The unique characteristics that define an icepick scar make it the most difficult type to treat. Successfully reducing the appearance of icepick scars typically requires a combination treatment approach and a series of sessions with an experienced, board-certified dermatologist, such as Dr. Michele Green in NYC. Some of the most popular icepick acne scar treatment options include punch excision, laser treatments, and chemical peels.

Which types of acne scars are permanent?

Unfortunately, most types of acne scars are permanent. Permanent acne scars are atrophic, hypertrophic, or sometimes even a combination of the two. However, the permanence of an acne scar does not mean its appearance can not be significantly improved. For many who have struggled with acne, the presence of acne scars can be a painful reminder of their breakouts. Acne scars frequently cause feelings of self-consciousness and low self-esteem, and many patients seek cosmetic treatment to achieve a smoother complexion and regain self-confidence. By implementing a customized acne scar treatment plan unique to you and the types of acne scars you have, Dr. Green can significantly diminish the appearance of your scars and provide you with a smooth, clear, beautiful complexion that lasts. 

eMatrix for Acne Scars – 2 weeks

How do you tell what an acne scar is?

An acne scar falls into one of two categories: hypertrophic or atrophic acne scars. Hypertrophic scars are thick raised scars that develop when too much new collagen is produced during wound healing. Atrophic scars include ice pick scars, boxcar scars, and rolling scars, and they develop when insufficient collagen is produced during the wound healing process. An acne scar can be identified by observing either of these types of lesions after a pimple has healed. While acne scars are largely permanent, their appearance can be improved with various treatment options. To guarantee the best results and prevent any unwanted side effects associated with acne scar treatment, it is always recommended to consult with a board-certified dermatologist, such as Dr. Michele Green, in New York City. Dr. Green can identify the types of acne scars present and recommend treatment options and skin care products that are best suited to reducing their appearance and restoring a healthy, smooth, and even skin tone and texture. Many of the treatment options available at Dr. Green’s private dermatology office in Manhattan’s Upper East Side are painless and require very little, if any, downtime.

What is a hypertrophic scar?

Hypertrophic scars grow above the skin’s surface and appear as firm, thick, raised scars. These scars are formed due to an excess of collagen produced by the skin as a part of the healing response to an inflammatory wound or acne lesion. Normal hypertrophic scars do not extend beyond the original wound and may regress independently. Keloid scars are a specific type of raised scar that usually grows larger than the initial wound. Not only can acne breakouts cause hypertrophic scars or keloid scarring, but any form of trauma to the skin may result in their development. Both keloids and hypertrophic scars are associated with excess new collagen production. Hypertrophic scars form approximately three times as much new collagen than what is typically produced during the wound-healing process, and the collagen fibers develop in a uniform pattern. Keloid scars can produce up to 20 times as much new collagen, and the collagen fibers form in a random arrangement.

Successfully treating hypertrophic scars typically requires a combination approach. Cryotherapy, corticosteroid injections, and the V-Beam laser treatment are among the most popular treatment options for hypertrophic scars. Keloid scars are a type of raised scar that can be particularly challenging to treat, as removing them can stimulate new collagen production, causing them to recur. Cryotherapy is a non-invasive procedure that entails the controlled application of extreme cold to a hypertrophic scar to destroy it. Corticosteroid injections are often used to reduce the thickness and volume of hypertrophic scars. An experienced board-certified dermatologist, such as Dr. Michele Green in NYC, can identify the types of acne scars you have and recommend suitable treatment options. Hypertrophic and keloid scars are difficult to treat and to guarantee the best cosmetic results, they should only be managed by a medical professional such as Dr. Green.

Which type of acne scar is the most common?

The most common type of acne scar that patients experience is atrophic scarring. Atrophic scars occur when inflammation causes irreparable damage to underlying skin tissue, resulting in collagen and volume loss. This type of acne scarring is most closely associated with inflammatory acne lesions, such as cysts and nodules. Any active acne lesion, however, can potentially result in the formation of an acne scar, making early intervention the best way to prevent acne scars altogether. If you are struggling with acne, you should schedule a consultation with Dr. Green as soon as possible to protect your skin against acne scars- often more difficult to treat than the acne breakout itself. Dr. Green can create a treatment plan for you that specifically caters to your skin type and cosmetic concerns, resulting in a clear and radiant complexion that is blemish and scar-free.

What are Grades 1, 2, 3, and 4 acne scars?

One system for evaluating the severity of acne scars is by using grades 1, 2, 3, and 4, which represent macular, mild, moderate, and severe acne scars, respectively. A macular scar is a flat, smooth scar that doesn’t have texture but does have notable post-inflammatory hyperpigmentation. A mild grade 2 scar is only observable at a distance of less than 50 cm and can be covered with makeup. A moderate grade 3 scar is visible at a distance greater than 50 cm and can’t be covered with makeup. Manually stretching the skin can flatten a grade 3 scar. A severe acne scar, grade 4, is very evident from a distance and can not be easily covered. Manually stretching the skin will not flatten a grade 4 scar. No two patients will develop acne scars in the same manner, and most patients have a mixture of multiple types of acne scars that can vary in their severity. An experienced board-certified dermatologist, such as Dr. Michele Green in NYC, has the expertise required to treat all types of acne scars in varying severities to improve their overall appearance and provide a smoother, clearer skin texture.

What is the best way to treat acne scars?

The safest, fastest, most effective way to treat acne scars is to consult an experienced board-certified dermatologist, such as Dr. Michele Green, in New York City. Dr. Green is an internationally recognized expert with over 25 years of experience providing the best non-invasive acne scar treatment options for all acne scars. Since there are many types of acne scars and a given individual may present with more than one type, the effective treatment of acne scars typically requires a combination approach. It is important to always consult with an expert in acne scar treatment, such as board-certified dermatologist Dr. Michele Green in NYC. Working with a medical professional like Dr. Green helps guarantee that you achieve and maintain optimal cosmetic results while limiting the potential for encountering unwanted side effects. Dr. Green has over two and a half decades of experience providing some of the world’s most discerning individuals with the best non-invasive acne scar treatment options. She will work with you to understand your acne scars and develop a customized acne scar treatment plan for permanently reducing their appearance to create a smooth, clear, healthy complexion without downtime.

What are the best acne scar treatment options? 

Internationally renowned board-certified dermatologist Dr. Michele Green in New York City is an acne and acne scar treatment expert. At her private dermatology office in Manhattan’s Upper East Side neighborhood, she offers a host of non-invasive treatment options for reducing the appearance of various acne scars. Dr. Green takes a holistic approach to acne scar treatment, customizing each patient’s treatment plan to include the best cosmetic procedures and specially formulated skincare products for achieving and maintaining a clear, smooth, healthy complexion. Below, several of the most popular acne scar treatment options available at Dr. Green’s office are discussed.

Subcision with Dermal Fillers

Subcision is a minimally invasive cosmetic procedure for treating atrophic acne scars. During subcision, Dr. Green uses a sterile needle to break apart the scar tissue that tethers the top layer of the skin to its underlying layers. Dr. Green takes an innovative approach to subcision as an acne scar treatment by injecting dermal fillers into the depressions as she breaks up the scar tissue underneath. The dermal fillers restore volume to the areas affected by the depressed acne scars, which can not be achieved to the same effect with subcision alone. It is combining these two treatment options results in optimal results and a long-lasting, smooth complexion.

Rolling and boxcar scars are particularly well-suited to treatment with dermal fillers. The number of treatment sessions required to provide patients with their ideal results varies on several contributing factors, including the type of dermal filler used, the severity of one’s acne scars, and the types of acne scars present. The dermal filler products most often used by Dr. Green include hyaluronic acid fillers, such as Juvederm and Restylane, as well as Sculptra. Sculptra is a unique dermal filler product composed of a substance called poly-L-lactic acid that induces collagen production in the skin. 

A topical numbing cream is applied to the treatment area one hour before the procedure to ensure patient comfort. During the treatment, Dr. Green inserts the needle underneath the scar. Once the needle is carefully positioned, the filler is deposited into the depression. Each scar is repeated until all the scars have been successfully treated. Some patients with more severe scarring may require several treatment sessions. Dermal fillers can also restore age-related volume loss, provide facial contour, smooth away fine lines and wrinkles, and enhance facial features. Dr. Green has provided her patients with the best cosmetic dermal fillers for over 25 years. She will develop a customized treatment plan during your consultation that targets your concerns and provides phenomenal, long-lasting results. 

Fraxel Laser Treatment

Two types of lasers are typically used to treat acne scars: ablative and non-ablative. Ablative lasers work by removing the outer layers of the skin to stimulate new collagen production and restructure scar tissue. Non-ablative laser treatments trigger new collagen production in the dermis while leaving the epidermis intact, which provides great cosmetic results while significantly reducing the amount of downtime that’s required. The Fraxel Dual is a non-ablative laser treatment that can improve skin tone and texture by inducing new collagen production in the treatment area. Dr. Green refers to Fraxel Dual as the “magic eraser” due to its unique ability to tackle many skin concerns, including acne scars. Fraxel operates on two distinct wavelengths and utilizes a fractional laser technology that allows the device to create precise, controlled microscopic wounds in the skin’s dermis. This stimulates the natural wound-healing process, leading to the production of new collagen. The result is a clear, smooth, beautiful, even-toned complexion that lasts. Patients interested in reducing the overall appearance of their acne scars should expect to have a series of three to five Fraxel laser therapy sessions spread one month apart to achieve optimal cosmetic results. 

The Fraxel Dual, often used by Dr. Green in her boutique dermatology office in the Upper East Side, is also an effective treatment for addressing skin concerns such as uneven skin pigmentation, sun spots, stretch marks, surgical scars, and overall tone and texture of the skin. Fraxel should not, however, be used to treat melasma. Melasma is a skin condition characterized by brown or gray-brown patches of skin that are darker in color than the rest of the surrounding skin. Several factors, including genetics, hormones, medical conditions, and UV exposure, can influence the presence of melasma. Melasma can be extremely difficult to remove after having treatment with laser therapy since the heat and energy from a laser may cause the hyperpigmentation to become even more entrenched in the deeper layers of the skin. Dr. Green can help you determine which cosmetic treatments best suit your skin type, skin tone, and specific acne scars and ensure that you are treated with the most appropriate treatments.

eMatrix

The eMatrix sublative rejuvenation is a non-ablative laser resurfacing technology approved by the FDA to minimize acne scars, fine lines and wrinkles, enlarged pores, and even stretch marks. This laser resurfacing treatment uses radiofrequency energy to stimulate new collagen production in the dermal layer of the skin while leaving the epidermal layer intact. The eMatrix is unique in that it boasts similar results to many ablative laser treatments without the discomfort or the need for such extensive downtime. 

Four to six treatments of eMatrix are typically required to achieve the ideal cosmetic results, and the eMatrix can be used for patients of all skin types and skin tones. Following a treatment session with the eMatrix, it is normal to experience redness and mild roughness in the treatment area. These side effects usually resolve on their own within 48 hours of the procedure. Results are cumulative, and throughout approximately 3 to 6 months, the appearance of acne scars continues to diminish as new collagen is developed.

VBeam Pulsed Dye Laser Treatment

The VBeam laser is considered the gold standard treatment for targeting skin redness, including that associated with acne inflammation. This laser operates on a wavelength of light that is selectively absorbed by skin cells with red pigment. The light is converted into energy and destroys the red pigment while leaving the surrounding structures of the skin unaffected. There is zero downtime involved with V-Beam treatment, meaning you can resume regular daily activities immediately after the procedure. As a bonus, the VBeam utilizes a patented cooling technology- the dynamic cooling device (DCD, that cools the skin directly before and after each laser pulse. The DCD greatly increases the comfort of the patient during treatment, and for this reason, no topical anesthetic is required. Dr. Green loves the results that the VBeam pulsed dye laser provides her patients seeking a solution for red acne scars, rosacea, surgical scars, broken capillaries, stretch marks, and angiomas.

Chemical Peels

Chemical peels are designed to promote cellular turnover to reveal healthier skin and an even, smooth, clear complexion. Peels remove dead, damaged, and discolored skin cells from the skin’s surface while stimulating the generation of new collagen. Chemical peels help diminish acne scars and can also treat skin concerns such as fine lines, sun damage, hyperpigmentation, and other blemishes. Chemical peels are a versatile cosmetic treatment that can effectively improve the appearance of acne scars or skin discoloration on the face, chest, back, and buttocks.  

Several types of chemical peels are available formulated with different types of acids. Most peels are offered in various strengths, allowing treatment with a mild, medium, or deep peel. The appropriate strength of the chemical peel for treatment is typically dependent on the targeted skin condition. Dr. Green often enhances the cosmetic effects of chemical peels by combining them with topical ingredients for at-home use, such as Retin-A, retinol, and Hydroquinone. 

Glycolic acid, an alpha-hydroxy acid (AHA), is used for a mild chemical peel treatment. A glycolic acid peel exfoliates and unclogs pores, eliminates blemishes, and helps boost skin health. Dermatologists like Dr. Green use trichloroacetic acid (TCA) peels in a medical setting. TCA peels are available in strengths from 10% to 100% and are especially effective against acne scars and hyperpigmentation. 

In a method known as TCA cross, a very high concentration of TCA is placed directly into an atrophic scar. The TCA produces a “frost,” an immediate whitening of the area, that encourages peeling over several days. TCA cross is a technique best suited for treating medium to deep ice pick scars. Following this procedure, strict sun avoidance and adamant use of sunscreen are essential to avoid hyperpigmentation of the treatment area. TCA cross is better suited to patients with fair to light skin tones, as patients with medium to dark skin tones are at higher risk for experiencing skin discoloration as a side effect. Consulting with Dr. Green is the most efficient and practical way to determine whether you are a good candidate for acne scar treatment with TCA Cross. 

Microdermabrasion for acne scars

Microdermabrasion is a non-invasive procedure that uses a microcrystal spray to remove the uppermost layers of dead and damaged skin cells. This technique helps to reveal a fresher, healthier-looking complexion. When it comes to treating acne scars, microdermabrasion can be useful because it encourages the production of new skin cells with increased collagen. This process can be beneficial for treating mild textural acne scars, though more severe acne scars are better treated with dermal fillers or laser skin resurfacing procedures.

Dermabrasion for acne scars

Dermabrasion is a more aggressive version of microdermabrasion that involves completely removing the superficial layers of the skin to trigger the growth of new, healthy skin cells and collagen underneath. Typically, it is performed by a physician using a handheld device to “sand” away the epidermis and upper layer of the dermis using a high-speed rotating wheel layered with wire brushes. Dermabrasion requires local or general anesthesia and approximately two weeks of downtime. The results of dermabrasion are more dramatic than microdermabrasion, although there is a greater risk of encountering unwanted side effects, such as infection, permanent changes in skin color, and scarring.

Cortisone injections for treating hypertrophic acne scars

Intralesional cortisone injections are administered by Dr. Green directly into acne lesions, cysts, or keloids. These steroid injections are highly effective for shrinking active acne lesions and raised scars. Generally, a series of intralesional Kenalog injections are needed to flatten hypertrophic scars successfully. In addition, if the scars are red or are very inflamed, the VBeam pulsed dye laser can be used in tandem with the cortisone injections to reduce their appearance further. 

Microneedling to treat different types of acne scars

Microneedling, or collagen induction therapy, is a non-invasive cosmetic procedure to improve the skin’s tone and texture. A microneedling treatment entails the application of ultra-fine needles to the surface of the skin to create controlled skin injury. This process stimulates the generation of new elastin and collagen within the skin as it heals itself. This treatment can be extremely beneficial for patients seeking to reduce the appearance of textural irregularities in the skin, such as fine lines and wrinkles, enlarged pores, and acne scars. Dr. Green often suggests to her patients that they take advantage of adding Platelet Rich Plasma (PRP) to their microneedling treatments. PRP contains a tremendous supply of epidermal growth factors that can further enhance the skin rejuvenating effects of microneedling. A topical numbing cream is applied to the skin an hour before the treatment to enhance patient comfort during the procedure. Due to its ability to kickstart collagen production in the skin, microneedling is extremely effective at permanently reducing or eliminating the appearance of atrophic acne scars.

Radiofrequency Microneedling Scar Treatment

RF microneedling, such as Vivace, is an innovative cosmetic procedure that combines two popular forms of skin rejuvenation therapy- radiofrequency technology and microneedling, to improve skin tone, elasticity, and texture. Microneedling involves creating micro-injuries in the epidermis with tiny needles, while radiofrequency is used to heat the dermis. This combination approach maximizes new collagen production in multiple layers of skin, providing optimal rejuvenation without downtime. RF Microneedling is commonly used to treat fine lines, large pores, stretch marks, hyperpigmentation, sun damage, skin laxity, dullness, and acne scars. Radiofrequency Microneedling is a safe and effective cosmetic treatment option for patients of all skin tones and skin types. This includes individuals with sensitive skin types and darker skin tones, which are more susceptible to developing side effects of skin irritation and hyperpigmentation.

Which acne scar type is easiest to treat?

The type of acne scars that are considered to be the easiest to reduce in appearance are rolling scars. Rolling scars are relatively shallow and soft, which means that they typically respond well to many different acne scar treatment options. Rolling scars tend to form in response to long-term acne breakouts rather than deep, infected cystic acne lesions, which tend to result in ice-pick scars. Ice pick scars are considered to be the most challenging type of acne scar to treat due to their depth and narrow v-shape. Many patients have some unique combination of different kinds of acne scars, and successfully reducing the appearance of acne scars typically requires a combination treatment approach and a series of sessions with an experienced, board-certified dermatologist, such as Dr. Michele Green in NYC. Rolling scars are often treated with laser resurfacing, traditional and radiofrequency microneedling, and subcision with dermal fillers.

When does each type of acne scar start to appear?

Acne scars appear when inflammation associated with an acne lesion causes irreparable damage to the underlying skin tissue. Collagen production occurs during the natural wound-healing process, which is triggered when inflammatory acne causes skin damage. When insufficient collagen is produced during the process, depressed scars form. Depressed scars can develop as rolling, icepick, or boxcar scars. When excess collagen is produced, raised scars form. Raised scars are also referred to as keloids or hypertrophic scars. Dark spots left behind on the skin following a breakout are referred to as post-inflammatory hyperpigmentation. Post-inflammatory hyperpigmentation is not a true skin scar and occurs when the skin cells that produce pigmentation, or skin color, are overactive during the healing process. Hypertrophic and atrophic acne scars usually do not improve without professional cosmetic intervention, whereas post-inflammatory hyperpigmentation has the potential to resolve on its own over time. A board-certified dermatologist, such as Dr. Michele Green in NYC, can treat post-inflammatory hyperpigmentation, raised scars, and depressed scars with a variety of treatment options to restore a smooth, clear complexion.

What types of acne scars go away?

It is estimated that one in every five individuals who experience acne breakouts will develop some type of acne scars. While dark spots associated with post-inflammatory hyperpigmentation have the potential to fade on their own over time, atrophic and hypertrophic scars are usually permanent. It is possible, however, to reduce the appearance of hypertrophic and atrophic acne scars with various cosmetic treatment options available at Dr. Michele Green’s private, boutique dermatology office in Manhattan’s Upper East Side neighborhood. Dr. Green is a board-certified dermatologist with over 25 years of experience providing some of the world’s most discerning individuals with the best personalized non-invasive acne scar treatment plans. When you consult with Dr. Green for acne scar treatment, she will collect a thorough medical history, review any previous cosmetic treatments you may have had for scars, and physically assess the treatment area to determine which combination of treatment options will provide you with a clear, smooth, health complexion that lasts.

How do you get started with removing acne scars today?

Acne scars can be difficult to treat and, for many, may induce feelings of self-consciousness or low self-esteem. Most patients with acne scars have several types, requiring a unique combination treatment approach to successfully reduce their appearance. An expert in cosmetic dermatology, such as Dr. Green in NYC, can work with you to create a customized acne scar treatment plan to address your scars and provide a healthy, smooth, clear, beautiful complexion that lasts. Dr. Michele Green in New York City is an internationally renowned board-certified cosmetic dermatologist with over two and a half decades of experience in providing some of the most discerning individuals worldwide with the best non-invasive treatment options, including acne scar treatments.

Dr. Green takes a holistic approach and embraces a less-is-more philosophy when it comes to facial rejuvenation, providing natural-looking and long-lasting cosmetic results by customizing each patient’s treatment plan according to their specific skin condition, needs, and aesthetic goals. For her dedication to her patients and expertise, she is consistently recognized as one of NYC’s best dermatologists by Castle Connolly, Super Doctors, New York Magazine, and The New York Times. When you consult with Dr. Green at her private dermatology office in Manhattan’s Upper East Side neighborhood, she will work with you to create a customized acne scar treatment plan that is best suited to your skin type, skin tone, and the types of acne scars present. To start treating your acne scars, call 212-535-3088 or contact us online to schedule a consultation with Dr. Green.