Atrophic Acne Scars
Atrophic Acne Scars — depressed or indented scars that form when acne inflammation destroys collagen and the skin heals with a loss of tissue. They are the most common type of acne scar and are typically grouped into icepick, boxcar, and rolling shapes based on their appearance.
Key points
- Icepick scars are narrow and deep, boxcar scars have sharp defined edges, and rolling scars create a wavy, uneven surface.
- They result from insufficient collagen production during healing after inflammatory or cystic acne.
- Because they reflect true tissue loss, they respond better to collagen-stimulating procedures than to topical products alone.
- Treatments such as microneedling, fractional lasers, chemical peels, subcision, and dermal fillers are commonly used, often in combination.
Frequently asked
Which atrophic acne scars are hardest to treat?
Icepick scars are often the most challenging because they are narrow and extend deep into the skin, sometimes requiring targeted techniques like punch excision or focal peels. A dermatologist can tailor treatment to the specific scar type for the best results.
Do topical creams work on atrophic scars?
Topical products like retinoids may modestly improve skin texture and support collagen over time, but they generally cannot fully correct established indentations. Procedural treatments that stimulate collagen or resurface the skin tend to produce more noticeable improvement.
Related topics
This is a foundational entry in the SYNC Skin Encyclopedia and is expanded over time. Educational information only — not medical advice.
