Acne scars (ice pick, boxcar scars)

Acne scars are per­ma­nent skin chan­ges left behind after inflamm­a­to­ry acne. Most are depres­sed, so-cal­led atro­phic scars. Rai­sed scars are less com­mon and tend to occur on the chest and back.

Cau­ses

Deep inflamm­a­ti­on in the oil gland fol­lic­les des­troys col­la­gen in the der­mis. If the tis­sue heals with too litt­le new con­nec­ti­ve tis­sue, a depres­si­on remains. Seve­re or late-trea­ted acne, squeezing spots and a gene­tic ten­den­cy all rai­se the risk.

Sym­ptoms

Three main types are distin­gu­is­hed: ice pick scars (nar­row and deep), box­car scars (broad with steep edges) and rol­ling scars (soft and undu­la­ting). Red or brown marks are often pre­sent as well. The­se are not true scars but post-inflamm­a­to­ry hyper­pig­men­ta­ti­on, which usual­ly fades with time.

Tre­at­ment

Acti­ve acne should be under con­trol first. Depen­ding on the scar type, opti­ons include frac­tion­al lasers, radio­fre­quen­cy micro­need­ling, che­mi­cal peels, sub­cis­i­on or fil­lers; nar­row ice pick scars can also be pun­ched out indi­vi­du­al­ly. Seve­ral ses­si­ons and a com­bi­na­ti­on of methods are usual­ly nee­ded. Clear impro­ve­ment is pos­si­ble, but com­ple­te­ly smooth skin can­not always be achieved.

Matching tre­at­ment at Swiss Der­ma Cli­nic: Acne and Acne scars