I had managed to get through my adolescent acne without a single scar. This summer my skin decided to act like an out of control teenager. By the time it was brought under control, I was left with my very first acne scar. Stuck in the lower half of my left cheek, I hoped that I could pass it off as a brand new dimple. But pictures don’t lie and it was clear that the indentation was it exactly what it looked like — an acne scar.
Four Types of Acne Scars
Scars develop from acne eruption when the skin hurriedly tries to repair itself after a pimple has demolished existing collagen. The fast track repaired collagen is not up to code and the result is not ideal. All acne scars are not created equally and there are actually four different kinds:
1. Saucer Shaped Scars– these are depressions in the skin where the collagen repair has not provided enough tissue to fill in what was destroyed. This is what is going on in my sca.r
2. Icepick Scars– Looking like a giant pore, they are called ice pick scars because they look like they have been made by a thin sharp instrument. ( Remember Basic Instinct? That kind of ice pick). These scars occur because the follicle and oil gland have been totally trashed leaving an empty space where the structures had been.
3. Hypertrophic Scars– Raised, bumpy often red scars are accumulations of badly made collagen from overlapping cysts. The body was so eagar to repair the skin it worked too hard and too fast.
4. Papular Scars– these white raised bumps are especially resistant treatment.
Treating Acne Scars
Each type of acne scar needs its own treatment protocol. Retin A, sunscreens and lightening creams, can relieve the hyperpigmentation or darkening of the skin that can accompany scarring. But the visable signs of collagen disruption need to experience the power of different types of lasers.
For my “dimple” Dr Marmur zapped the area with Clear and Brilliant laser to lighten the scar
and encourage growth of new collagen. Two weeks later my saucer scar is more like my natural skin tone and the indention is less deep. We’re going to try another Clear and Brilliant treatment to encourage a bit more more natural collagen. Saucer shaped scars can also be leveled off with fillers like Juvaderrm or Radiesse. These are generally not permanent solutions but over time, these injectables can also stimulate the growth of healthy organized collagen.
I am personally delighted that I do not have any more acne scars to repair, but I will be showing before and after posts from other women that illustrate treatments of the three other types of scars. Perfection may not be possible, but new treatments, especially combination of treatments, can make a huge difference.







Microdermabrasion is great for acne scars – it has definitely a less dramatic effect than the laser, though.
Microdermabrasion like Parisian Peel is less costly than lasers and can certainly freshen the skin, but usually it cannot deal with scars that have altered the skin’s architecture.
Microdermabrasion definitely helps by increasing collagen production as well as increasing circulation in newly formed scars, but, you’re right. The fraxel laser and CO2 resurfacing laser will give you more dramatic results in new and old scars.
You’ve raised an importance issue — the different needs of old scars and new scars. I will be showing how to deal with both. Turns out that scars tissue tends to age earlier and dealing with acne scars can improve skin texture as well as make the skin look younger.
I look forward to reading about it! Very interesting blog! Cheers, Toni
This is helpful information, Deb. I haven’t experienced any recent new blemishes but my 21 year old daughter is prone to them. We’ll check this out next trip to her dermatologist. Thanks.