You could find yourself with acne scars even with the most comprehensive skin care routine. But scars have different types and appearances. Usually, they come in two types: those that are caused by tissue loss (atrophic), or those that are caused by an excess of tissue (hypertrophic). 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. The name relates to the skin's appearance as though it's been stabbed by a sharp picked edge. The scars cause long narrow deep holes that might look like a large open pore.

*Development: Ice pick scars develop due to infections within cysts or other deeply inflamed blemishes. In the case of ice pick scars, skin tissue is lost leaving the deep hole.

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

Boxcar Scars

*Appearance: Boxcar scars can be described as round impressions with deep vertical sides. They are wider than ice pick scars which gives the skin more of a pitted appearance.

*Development: Boxcar scars are created when an inflammatory breakout destroys collagen and tissue is lost. The skin is no longer supported and a depression is formed. Boxcar scars vary in severity, depending on the amount of tissue lost.

*Common treatments: Boxcar scars can be treated with punch excision, elevation, dermal fillers, or laser resurfacing.

Rolling Scars

*Appearance: Rolling scars cause rolling or 'wave like' indentations across the skin.

*Development: The development of these scars is due to the production of fibrous tissue bands between the skin and subcutaneous tissue below. These tissues pull the skin, binding it to deeper structures of the skin. This reaction creates the rolling characteristic of this type of scar.

*Common treatments: Rolling scars are most often treated with subcision.

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: Hypertrophic scars are unique in that they are formed by an overproduction of collagen.

*Common treatments: These scars are most effectively treated with steroid (cortisone) creams, tapes, or injections that flatten or reduce the area of raised scar tissue. Interferon injections are also given to soften the scar tissue.