Types of acne scars
Acne scars are usually based on appearance and classified as:
Atrophic scars are a result of severe acne and appear as dents. They form when the skin is unable to regenerate tissue and depending on their morphology, are subdivided into 3 main categories which can coexist:
- Ice pick scars (narrow deep pits)
Ice pick scars are narrow deep pits which extend inward to the deep dermis or subcutaneous tissue. They look as if they have been caused by a blow from of a sharp tool’s head, like an icepick, thus their name. These specific scars are the most difficult to treat.
- Boxcar scars (wide deep pits)
Boxcar scars can be wide or narrow deep pits with steep defined edges resembling chicken pox scars. Sometimes, they seem like a fingernail dent in the skin.
- Rolling (wave-like scars)
Rolling (wave-like) scars have a rough texture, create broad depressions in the skin and have rounded sloping edges. They are usually caused by dermal tissue atrophy, a thinning of the skin due to the reduction of underlying tissue.
Hypertrophic & Keloid Scars
Unlike atrophic scars, these types of scars derive from the excessive fibrotic tissue proliferation. Hypertrophic scars usually remain within the boundaries of pre-existing acne lesions whereas keloid scars extend beyond the initial acne lesion. However, both hypertrophic and keloid scars can cause certain symptoms, such as itching or pain.
In addition, changes in the colour of the skin may also occur, including erythema with or without associated telangiectasia and hyperpigmentation or hypopigmentation syndrome. Since acne scars are imperfections of the skin, they should be treated in a therapeutic scheme that can reach the dermis in order to achieve clinically significant results and aesthetic improvement.