Acne Scarring

Acne scarring refers to permanent texture or pigment changes in the skin that develop following inflammatory acne, a form of acne characterized by red, swollen, and often painful lesions that result from deeper inflammation within the skin. Unlike non-inflammatory acne, inflammatory acne involves a stronger immune response to clogged pores, bacteria, and sebum, sometimes leading to scarring.

Acne is a chronic inflammatory skin condition. The depth and duration of inflammation play a significant role in the development of scars. Deeper inflammation damages the skin and can disrupt the skin’s ability to regenerate normally, leading to long-term structural changes including scarring. Some individuals may be more prone to scarring due to their skin type or family history.

The main types of acne scars:

Atrophic scars

The most common type, these scars create indentations in the skin due to collagen loss. They include:

• Ice pick scars, which are narrow and deep
• Boxcar scars, which are wider with sharp edges
• Rolling scars, which have a wavy appearance due to fibrous bands under the skin

Hypertrophic or keloid scars

These are raised, firm scars caused by excessive collagen production during the healing process, more commonly seen on the chest, back, jawline, or shoulders.

Diagnosing acne scarring begins with a detailed skin evaluation. Dr. Neely will examine the affected areas to assess the type, severity, and distribution of scars. She may inquire about the patient’s history of acne, any treatments used, and skin care habits. High-quality clinical photography and magnified skin examination tools may be used to assist in diagnosis and to track treatment progress over time.