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How acne scars form and the different types of acne scars.

Writer's picture: Dermal ClinicianDermal Clinician

Acne scars are permanent changes to the texture of the skin with indentations that occur as a result of acne. The temporary red and brown marks left after a blemish has gone is not considered acne scarring, as these marks will almost always improve without treatment. Acne scarring has varying degrees of sizes and depth on the skin.


When blemishes are inflamed in the skin, as a result of clogged pores, they swell and can break the pores walls. These blemishes destroy skin tissue which is not replaced during the healing process. When the cyst eventually empties and the area heals, it usually leaves behind an indentation (or scar) due to not enough collagen being made while the wound is healing.

While it is estimated that 80 percent of people between ages 11 and 30 will have acne outbreaks at some point, not all of these will result in scarring. Scarring can also come in many different shapes and sizes even in the same area on the face or body.

Acne scars fall into two main categories: those caused by a loss of tissue (atrophic scars), and those caused by an excess of tissue (hypertrophic scars). Within these categories, there are four main types of acne scars: ice pick, boxcar, rolling, and keloid scars.


Ice pick scars are a type of atrophic scar. This is characterised by indentations in the skin rather than raised above the skin. These look like small, narrow pinholes in the skin. Ice pick scars get their name because it looks like an ice pick has pierced the skin. They're very deep and often go all the way down into the lower levels of the dermis.

Boxcar scars are another form of atrophic scarring. They look like small oval, circular, rectangular, or square indentations. These often appear as a U-shaped scar. They are shallower than ice pick scars and don’t form deep in the skin.


Rolling scars are the last variety of atrophic scarring. These are wide depressions that typically have rounded edges and an irregular, rolling appearance. This type of scarring is the result of long-term, chronic acne due to the repeated inflammation and trauma to the skin. This creates uneven scar tissue. As the skin ages it naturally sags making the appearance of rolling scars more evident.

Hypertrophic/ Keloid scars are a more severe raised, scar that grow above the surface of the skin and grow larger than the original wound and can continue to grow long after the original wound has healed. Some people are more prone to developing keloids as it can be hereditary. Hypertrophic scars are more common after a deep wound or trauma. Keloid scars develop due to an overproduction of collagen.

The best acne scar prevention is to prevent them from forming in the beginning. The golden rule is don't pick at acne. Picking blemishes only causes further damages to the surrounding tissue, which will prolong the healing process, and can exacerbate further breakouts, starting the cycle all over again.


Treatments such as Microdermabrasion and Skin Needling combined can combat atrophic scaring. Microdermabrasion mechanically re surfaces the outer most layer of the epidermis. Removing unwanted dead skin cells, preventing future breakouts and reducing he appearance of atrophic scaring by cutting back the epidermis. New collagen production is stimulated as part of the body's natural wound healing response. Skin Needling is a pen like device with hundreds of micro needles which gently penetrate the skin to promote a natural healing response and stimulate essential growth factors and natural production of collagen to improve and strengthen the underlying structure of the skin reducing and even removing the appearance of atrophic scaring.


For other treatments that can help atrophic scaring;

Mesoestetic skin peels due to the resurfacing effect boosting cellular rejuvenation and renewal.

Clear + Brilliant triggering the body’s healing process, replacing damaged skin with new, fresh tissue diminishing pitted scaring or uneven textures to the skin. These are all great effective and non invasive treatments. You Can find more information HERE or call True Dermal Clinic on 03 9882 8228.


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Fabulous At Every Age

  • WHAT IS MICRODERMABRASION?
    The Microdermabrasion Treatment is a skin resurfacing treatment suitable for all skin types. It combines a deep clean and exfoliation, extractions and antioxidant rejuvenation for instantly brighter, cleaner and clearer skin.
  • HOW DOES THE MICRODERMABRASION WORK?
    Using an abrasive hand-piece with vacuum suction directed onto the skin, it simultaneously exfoliates, clears blocked pores, buffs and polishes the skin for a smooth even complexion. This treatment is completed within half an hour. The Microdermabrasion treatment buffs and polishes the surface of the skin, stimulating the receptors in the epidermis which in turn stimulates the production of new skin cells in the deepest layer of the epidermis. This encourages the production of new epidermal skin cells, while the buffing and polishing action removes dead skin cells from the surface. Together this process creates glowing skin, refreshed with bright new skin cells. As we age the regeneration of skin cells slow down leaving our skin looking dull and lifeless, showing wrinkles, pores and old acne scarring, by stimulating the upper layers of the skin, we will begin the process of regeneration. We recommend combining with Skin Needling treatments to stimulate the second layer of the skin, the dermis. Clinical trials and studies of microdermabrasion show a smoother, more even and healthier looking epidermis. The results of Microdermabrasion are instant with little downtime. Your skin may be pink immediately after treatment, this subsides over the next few hours. For those with a more sensitive skin type it may appear pink to red until the next day.
  • WHAT ARE THE SIDE EFFECTS?
    It is normal to experience some redness immediately post treatment, which usually subsides within a few hours. Some people may experiences dryness or peel several days post treatment as the skin cells shed and fresh new skin cells are brought to the surface.
  • HOW MANY SESSIONS DO I NEED?
    You will notice improvements immediately after your first treatment. One treatment will improve the skin, however a series of treatments will give you long-term stimulation of the epidermis, leading to fresher, brighter looking skin. Depending on your age or the nature of why you are having the treatment, your skin therapist will discuss with you how many sessions it will take to get the results you're looking for. We recommend a course of 6 to 12 sessions depending on your skin focus and a maintenance session with every change in season.
  • WHAT HAPPENS DURING MY TREATMENT?
    The Microdermabrasion is performed as a multi-step process. First we will deeply cleanse and exfoliate your skin. Next we will perform the Microdermabrasion on your skin, and then apply a pumpkin enzyme peel to smooth the skin. This is followed by an extraction of blackheads and whiteheads. The final step offers rehydration where hyaluronic, peptides and an infusion of antioxidants and essential nutrients is applied to the skin. The entire treatment takes 30 minutes.
  • WHAT CAN I EXPECT AFTER MY TREATMENT?
    You may experience slight redness for up to an hour following your treatment, similar to that after a workout. Otherwise you will notice instantly fresher, dewy, clear and glowing skin.
  • WHAT PRECAUTIONS CAN I TAKE PRE AND POST TREATMENT?
    As we have removed layers of dead skin cells, we recommend no scrubs, acids or anything harsh for 24-48 hours post treatment. We also recommend to not use any harsh products on the skin for at least two days before a treatment – specifically no Vitamin A or home masks. We always recommend the daily use of SPF 30 sunscreen to prevent the skin becoming sun damaged. Please apply at least once every two hours when out in the sun.
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