Are acne scars permanent?

Some scars fade with time, but most require targeted treatment for noticeable improvement.

Do acne scars look worse in certain lighting?

Yes. Raking or side lighting creates shadows that make depressions more obvious, while flat, frontal light hides them. Assess progress with consistent angles and lighting each time.

How do I tell enlarged pores from acne scars?

Enlarged pores usually have a central opening and look uniform; depressed scars often have irregular edges and no visible opening. If the area looks smoother when you gently stretch the skin sideways, it’s more likely a scar than a pore.

Can acne scars form without severe cystic acne?

Yes. Repeated inflammation, picking or squeezing, and delays in treating breakouts can lead to scarring even without large cysts.

Are acne scars influenced by genetics?

Genetics can affect how skin heals and remodels collagen. Some people are more scar-prone than others even with similar acne severity.

When after isotretinoin can I consider scar procedures?

Your doctor may recommend waiting several months after finishing isotretinoin before certain ablative procedures. Timing depends on your skin, dose, and the specific treatment being considered.

Will acne scars look more obvious as I age?

They can. Natural collagen loss and changes in skin elasticity and volume with age may make depressions appear deeper. Consistent sun protection and good skin care help maintain skin quality.

What sunscreen is best if I darken easily after acne?

Use a broad-spectrum SPF 30+ daily, reapply outdoors, and choose non-comedogenic formulas. Tinted mineral sunscreens with iron oxides can help against visible light if you are PIH-prone.

Do at-home dermarollers or microneedling pens fix acne scars?

They create superficial channels but carry infection and pigment risks and rarely address deeper tethering. Professional treatments are designed to reach the correct layer with controlled settings.

Can silicone gel or sheets improve acne scars?

They are most helpful for raised (hypertrophic or keloid) scars, especially on the body. They do not significantly change pitted (atrophic) facial scars.

What’s the safest way to conceal acne scars for events?

Use a hydrating base, a blurring silicone primer, thin layers of non-comedogenic foundation, and light setting. Avoid heavy shimmer or frosted highlighters that emphasise texture.

How should I photograph my scars to track progress accurately?

Use the same camera, distance and angle on clean skin with no makeup. Shoot in consistent raking light (around 45 degrees from the side) and keep a dated photo log.

Can diet or supplements reduce acne scarring?

Balanced nutrition supports overall healing, but no supplement has proven to erase scars. Early acne control and avoiding picking are the most effective ways to reduce scarring risk.

Wednesday, September 17th, 2025

Acne Scars: Types, Causes & Evidence‑Based Treatments

Acne scars are common skin issues on the face, chest, and back. A large percentage of people in Singapore between the ages of 11 and 30 will experience acne, and one in five of them will leave behind scars.

Most individuals who went through puberty will experience active outbreaks of acne, either through hormones or diet.

Thereafter, they will have to face acne scarring as a permanent residual effect. The good news is that scarring from acne is treatable.

Acne scars change the skin’s texture (not just colour). Many people have a mix of scar types—rolling, boxcar, ice pick, or raised scars—so the most effective plan depends on an in‑person assessment. (If you’re looking for treatment options and prices in Singapore, see our service page: Acne Scar Treatments

Contents hide

1) Quick Facts

2) Acne marks vs acne scars (PIH/PIE vs texture)

3) How do Acne Scars Form?

4) Types of Acne That Cause Scars

5) Types of Acne Scars

5.1) Ice Pick Scars

5.2) Boxcar Scars

5.3) Rolling Scars

5.4) Hypertrophic and Keloid Scars

6) Can Acne Scars go away on their own?

7) Treatment overview (Evidence‑based)

7.1) Self‑care & prevention

7.2) Back & body acne scars

7.3) When to see a doctor

8) Frequently Asked Questions

Quick Facts

Scars vs marks: PIH/PIE are colour changes that can fade; scars are texture changes.
Mixed scarring is common → combination therapy is typical.
Prevention matters: treat active acne early to reduce future scarring.

Acne marks vs acne scars (PIH/PIE vs texture)

Marks (PIH/PIE) = colour; may fade over months with sun protection and gentle actives.
Scars = texture; usually need procedural options for visible change.

Want doctor‑led options & prices in SG? See Acne Scar Treatment in Singapore

How do Acne Scars Form?

Inflammation from deeper lesions (e.g., nodules, cysts) disrupts collagen and healing, leaving depressions (atrophic scars) or raised scars (hypertrophic/keloid).

Managing breakouts and avoiding picking helps reduce risk.

Types of Acne That Cause Scars

Acne scars often result from inflammatory acne, including cysts and nodules, which penetrate deep into the skin. After acne treatments, the healing wounds can leave behind scars due to the skin’s natural healing process and collagen disruption.

Cystic acne is also one of the most common causes of acne scars due to its depth and inflammation.

Types of Acne Scars

Ice Pick Scars

Ice pick scars are deep, narrow, and pitted scars that appear as if the skin has been punctured with a sharp object. They are usually the result of severe acne, such as cysts or papules.

Treatment Options: Treatments include fractional CO2 Laser , TCA Cross chemical peels, and punch excision.

Boxcar Scars

Boxcar scars are round or oval depressions with steep vertical sides. Wider than ice pick scars, they give the skin a pitted appearance and result from widespread acne, chickenpox, or varicella.

Treatment Options: Effective treatments include fractional CO2 laser, dermal fillers, and RF microneedling.

Rolling Scars

Rolling scars are characterized by their wave-like appearance. They are caused by fibrous bands of tissue that develop between the skin and the subcutaneous tissue below, pulling the epidermis and causing the skin surface to appear uneven.

Treatment Options: Subcision, microneedling, and fractional CO2 laser are common treatments.

Hypertrophic and Keloid Scars

Unlike the other types, hypertrophic and keloid scars are raised above the skin surface. They are the result of an overproduction of collagen during the healing process.

Treatment Options: Treatments include steroid injections, laser therapy, and surgical removal.

Acne Scar Types — What They Look Like & Typical First‑Line Options
Scar type	How it looks	Typical first‑line	Learn more
Rolling (tethered)	Broad, shallow dips; “wavy” skin surface	Subcision ± Fractional CO₂	Subcision · Fractional CO₂
Boxcar	Wider edges; well‑defined borders	Fractional CO₂ / RF microneedling	CO₂ · RF microneedling
Ice pick	Narrow, deep tracts	TCA CROSS / punch techniques	TCA CROSS overview
Hypertrophic / Keloid	Raised above skin surface	Steroid injections (± energy devices)	Keloid management

Exact plans are personalised after doctor assessment; many patients have more than one scar type.

Can Acne Scars go away on their own?

Colour changes (PIH/PIE) can lighten; true texture scars rarely disappear without procedures.

The goal is a realistic improvement with a personalised plan.

Treatment overview (Evidence‑based)

This page is educational. For doctor‑led plans, downtime and “from” prices in Singapore, see Acne Scar Treatment Option and Price in Singapore.

A brief overview of modalities:

Fractional CO₂: texture resurfacing (atrophic).
Subcision: releases tethering for rolling scars.
RF microneedling: dermal collagen with shorter surface downtime.
TCA CROSS: focal, deep pits (ice pick).
Adjuncts: PN/skin quality injectables; fillers (temporary lift).

Self‑care & prevention

Treat active acne early to reduce scarring risk.
Do not pick lesions; hands‑off healing.
Sun protection daily to minimise darkening and support recovery.

Back & body acne scars

Back, chest and shoulders can develop both atrophic and hypertrophic/keloid scars. Principles are similar, but plans and aftercare differ due to skin thickness and friction areas.

When to see a doctor

Scars affecting confidence or daily life
Frequent breakouts leaving new marks/scars
Unsure whether it’s a mark or a scar

Ready for a personalised plan & prices in Acne Scar Removal Singapore

Frequently Asked Questions

Do acne scars look worse in certain lighting?
Yes. Raking/side lighting creates shadows that make depressions more obvious, while flat, frontal light hides them. Assess progress with consistent angles and lighting each time.
How do I tell enlarged pores from acne scars?
Enlarged pores usually have a central opening and look uniform; depressed scars often have irregular edges and no visible opening. If the area looks smoother when you gently stretch the skin sideways, it’s more likely a scar than a pore.
Can acne scars form without severe cystic acne?
Yes. Repeated inflammation, picking/squeezing, and delays in treating breakouts can lead to scarring even if you don’t get large cysts.
Are acne scars influenced by genetics?
Genetics can affect how your skin heals and remodels collagen. Some people are simply more scar‑prone than others, even with similar acne severity.
When after isotretinoin can I consider scar procedures?
Your doctor may recommend waiting several months after finishing isotretinoin before certain ablative procedures. Timing depends on your skin, dose, and the specific treatment being considered.
Will acne scars look more obvious as I age?
They can. Natural collagen loss and changes in skin elasticity/volume with age may make depressions appear deeper. Good sun protection and skin care help maintain skin quality over time.
What sunscreen is best if I darken easily after acne?
Use a broad‑spectrum SPF 30+ daily, reapply outdoors, and choose non‑comedogenic formulas. Tinted mineral sunscreens with iron oxides can help against visible light, which is useful if you’re PIH‑prone.
Do at‑home dermarollers or microneedling pens fix acne scars?
They can create superficial channels but carry infection and pigment risks and rarely address deeper tethering. Professional treatments are designed to reach the right layer with controlled settings.
Can silicone gel or sheets improve acne scars?
They’re most helpful for raised (hypertrophic/keloid) scars, especially on the body. They don’t significantly change pitted (atrophic) facial scars.
What’s the safest way to conceal acne scars for events?
Use a hydrating base, a blurring silicone primer, thin layers of non‑comedogenic foundation, and a light, targeted setting step. Avoid heavy shimmer or frosted highlighters that emphasise texture.
How should I photograph my scars to track progress accurately?
Use the same camera, distance, and angle on clean skin with no makeup. Shoot in consistent raking light (about 45° from the side) and keep a dated photo log.
Can diet or supplements reduce acne scarring?
Balanced nutrition supports overall healing, but no supplement has proven to erase scars. The most effective prevention is early acne control and avoiding picking.

Reviewed by Dr Vijay Sampath
MBBS, MS (Gen Surg), DNB (Gen Surg), MRCS (Edinburgh)
Medical Director, Bio Aesthetic Laser Clinic
Last reviewed: September 2025