What are the different types of acne scars, and why does it matter?
Not all acne scars are the same. The type of scar often shapes the treatment plan.
Types of acne scars:
Ice pick scars are deep and narrow.
Boxcar scars are the larger ones round or box-shaped, with a flat floor.
Rolling scars look like soft, shallow indents across the skin.
And some scars are hypertrophic, meaning they sit raised above the surface rather than sunken below it.
Knowing which kind you have is the first step in choosing what will actually help.
What treatments work on acne scars?
One preliminary acne scar treatment that has worked well for many patients at Toribella is acne scar subcision. A cannula, or a flexible, hollow needle, is passed under the skin, between the dermis and the epidermis, to release any tethering that has pulled the scar down and is holding it in place. Once that adhesion is broken up, the skin can lift. It does hurt a little, but not as much as you'd expect. Subcision can be done as a standalone treatment, or the area can be gone over that same day with microneedling, Morpheus8, or CO2 laser.
These three: microneedling, Morpheus8, and CO2 laser are the workhorses for acne scars. Scars are genuinely hard to treat, and it usually takes a series of treatments, but these are the tools that make a real difference. During a consultation, we would go over what the best course of action is for your specific situation.
When would you choose one treatment over another?
Microneedling is the most broadly suitable treatment for acne scars. It's good for almost anyone, at almost any age, and it can be done year-round no matter your skin concern and no matter how light or dark your skin is.
Morpheus8 is best in the cooler months, when you're staying out of the sun. It's a strong choice if you also want some tightening, though it costs more than microneedling, and it calls for extra care in anyone with a risk of hyperpigmentation.
CO2 laser is a resurfacing treatment which means it's taking off that whole top layer of skin, so it's suited to more involved concerns like wrinkles, uneven skin tone, hyperpigmentation, and scarring. It comes with downtime: anywhere from about three days to two weeks, depending on how deep the treatment goes and on your skin type. Like Morpheus8, it should be done in the winter or cooler months, with at least two weeks out of direct sun.
Can you treat acne scars if you still have active breakouts?
You can treat acne scars with active breakouts. Scar treatment doesn't require perfectly clear skin first. In fact, Morpheus8 has been shown to help decrease the bacteria associated with acne, so it can actually improve active acne while it works on the scarring.
For adults dealing with ongoing acne alongside their scars, getting onto a good skincare regimen is part of the plan — and that's where Toribella’s Acne Boot Camp program can be a good fit. This article has the step by step of how the program works.
We wrote another article that might be helpful for more information on Adult Acne: Why It Keeps Coming Back, and What Actually Clears It.
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