You could find yourself with acne scars even with the most comprehensive skin care routine. But not all scars are the same. Usually, they come in two types: those that are caused by tissue loss (atrophic), or those that are caused by an excess of tissue (hypertrophic). Included in these two categories are more specific varieties, such as ice pick, boxcar, rolling and keloid scars.

Red marks left by acne are not scars, they are merely a type of hyper pigmentation that will lessen and disappear with time.

Types of Acne Scars

Ice Pick Scars

*Appearance: Ice pick scars are thin and profound. Its name comes from the skin's appearance as if it's been stabbed by an ice pick. The scars cause long narrow deep holes that might look like a large open pore.

*Development: Ice pick scars develop due to infections within cysts or other deeply inflamed blemishes. In this case, skin tissue is destroyed and leaves a thin deep scar.

*Common treatments: Punch excision or punch grafting is the normal treatment for ice pick scars.

Boxcar Scars

*Appearance: Boxcar scars are rounded impressions that have deep vertical sides. They are wider than ice pick scars which gives the skin more of a pitted appearance.

*Development: Boxcar scars are created when an inflammatory breakout destroys collagen and tissue is lost. The skin is no longer supported and a depression is formed. Boxcar scars can be small to severe, depending of the loss of tissue.

*Common treatments: Punch excision or elevation are the most common treatments for boxcar scars, as well as dermal fillers or laser resurfacing.

Rolling Scars

*Appearance: Rolling scars cause rolling or 'wave like' indentations across the skin.

*Development: The development of these scars is due to the production of fibrous tissue bands between the skin and subcutaneous tissue below. The tissues then pull the skin and bind it to deeper structures. This reaction creates the rolling characteristic of this type of scar.

*Common treatments: Subcision is the most common treatment for rolling scars.

Hypertrophic or Keloid Scars

*Appearance: A hypertrophic scar is a raised mass of scar tissue. These types of scars usually develop to a larger size than the original wound. Men are most prone to this type of scarring, usually in the area of their torso.

*Development: Hypertrophic scars are unique in that they are formed by an overproduction of collagen.

*Common treatments: These scars are most effectively treated with steroid (cortisone) creams, tapes, or injections that flatten or reduce the area of raised scar tissue. Interferon injections are also common treatments that soften the scar tissue.