No Scar is the Same: Types of Acne Scars and Their Causes

“The most common type of acne scars that I see in my practice are ice pick scars, box scars, rolling scars, and keloid/ hypertrophic scars,” said Dr Verma. 

• Boxcar Scar: Broad and deep acne scars with sharp edges, often seen on the temple and cheeks. 

Cause: Picking and squeezing acne and collagen degradation.

• Ice Pick Scars: Deep, narrow, and pitted scars that resemble puncture marks.

Cause: Genetic predisposition or delayed treatment of deep acne lesions.

• Rolling Scars: Shallow, wave-like indentations across the skin.

Cause: Prolonged and untreated acne can cause these nodules that lead to scarring.

• Keloid/Hypertrophic Scars: Raised, thick scars that can grow beyond the boundaries of the original acne site.

Cause: Abnormal wound healing, trauma to the skin, or overproduction of collagen.

Different Skin Colour, Different Pigmentation Problems: Dr Verma

According to Dr Verma, skin type also plays a crucial role in the kind of scarring one might develop. When treating acne in skin of colour, dermatologists must carefully plan therapies to prevent further pigmentation and inflammation.

• Fitzpatrick IV–VI, aka darker skin types, are more prone to post-inflammatory hyperpigmentation (PIH) and keloid formation.

• Lighter skin types tend to experience more atrophic scarring, like ice pick or boxcar scars.

How Acne Turns into Scars

Acne doesn’t transform into scars overnight, but it is rather a long and often neglected process. Once deep acne, like boxcar or adult acne/hormonal acne, forms, it is important to seek treatment from a dermatologist asap to stop it from spreading.

According to Dr Verma, here’s what happens under the surface:

• Inflammation disrupts collagen synthesis, leading to indentations or atrophic scars.

• Repeated eruptions without control break down the skin’s healing cycle, making it vulnerable to scarring.

• Delayed treatment increases both PIH and uneven texture due to chronic inflammation and fibrosis.

• Early intervention is key to preventing scars that are difficult and costly to reverse.

The Role of Sun Exposure in Scarring

By now, it is more than evident that harsh sun exposure is bad for skin. To this, add acne, and it becomes a healing nightmare. Sun’s UVA+UVB rays cause problems like hyperpigmentation, tanning, and even premature ageing. 

“Sun exposure increases the tendency of acne scar formation as it delays healing. It leads to inflammation and oxidative stress and slows skin rejuvenation. It induces melanin formation, leading to post-acne hyperpigmentation,” said Dr Verma.

ALSO READ: https://www.onlymyhealth.com/benefits-of-amoxicillin-for-managing-acne-12977831579 

Sun-Damage Prevention Tips According to Dr Verma: 

1. Use broad-spectrum sunscreen (SPF 30+) daily, even indoors.
2. Reapply sunscreen every two hours, if outdoors or after swimming in the sun.
3. Wear hats or cover your face during peak sun hours.
4. Avoid tanning, and never skip sunscreen post-procedures.

Acne Scarring isn’t Just Skin Deep

People dealing with persistent and recurring acne don’t just fight to keep off the acne cysts, but also fight the inner fight. This internal conflict, caused due to deep acne scarring, leads to low self-esteem and under-confidence. Beyond the physical marks, acne scarring can deeply affect mental health, especially in adolescents and young adults.

In Dr Verma’s experience, “Scarring can lead to social withdrawal, anxiety, and even depression, especially in adolescents. Many patients report body image issues and reduced confidence in personal and professional interactions.”

How to Support People Struggling with Acne Scarring Mentally? Dr Verma Answers

• Encourage Early Treatment: Guide people towards a good medical professional who understands specific acne and its proper treatment.
• Educate and Empower: People dealing with persistent acne and its scarring tend to see their acne as a flaw, which makes them feel safe and empowered through words.
• Learn and Debunk Common Myths: Still, acne and acne scarring are met with myths and misconceptions. Learn not to pick and ask about scars.

ALSO READ: https://www.onlymyhealth.com/causes-of-scalp-zits-in-humid-weather-and-how-to-fix-it-12977831339 

Common Acne Myths That Worsen Distress:

• “Acne means you’re dirty” – creates unjust shame and guilt. 
• “You shouldn’t eat oily foods at all” - leads to unnecessary food restrictions. 
• “It will go away on its own” – delays timely treatment, worsening scars 
• “Only teens get acne” – isolates adult patients and increases frustration.

Truth: Acne is a medical condition, and timely treatment can prevent not just physical scars, but long-lasting emotional damage as well, explained Dr Verma.

Diet, Lifestyle, and Acne Severity

While acne isn’t solely caused by what you eat, certain foods and lifestyle habits can make it worse.

1. Cut Sugar & Carbs: High-glycemic index foods like white bread, sugary snacks, and processed cereals spike insulin, which increases sebum production.
2. Size Down Dairy Products: Dairy, particularly skim milk, is linked to acne flares due to insulin-like growth factor 1 (IGF-1).
3. Prioritize Sleep: Stress, poor sleep, and hormonal fluctuations elevate cortisol levels and worsen inflammation, leading to acne flare-ups.

A balanced lifestyle, low-glycemic diet, and good sleep hygiene can support skin health from the inside out.

ALSO READ: https://www.onlymyhealth.com/diy-clay-body-mask-for-armpits-back-and-chest-12977832652 

Conclusion: Don't Let Scar Dim You 

Acne scars are not just cosmetic—they reflect deeper skin damage and can have a lasting emotional impact. Recognizing the factors that contribute to scarring, including inflammation, sun exposure, and lifestyle, can empower individuals to take early action. With the right treatment and guidance, both the skin and self-esteem can heal beautifully.