What Causes Acne Scars and How Can They Be Treated?

Acne scars form when severe or inflamed acne damages the deeper layers of the skin during the healing process. The body's inflammatory response to cystic or nodular acne disrupts collagen production in the dermis, leaving permanent textural changes that range from shallow surface depressions to deeper pitted scars.

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Why Does Acne Leave Permanent Scars?

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Mild acne typically heals without permanent scarring. Severe inflammatory acne, including cysts and nodules that extend deep into the skin, triggers an excessive inflammatory response that destroys collagen in the dermis faster than the body can replace it. Picking, squeezing, or manually expressing acne lesions dramatically increases the risk of scarring by spreading bacteria and deepening inflammation into the dermis.

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What Are the 4 Main Types of Acne Scars?

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Understanding the type of scar guides the selection of treatment:

• Ice pick scars: narrow, deep pits extending into the dermis, the most difficult type to treat
• Boxcar scars: wide, rectangular depressions with defined edges
• Rolling scars: broad, wave-like depressions caused by fibrous bands pulling skin downward
• Hypertrophic scars: raised scars caused by excess collagen production, opposite in texture to atrophic scars

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How Does Treatment Address Acne Scars?

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Microneedling for acne and scars is among the most effective treatments for rolling and boxcar scars because it stimulates new collagen production within the exact area of the scar deficit. Over a series of 3 to 6 sessions, the accumulated collagen response progressively fills depressions and smooths surface irregularities.

Laser skin treatments address acne scarring by resurfacing the top layers of skin, stimulating deeper collagen remodeling, and reducing any associated post-inflammatory hyperpigmentation. The laser skin treatments team at Raleigh Laser and Aesthetics matches the specific laser wavelength and energy level to the depth and type of scarring.

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What Is the Best Treatment Plan for Acne Scars?

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Most acne scar treatment plans combine 2 or more modalities for optimal results. A common approach includes an initial series of microneedling sessions to stimulate collagen, followed by laser resurfacing to improve surface texture and tone, and a maintenance protocol of periodic facials and chemical peels to sustain skin health over time.

The face treatments team will design a personalized plan during a consultation. Book at Raleigh Laser and Aesthetics to receive a detailed treatment recommendation based on your specific scar type and skin tone.

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