Depressed acne scars are the most common type of acne scars. About 80 to 90% of people with acne scars have this type. During the skin’s healing process, too little collagen is deposited to fill up the holes left in the skin after acne, leaving indents.
There are 3 kinds of depressed scars. Sometimes people have all 3 forms of depressed scars.

Depressed scars:Scars_Eng
Ice-pick: narrow, deep and V-shaped.
Boxcar: a wide, round or oval opening at the surface with a box–shaped hollow into the skin. These can be deep or shallow.
Rolling: the widest scars with a rippled, layered look.

If acne scars make you feel self-conscious or you believe your appearance is holding you back from opportunities at work, school or in your social life, there are treatments to make acne scars less noticeable. Here’s some general tips about acne scar treatment to be aware of before getting into specific treatments.

Medical treatment

See your dermatologist or physician for a consultation including an examination of your scars. He or she will come up with a treatment plan that considers scar types, width, depth, amount of skin involved and location, as well as your skin type and colour. Most people will need two or more different types of treatment for best results. Advise your doctor if you are taking isotretinion.


Most medical treatments for acne scars offer improvement in the 40-50% range over the course of a few months to a year or more, making scars much less noticeable.

(Here Before and After a 14 month period of treatments. (Images courtesy Dr. Chantal Chiasson).

Other considerations

Aside from results, other considerations are cost for these cosmetic procedures, recovery time, and number of treatments needed.

For some people, especially with darker skin, treatments such as lasers and chemical peels may cause a change in skin colour such as a skin darkening effect. Everyone should avoid the sun and use sun protection during the treatment period and for several months afterwards.

(Here Before and After a 14 month period of treatments. (Images courtesy Dr. Chantal Chiasson)

Treatments for depressed acne scars:

  1. Scar surgery
    These in-office medical procedures are for noticeable, large and/or deep scars. The scar is removed and replaced with a smaller, flatter scar that will lessen with time. Alternatively, the scar is lifted and boosted underneath to make it level with the skin’s surface.
  1. Laser resurfacing
    Lasers can be used on all types of scarring although depressed rolling scars are best suited for laser surgery. Many lasers are non-ablative – that is they don’t remove any tissue – and simply heat the skin to stimulate new collagen production.
  1. Fillers
    This treatment is used for a few depressed scars. Filler injections plump up scars to reduce the appearance. Results are quick but most are not permanent. Fillers remain in the skin for 6-12 months. PMMA (polymethylmethacrylate), recently approved in Canada, is the only permanent filler material available. Side effects from most fillers are minimal such as mild temporary swelling and redness or bumps.
  1. Chemical peels
    Often used in combination with other treatments, potent concentrations of chemicals such as trichloracetic acid are applied to the skin in order to remove a thin, top layer. New skin forms, giving a smoother more even appearance to the skin.