Unveiling the Most Stubborn Acne Scars

Unveiling the Most Stubborn Acne Scars

Most people commonly deal with acne scars, but some acne scars are more stubborn than others. What is the most stubborn acne scar to remove? This post is the perfect place to start for solutions for tackling your persistent acne scarring. In it, we’ll unveil the most stubborn acne scars and their available acne scar removal treatments.

Who Might Get an Acne Scar?

Anyone can get an acne scar, but certain factors may increase the risk. Darker skin tones likely develop acne scarring than those with lighter skin tones because dark-skinned individuals have more melanin, which makes scars more pronounced. Those with a family history of acne also have an increased risk of developing scars. 

People picking or popping their pimples develop acne scarring because of further inflammation and damage to the skin, leading to more severe scarring. 

Which Type of Acne Scar Is the Hardest to Remove?

Several factors determine the difficulty of removing acne scars, such as the type and severity of the scarring, skin type and response, and treatment used.

  • Type and severity of scarring

Severe acne scars are the most difficult to treat, as they require more intensive treatments to target deep layers of skin. It includes atrophic scars.

Different skin types respond differently to treatments – some cannot receive certain treatments due to their sensitivity, while others do not respond as well to a particular treatment.

Different types of treatments are available for treating acne scars. Some are more successful than others depending on the type and severity of scarring. Laser resurfacing, chemical peels, dermabrasion, and microdermabrasion reduce the visibility of scars, while skin needling and injectables plump up indented scars.

Atrophic Acne Scars: Ice Pick, Boxcar, Rolling

Atrophic acne scars are caused by damage to the underlying skin tissue. It tends to be sunken and can range from very small to large. Atrophic scars can be difficult to treat because they are caused by loss of tissue and collagen from the skin during an inflammatory response, usually due to cystic or nodular acne. 

Laser resurfacing and skin needling improve the appearance of these scars, but they cannot restore lost tissue or collagen. As a result, atrophic acne scars are one of the most stubborn scars to remove. The most common atrophic acne scars are ice pick, boxcar, and rolling scars.

Ice Pick Scars 

Ice-pick scars are caused by severe cystic or nodular acne. It causes tissue damage deep within the dermis, creating a pitted appearance to the skin – deep and narrow, with a jagged or sharp edge. It is difficult to fill the depression created by ice-pick scars with traditional treatments like dermal fillers and skin needling. Punch excisions are for deeper ice pick scars, while laser resurfacing and chemical peels reduce the appearance of milder cases.

Boxcar Scars 

Boxcar scars are wider, round or oval depressions with sharp vertical edges due to the damage of collagen and elastin fibres in the skin. It can be challenging to treat because they’re deeper than ice-pick scars but not deep enough for punch excisions. It can be difficult to remove boxcar scars completely, but with a combination of treatments, they can reduce size and appearance. Dermal fillers and skin needling restore volume lost, but laser resurfacing or chemical peels are needed for more severe cases to reduce the appearance of scars.

Rolling Scars 

Rolling scars are caused by collagen and elastin damage. They have sloping edges and create an uneven, rolling texture to the skin. They can be improved with dermal fillers or skin needling, but laser resurfacing reduces their appearance. 

Hypertrophic Acne Scars 

Hypertrophic acne scars are raised, thickened scars due to an overly aggressive inflammatory response. They can be difficult to treat because they tend to recur after treatment. Dermal fillers, skin needling, and laser resurfacing can reduce the appearance of hypertrophic scars.

Keloid Acne Scars 

Keloid scarring is an excessive formation of collagen caused by an overly aggressive inflammatory response. They are raised and thickened, often with a red or purple hue. Keloid scars can be difficult to treat because they do not respond well to traditional treatments like dermal fillers and skin needling. Steroid injections, cryotherapy, and laser resurfacing are more effective for reducing the appearance of keloid scars.

Post-Inflammatory Hyperpigmentation

Post-inflammatory hyperpigmentation creates patches of discolouration on the skin, usually brown or red in colour, caused by an inflammatory response. Treatments like laser resurfacing and chemical peels reduce the appearance of post-inflammatory hyperpigmentation, but they can also be improved with topical creams and lightening agents.

Prevention Is Key

Preventing acne scars is important to maintain healthy skin and avoid permanent damage. Active acne is more likely to form acne scars, so keep the condition under control. Scars can lead to physical and emotional distress, so addressing them right away is key for maintaining good skin health. 

Treating acne correctly and consistently can help prevent the formation of scars. Use gentle exfoliants, moisturise skin, minimise inflammation with topical treatments, and always wear sunscreen outdoors.


Acne scars are more than just an aesthetic nuisance – they can cause physical and emotional distress. Prevention maintains healthy skin and avoids permanent damage, so take care of your skin daily to keep your skin looking healthy and reduce the appearance of acne scars. Various treatments are available to reduce their appearance.

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