Acne scars generally fall into four broad shapes: narrow “ice pick” indents, wider “boxcar” depressions, shallow rolling dips, and raised hypertrophic or keloid scars. Most textural scarring comes from deeper, inflamed spots, and the type affects what kind of treatment a professional might even bring up.
It helps to say upfront: not every mark left behind by a spot is a scar. A lot of what people worry about is actually a flat, temporary discolouration rather than a change in skin texture. If that distinction is unclear, the difference between a scar and a dark mark is worth reading first, since it changes what’s realistic to expect from any treatment.
What actually counts as an acne scar?
A true acne scar is a change in the skin’s texture — a dip, pit, or raised area — caused by damage to collagen during healing. This is different from a flat red, pink, purple or brown mark, which usually fades on its own over weeks or months as skin cell turnover continues.
Textural scarring tends to come from spots that went deep into the skin — cysts and nodules, in particular — where inflammation damaged the collagen structure underneath. Surface-level whiteheads and blackheads are far less likely to leave lasting texture change. Picking at or squeezing a spot can also increase the odds of a deeper injury, which is one reason whether popping a spot is always a bad idea comes up so often.
What is an ice pick scar?
An ice pick scar is a narrow, deep, pinprick-like indent, often described as looking like the skin was pierced with a small tool. They’re usually the hardest of the textural scars to treat because they go quite deep relative to how narrow they are on the surface.
They tend to show up more on the cheeks and are commonly linked to spots that were cystic or took a long time to heal. Because of their depth, options a dermatologist might discuss for this type often involve more intensive in-clinic approaches rather than anything applied at home.
What is a boxcar scar?
A boxcar scar is a wider depression with defined, somewhat sharp edges — often described as looking similar to chickenpox scarring. Unlike ice pick scars, they don’t taper to a deep point; they’re more like a shallow-to-medium crater with straight sides.
Boxcar scars can vary a lot in depth, and that variation matters for treatment. Shallower ones sometimes respond to resurfacing approaches like certain chemical peels or laser treatments, while deeper ones may need a different plan. What a chemical peel actually does to skin is a reasonable starting point for understanding one option that sometimes gets discussed for this type.
What is a rolling scar?
A rolling scar is a broad, shallow depression with sloped rather than sharp edges, which gives the skin a slightly uneven, wave-like texture rather than a distinct pit. They’re caused by fibrous bands pulling the skin down from underneath as it heals.
Because the edges are gradual rather than sharp, rolling scars can be easy to miss in good lighting and more obvious in harsher light or certain angles. This is the type most often described as making skin look “textured” rather than clearly scarred.
What is a hypertrophic or keloid scar?
These are raised scars, sitting above the surrounding skin rather than dipping below it. A hypertrophic scar stays roughly within the size of the original spot, while a keloid scar can keep growing beyond it. Both come from an overproduction of collagen during healing, which is the opposite problem to the indented types above.
Raised scarring is less common on the face than on the chest, back, jawline and shoulders, and some people are more prone to it than others for reasons that aren’t fully within anyone’s control. Because keloids in particular can keep changing over time, this is a type where getting an opinion from a professional early is generally more useful than waiting to see what happens.
Can someone have more than one type at once?
Yes — it’s common for skin to show a mix of ice pick, boxcar and rolling scarring together, especially after a longer stretch of cystic or nodular acne. There isn’t usually one single “type” that neatly describes a whole face or back.
This mixed picture is part of why in-person assessment matters more than trying to self-diagnose from a mirror or photos. A professional looking at the skin directly, in good light, can usually tell the different types apart far more reliably than guesswork at home, and that assessment is what actually shapes a sensible plan.
What actually helps with different types of scarring?
There’s no single treatment that addresses every type of acne scar, and what might be discussed depends heavily on which type (or mix of types) is present, how deep it is, and where on the body it sits. Options that sometimes come up in these conversations include:
- In-clinic resurfacing approaches such as certain lasers or peels, more relevant for shallower boxcar or rolling scars
- Procedures aimed at deeper scars, which a dermatologist would explain in more detail based on what they see
- Steroid injections, which are sometimes discussed specifically for raised, hypertrophic or keloid scarring — what steroid injections for cystic spots actually involve covers how that conversation tends to go
- Light-based devices, where the evidence is genuinely mixed depending on the device and the type of scarring — whether LED masks and light therapy are worth anything is a fair, unhyped look at this
None of these come with a guaranteed outcome, and most take a considerable stretch of time before any change is visible, if it’s visible at all. Anyone hoping for a quick fix is likely to be disappointed, and that’s worth knowing before spending money on a specific treatment.
When is it worth seeing a professional about scarring?
Seeing a dermatologist is worth considering whenever texture changes are noticeable, when acne itself is still active and cystic, or when scarring or ongoing breakouts are affecting mood or confidence. Getting an assessment early tends to open up more options than waiting.
This is also simply the only reliable way to find out which type of scarring is actually present, since ice pick, boxcar and rolling scars can look similar in a mirror but respond very differently to treatment. If active, deep or painful spots are part of the picture, that’s worth raising too — treating the acne itself is usually the first step before any scarring is addressed. When acne is worth seeing a doctor about and what happens at a first dermatology appointment are both useful to read beforehand, so the appointment itself feels less unfamiliar.
For a broader look at how scarring and marks are covered on this site, the Scarring & Marks section brings together related explainers, including how long-lasting dark marks after a spot heals compare to genuine textural scarring — a distinction that’s easy to blur but genuinely changes what’s worth trying next.
Acne Cut publishes general information about skin, not medical advice. We are writers and researchers, not dermatologists, doctors or pharmacists. Acne varies enormously from person to person, and what suits one person’s skin can irritate another’s. If your acne is painful, scarring, getting worse, or affecting how you feel day to day, speak to a doctor or a dermatologist — that is a normal thing to do and it is what they are there for.