Acne scars form from the way your skin cells respond to the inflammation of active acne. Some scars are created from an overgrowth of skin tissue. These are keyloid scars, and form when the cells secrete too much collagen. Keyloid scars are firm, soft, and ususally irregularly shaped. These type of scars are not as common as other types in acne.

The other way scars are formed is by the loss of tissue. These scars are very common with acne, although early treatment of acne will help prevent scar formation. 'Ice pick' scars fall into this category. They are named because they make the skin look like it has been punctured by an ice pick.

Other types of acne scar are boxcar and rolling scars. Boxcar scars vary in depth and are round to oval indentations. They have vertical edges. But they aren't pointed like ice pick scars. Rolling scars are formed by the adhesion of the surface of the skin to the subcutaneous layer.

The different types of acne scars require different treatments. The range of treatments include dermabrasion, laser resurfacing, chemical peels, punch techniques, subcision, collagen injections, and some topical treatments. Newer treatments include pulsed laser technology. Sometimes a combination of treatments is required depending on the type and severity of your acne scars.

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Another cream that has proven beneficial is azaleic acid cream. And chemical peels are effective at this stage.

Treatment for ice pick scars is usually dermabrasion and laser resurfacing. For deep scars, punch grafting may be required. Dermabrasion involves a local anasthetic. A brush at high speed removes the surface of the skin. It can make ice pick scars worse if the width of the scar is wider underneath the skin.

Punch grafting involves cutting the scar down to the layer of fat beneath and then stitching the hole, or using a small skin graft. Another surgical technique, subcision, involves dividing the fibrous band underneath the scar.

Collagen injections are not recommended for ice pick scars. Collagen injections, or injecting your own fat into scar tissue, is usually done on flat, thin scars.

Treatment of keyloid acne scars includes injections of steroids into the scar, silicone gel dressing, crytotherapy, and surgery.

Pulsed laser treatments have been successful with keyloid acne scars, and reddened and thickened scars. A combination of pulsed dye laser treatment and carbon dioxide laser vaporisation has been effectively used when scarring is not red, and not so thick.