Acne scars: Signs and symptoms

Icepick scars: When this type of acne scar forms, it often looks like an icepick punctured the skin. Treatment usually begins with acne scar surgery. About 6 to 12 weeks after this surgery, some patients have laser resurfacing to help their skin look its best.

Boxcar scars: This acne scar leaves a depression in the skin that often looks like a large pore. The scar can be shallow or deep and is most likely to develop on the cheeks and temples. Treatment depends on how deeply the scar penetrates the skin.

Rolling scars: This acne scar leaves depressions that give the skin a wavy texture. Injecting these scars with a filler can make them less noticeable. Acne scar surgery and laser treatments also help to diminish these scars. For best results, a dermatologist may use more than 1 treatment.

Raised acne scars: As severe acne cleared, raised acne scars formed. Most raised acne scars have a pinkish color and feel firm. They can itch. Raised scars tend to form on the back, chest, shoulders, upper arms, or jawline. Treatment can ease the discomfort and diminish the scars.

Dark spots are not scars: This woman has active acne and dark spots on her face. Dark spots appear as deep acne clears. These dark spots are not scars because they eventually disappear.

Dark spots can linger: These spots can remain for weeks, months, or even years before they disappear. The medical term for these dark spots is “post-inflammatory hyperpigmentation” (PIH). Dermatologists offer treatments and tips that can help fade PIH more quickly.

Depression, anxiety, and other symptoms: Acne scars can affect more than a person’s skin. Some people develop anxiety, a medical condition that causes a person to feel so anxious that the feelings interfere with everyday life. Others feel depressed and withdraw from people.

Treatment can diminish signs and symptoms: If acne scars cause you to feel depressed or anxious, you may want to talk with a dermatologist about treatment for acne scars. Many people find that treating their scars boosts their self-confidence, so they feel better.


What you see on your skin varies with the types of acne scars you have. Your dermatologist will talk about two types of acne scars:

Depressed: Most acne scars cause depressions or pits in the skin.

Depressed scars usually form on the face. A dermatologist may refer to these scars as “atrophic” (a-tro-fic) scars or use the name of the specific depressed scar:

  • Boxcar
  • Icepick
  • Rolling
Raised: These acne scars are more common on the back and chest. The medical term for a raised scar is “hypertrophic.” 

Now that you know what the different types of acne scars look like, you may be wondering why some people get them. You’ll find the answer within Acne scars: Who gets and causes.

Learn more:

Images of acne scars used with permission of Journal of the American Academy of Dermatology. J Am Acad Dermatol 2001;45:109-17 and 2013;68:834-53.

Images of dark spots used with permission of Journal of the American Academy of Dermatology. J Am Acad Dermatol 2002;46(issue 2; sup 2):S98-S106.


Jacob CI et al. “Acne scarring: A classification system and review of treatment options.” J Am Acad Dermatol 2001;45:109-17.

Thiboutot, D et al. “New insights into the management of acne: An update from the Global Alliance to Improve Outcomes in Acne Group.” J Am Acad Dermatol 2009;60:5(sup. 1) S1-S50.