Atrophic acne scars are the most common type of acne scar. Atrophic acne scars are depressions that develop when the skin’s natural wound-healing response produces insufficient new collagen. Inflammatory acne lesions, such as nodules and cysts, are the most likely to cause atrophic acne scars. Three different types of atrophic scars include icepick, rolling, and boxcar scars. Ice pick scars have a deep, narrow, v-shaped indentation and are the most difficult to treat due to their depth and shape. Rolling scars are shallow, uneven, and wave-like in appearance, seemingly “rolling” across the skin’s surface. Boxcar scars have a round or oval-shaped appearance, well-defined edges, and deep vertical sides.
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