A symptom-first summary
- Flat red or brown areas are colour changes; depressed and raised scars change skin texture.
- Ice-pick, boxcar and rolling scars have different shapes and may appear together.
- Active acne should be discussed because preventing new breakouts can be part of preventing new scars.
Flat marks versus changes in texture
A mark may look red or brown while the skin surface remains flat. A depressed scar creates a pit or wave; a raised scar sits above the surrounding skin. Lighting can change how a depression looks, so a photo alone is not a complete assessment.
Ice-pick, boxcar, rolling and raised scars
The American Academy of Dermatology describes ice-pick scars as small and deep, boxcar scars as round or oval depressions, and rolling scars as wide and shallow with a wavy appearance. Raised scars form when too much collagen is produced during healing.
Why a one-device answer is incomplete
Different scar shapes, depths and skin characteristics can require different discussions. A consultation may consider procedures, medicines applied to skin, acne control, postponement or no treatment. The choice also depends on health history, skin tone, time for aftercare, cost and personal priorities.
A consultation checklist
Ask the clinician to name the concern being assessed, explain why an approach is proposed for that type, describe alternatives and uncertainty, and provide procedure-specific risks, aftercare and a follow-up plan. Bring the acne medicines and procedures used in the previous two years.
Acne mark and scar questions
Can one person have several scar types?
Yes. Mixed depressed scar types are common, and colour changes or active acne may also be present.
Can a photo identify the right treatment?
A photo can document a concern but cannot replace examination of texture and depth, health-history review, skin-tone assessment and discussion of active acne.
Why does active acne matter?
Ongoing breakouts can cause new scars. A clinician may recommend controlling acne before or alongside planning for existing scars.
Is one procedure appropriate for every scar?
No. Treatment planning depends on scar type, depth and location as well as individual medical and practical factors.