Not all acne marks are scars. Flat brown or red marks are pigmentation and usually fade on their own over months. True scars involve permanent structural change to the skin — and the three main types (ice pick, boxcar and rolling) each respond to different treatments, which is why a single approach rarely clears everything.
Marks That Aren't Scars
Post-inflammatory hyperpigmentation is a flat brown or dark mark left after a spot heals, and post-inflammatory erythema is the flat red equivalent. Neither involves structural damage — the skin surface is level, just discoloured. Both usually fade over 3–12 months, faster with sun protection. Treating these as scars leads to unnecessary and sometimes counterproductive intervention.
Ice Pick Scars
Narrow, deep and steep-sided, ice pick scars look like small punctures. Because they extend deep into the dermis with a very small surface opening, resurfacing treatments struggle to reach the base — they smooth the surrounding skin without lifting the scar floor. These are the most challenging type and often need targeted rather than general treatment.
Boxcar Scars
Boxcar scars are wider with defined vertical edges and a flat base, like a shallow crater. Because the base is broader and often shallower, they respond better to collagen-stimulating and resurfacing approaches that build volume beneath and soften the edges.
Rolling Scars
Rolling scars create a wavy, undulating surface caused by fibrous tethers pulling the skin down from below. The skin itself is relatively intact — the problem is the tethering. Treatments that address the fibrous bands and stimulate collagen beneath tend to give the most satisfying improvement in this type.
Setting Realistic Expectations
Meaningful improvement is very achievable; complete erasure usually is not. A realistic goal is substantial softening — scars becoming much less noticeable in normal lighting rather than disappearing entirely. Anyone promising complete clearance in one session is overselling. Most people need a course, and often a combination of approaches for different scar types on the same face.
If this describes what you are dealing with, our Rejuran® PDRN Facial protocol is the relevant option to discuss — our Aesthetic Specialist will confirm whether it suits you, or tell you honestly if it does not.
Frequently Asked Questions
It depends entirely on scar type. Ice pick scars need targeted treatment; boxcar and rolling scars respond better to collagen stimulation and resurfacing. Our Rejuran® PDRN Facial supports dermal repair and texture improvement over a course. Assessment first is essential — a single approach rarely suits every scar type.
Flat brown or red marks (post-inflammatory pigmentation and erythema) usually fade over 3–12 months. True structural scars — indentations you can feel — do not resolve on their own and need active treatment to improve.
Most people need a course rather than a single session, typically spaced several weeks apart to allow collagen remodelling between visits. The number depends on scar depth and type, which is determined at consultation.