This is an inflammatory response to the sebum, bacteria and dead cells inside the blocked follicles. The nodulo-cystic type acne that occurs deep in the skin is most likely to result in scars, although more superficial lesions can do the same.

The presence of acne scars is very distressing psychologically, particularly in young people who are just starting a relationship or a career. It is therefore very important to prevent this by effective treatment of acne in the early stages. Treating acne scars is far more expensive and time-consuming than treating acne itself.

Acne scars can be seen as shallow depressions like the shape of a saucer plate, or as deep holes with sharp margin described as ice-pick scars. In the predisposed individuals, it can appear as raised lumps called keloids or hypertrophic scars, which are the most distressing and difficult to treat. There are few other descriptions of acne scars but they are not too useful to know.

There are many different treatments available for acne scars. What treatment to choose depends on the severity of scarring, the cost, the life-style and the expectation from treatment, and is best arrived after discussion with the physician.

Be realistic. Total restoration of the skin to the way it looked before the acne stared is often not possible, although some dramatic improvement of the appearance of your skin can be achieved in many cases.

The treatments for depressed scars available include:

1. Collagen or fat injection to stretch and fill out some depressed but soft scars. It only lasts for a few months.
2. Dermabrasion uses a high-speed brush to sand away the top layers of skin and can be used to lighten deep scars, and superficial scars may be removed completely.
3. Microdermabrasion is a mild form of sanding using aluminum oxide crystals passing through a vacuum tube.
4. Chemical peelings using different strengths of acids to corrode away the top layers of skin.
5. Different types of ablative or non-ablative lasers, to remove the top surface and / or stimulate the underlying collagen regeneration.
6. Skin surgeries, like punching out the ice-pick scars, or by grafting a new piece of skin altogether.