Acne scar formation can be one of the worst and most self-conscious issues which can decrease self-esteem and confidence if not dealt with appropriately. Acne is one of the most annoying problems most of us go through during our teenager years. Some of us less fortunate can even have to deal with acne as an adult. Acne scar formation can be due to a multitude of underlying factors, but one of the most common reasons is that the acne is not left alone to come to the surface and release and instead is squeezed with a lot of pressure causing the comedone to burst while it’s still forming in the deeper layers of the skin.

Acne Scar Treatment
The trauma which occurs in the skin with significant damage creates scar tissue. This scar tissue is composed of various types of collagen. However instead of the collagen being laid in neat and orderly lines which follow the natural flow of your face, the scar tissue collagen is laid down as as fast as possible in a mix matched and cross linking patterns. This means it isn’t as elastic as your regular healthy skin and will feel and look different.

With the acne scar formation the scar can create various types. And though we all may have thought there was only one type of acne scar there are in fact many different types of acne scarring.


Acne Scar Types

Micro-needling and Skin Rejuvenation


  1. Boxcar Scarring: round or oval shaped depressions in the skin and can be quite large. It causes the skin to have a pitted appearance. Boxcar scarring is due to loss of collagen which allows the skin to fall and sag in the area of the scar.
  2. Ice-pick scarring: these are the deep hole like scars in the skin which extend all the way down to the dermal layer. Sometimes these can appear as an enlarged pore.
  3. Rolling Scarring: The skin appears to be rolling, such as waves in an ocean with rises and falls thus creating valleys which create shadows and therefore appears as a blemish on the face.
  4. Divot Scarring: This is similar in appearance to a golf divot on a golf course. This divot is deep due to a loss of subcutaneous connective tissue.
  5. Hypertrophic & Keloid Scarring: These scars are very large and over compensate for the amount of damage. Therefore these scars can become raised and coloured, normally these scars will be purple or reddish.

Scars are graded by severity. Grade 1 scars are minimal and are easily covered with makeup. Grade 4 scars are the worst which almost always require medical treatment.

Acne Scar Treatment

I treat boxcar, icepick and divot acne scarring with a combination of platelet-rich plasma and medical grade micro-needling. First I create a platelet-rich plasma filler made from your own body which I inject under the scar. This creates a lift thereby eliminating the hole and valley of the scar. I think combine your own platelet-rich plasma with medical grade micro-needling which creates thousands of controlled depth holes in the acne scar. This stimulates the body’s natural ability to heal. These holes are then filled with elastin and collagen. The final result is more supple skin, decreased appearance of the acne scarring and increased tone.


Number of treatments

Depending on the severity of scarring, often grade 4 acne scarring will take 2-4 treatments. Treatments are conducted on average 1 month apart in addition to proper skin maintenance as well as nutrition and supplementation for optimal skin health if necessary.


Dr. Ben is a Naturopathic Doctor at Cornerstone Naturopathic in Halifax Nova Scotia. You can find him out and about challenging the status quo of our health care system by providing the most current and evidence based medicine to help people look, feel and move their best. 

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