See also acne vulgaris and papular acne scars.
Acne may cause a wide variety of scar morphologies including the typical papules, plaques, and nodules. Flat, red macules--most common on the face--should not be considered scars. They usually represent inflammation and healing after the acne process. However may patients refer to them as "acne scars". Acne has a propensity to cause a specific perifollicular scar--called papular acne scars. It is centered about the follicle and may appear white, papular or anetodermic. It is often best seen on the upper back and shoulders. Loss of pigment leaving white macules is typical if the patient habitually scratches the acne lesions.
Any active acne must be treated aggressively. Often, a course of isotretinoin is indicated. Once all acne has been eliminated, great improvement in the appearance of the skin will occur over 6-12 months. For any scars that remain, a variety of cosmetic procedures are available including intralesional triamcinolone (see keloids), punch grafting, dermabrasion, and laser resurfacing. Polymethylmethacrylate injection (a collagen-based filler) significantly improved atrophic acne scars over placebo injection [SAN January 2015]. Fractional laser using a diffractive lens array and a picosecond 755-nm alexandrite laser improved the appearance and texture of acne scars within 3 months [JAMA Derm 2014].
Keloidal scars at the jawline.
White scars after picking.
Papular Acne Scars Indian J Dermatol 2015;60:603-5