Acne Scars — What Causes Them and Can They Really Be Treated?

Acne scars — the depressed pits and marks left behind after inflammatory acne heals — are one of the most common and frustrating skin concerns we see at Villa Clinic. The good news: yes, they can be treated effectively. But understanding what causes them is key to choosing the right treatment.

What Causes Acne Scars?

When inflammatory acne (papules, pustules, nodules, or cysts) damages the dermis, the skin’s natural healing process kicks in. If too little collagen is produced during healing, a depressed (atrophic) scar forms. There are three main types:

• Ice pick scars — deep, narrow, V-shaped pits that extend into the dermis. The most difficult to treat.
• Boxcar scars — wide, U-shaped depressions with sharply defined edges. Respond well to resurfacing treatments.
• Rolling scars — broad depressions with sloping edges caused by fibrous bands tethering skin to deeper tissue. Subcision is often needed.

Raised (hypertrophic or keloid) scars are less common after acne on the face but may occur on the chest or back.

Can Acne Scars Really Be Treated?

Yes — but realistic expectations matter. Modern treatments can significantly reduce the appearance of acne scars, and many patients achieve dramatic improvements. Complete elimination of deep scars is rarely possible, but a 50–80% improvement is achievable with the right combination approach.

Effective Treatments at Villa Clinic

• Morpheus8 — fractional RF microneedling that remodels collagen deep in the dermis. Excellent for boxcar and rolling scars.
• eMatrix — sublative fractional RF, ideal for shallow to moderate scarring with low risk of PIH on Asian skin.
• CO2 Laser — ablative resurfacing for more significant texture irregularities; longer downtime but highly effective.
• Subcision + filler — for rolling scars with fibrous tethering, breaking the bands and restoring volume.
• ARA Peel / Chemical Peel — improves superficial scarring and post-acne pigmentation.

The best results come from a combination protocol tailored to your scar types and skin tone. Our doctors at Villa Clinic Bangkok will assess your scars and design a phased treatment plan. Book a consultation today.