Tool · Acne scars

Which type of acne scar
do I have?

Medically reviewed by Dr Sin Yong · Last reviewed 20 October 2026 · 5 min read

Published 7 October 2026 · Reviewed by Dr Sin Yong

Acne scars are grouped into ice-pick, boxcar, rolling and raised scars, and flat red or brown marks are not textural scars at all. Each type is approached differently, so the first useful question is which pattern you have. Four questions below sort the common patterns; the result is a reading guide, not a diagnosis, and an in-person assessment with a stretch test and good light decides the plan.

A woman with her eyes closed against a soft pink background, illustrative image, not a patient

LookalikesFlat red or brown marks are often confused with scars: a mark has normal texture, while an ice-pick scar is a sharp narrow pit, a boxcar a flat-bottomed dent and a rolling scar a broad dip that flattens on stretch. red marks (PIE).

The four-question checker

When you stretch the skin around the scar with two fingers, what happens?

It flattens or almost disappearsIt stays as a sharp, deep pitIt stays as a flat-bottomed dent with defined edgesIt is raised above the skin, not depressed

How wide is the typical scar?

Broad and soft-edged, like a shallow dip (4 mm or more)Very narrow, like an enlarged pore or a pin-prick (under 2 mm)Medium, round or oval, 2–4 mm, with a sharp rimAny size, but firm and raised

Is there still active acne (new pimples, cysts or nodules) in the area?

Yes, new spots still appearNo, the acne has settled

What colour is the mark?

Pink or red, flatBrown, flatSkin-coloured, but the texture is uneven

“Naming the scar type is the first treatment decision; everything after it depends on getting that right.”
Dr Sin YongOn typing acne scars

Active acne first

New spots mean the skin is still being injured, and scar work on inflamed skin tends to be deferred. The first step is acne control, which is assessed separately from scarring. Once it has settled, the scar pattern can be read properly.

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Flat red marks: post-inflammatory erythema

Flat pink or red marks with normal texture are usually post-inflammatory erythema rather than true scars: dilated small vessels left after inflammation, which often fade on their own and are assessed differently from textural scars.

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Flat brown marks: post-inflammatory hyperpigmentation

Flat brown marks with normal texture are pigment, not a textural scar. They are approached as pigmentation, and the wrong laser can darken them, which is why the type is confirmed first.

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Pattern most consistent with rolling scars

Broad, soft-edged depressions that flatten when the skin is stretched are usually tethered from below by fibrous bands. This is the pattern where subcision is usually assessed first, sometimes with volume support once the tether is released.

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Pattern most consistent with ice-pick scars

Very narrow, deep pits that do not flatten on stretching are usually ice-pick scars. They are assessed for TCA CROSS, a focal chemical reconstruction applied to the scar base, rather than broad resurfacing.

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Pattern most consistent with boxcar scars

Round or oval depressions with a sharp rim and a flat base are usually boxcar scars. Shallow ones are assessed for fractional resurfacing or RF microneedling; deep ones may need edge work or punch techniques first.

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Raised scar: hypertrophic or keloid

A firm scar above the skin surface is a raised scar, not a depression. Hypertrophic scars stay within the original wound; keloids grow beyond it. They are managed differently from depressed scars, usually with injection and silicone rather than resurfacing.

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A mixed pattern

Most acne-scarred skin carries more than one scar type, and the answers here point to a mix. A mixed pattern is sequenced in stages, with each scar type addressed by the method that suits it, which is exactly what an in-person assessment maps.

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General information only. The checker reads your own description of the scar and cannot see your skin; patterns are commonly mixed, and the stretch test is easier for a doctor to read than for you in a mirror. Nothing here is a plan, a price or a promise.

Key facts

What it is: A four-question reading guide that sorts ice-pick, boxcar, rolling and raised acne scars from flat red or brown marks, so you know which page to read next.
Layer: Textural scars sit in the dermis, tethered or not; flat marks are pigment or dilated vessels at the surface with normal texture, which is why the stretch test matters.
Who suits: Anyone with settled acne trying to name their scar pattern before an assessment; active acne is controlled first, because scar work on inflamed skin is deferred.
What it is not: Not a diagnosis and not a treatment plan: depth, tethering and skin type are confirmed in person with a stretch test and good light before FSX, S3, subcision or TCA CROSS is chosen.

How the checker sorts scars

The stretch test separates tethered depressions (rolling scars, which flatten when the skin is pulled taut) from scars with their own fixed walls (ice-pick and boxcar, which do not). Width then separates narrow pits from flat-bottomed dents. Anything raised is a hypertrophic scar or keloid and is managed on different principles. Flat colour change without a texture change is post-inflammatory erythema (red) or hyperpigmentation (brown), which are pigment and vessel problems rather than scars. Active acne overrides all of it, because scar work waits for the skin to stop being injured.

The categories follow the Jacob classification of atrophic acne scars (ice-pick, boxcar, rolling), which is the grouping Dr Sin Yong uses when he maps a face before a staged 4D Scar Reconstruction plan.

Illustrative diagram.

Which method fits which acne scar type?

This table compares the five patterns the checker sorts, the feature that identifies each, what happens on the stretch test, and the method usually assessed first for that pattern. The last column matters as much as the others: each method has a job it cannot do, which is why a mixed pattern is sequenced in stages rather than treated with one tool.

Scar type	What it looks like	Stretch test	Method usually assessed first	What that method cannot do
Ice-pick	Very narrow, deep pit, like an enlarged pore; deeper than it is wide	Stays as a sharp pit	TCA CROSS applied to the scar base	Cannot lift a broad depression; broad resurfacing over an ice-pick tract tends to leave the pit
Boxcar	Round or oval dent with a sharp rim and a flat floor; shallow or deep	Stays as a flat-bottomed dent	Shallow: RF microneedling or FSX laser; deep: S3 Resurfacing Lift, sometimes edge or punch work first	Resurfacing cannot rebuild a wall that is missing; depth decides FSX against S3
Rolling	Broad, soft-edged dip tethered from below by fibrous bands	Flattens or almost disappears	Subcision to release the tether, then resurfacing; volume support where needed	Resurfacing alone cannot release a tether; the band pulls the surface back down
Raised (hypertrophic or keloid)	Firm scar above the surface; a keloid grows beyond the original wound	Not depressed; stays raised	Steroid injection and silicone; laser for redness and texture	Resurfacing and subcision are for depressions and can provoke a keloid
Flat red or brown mark	Normal texture; pink or red (post-inflammatory erythema) or brown (post-inflammatory hyperpigmentation)	No change: there is no dent to flatten	Assessed as a vessel or pigment problem, not as a scar; sun protection and topicals first	Scar methods do nothing for colour, and the wrong laser can darken a brown mark

Active acne overrides every row, because scar work on skin that is still being injured is deferred until acne treatment has settled it. The categories follow the Jacob classification cited below, and the full staged sequence by scar type is on acne scar treatment Singapore.

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<p>Which type of acne scar do I have? <a href="https://drsinyong.com/tools/acne-scar-type/">Try the scar-type checker by Dr Sin Yong, Singapore</a>.</p>

Which type of acne scardo I have?

The four-question checker

When you stretch the skin around the scar with two fingers, what happens?

How wide is the typical scar?

Is there still active acne (new pimples, cysts or nodules) in the area?

What colour is the mark?

Active acne first

Flat red marks: post-inflammatory erythema

Flat brown marks: post-inflammatory hyperpigmentation

Pattern most consistent with rolling scars

Pattern most consistent with ice-pick scars

Pattern most consistent with boxcar scars

Raised scar: hypertrophic or keloid

A mixed pattern

Key facts

How the checker sorts scars

Which method fits which acne scar type?

Link to or embed this checker

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