A clinician-reviewed guide to understanding acne scar types, evidence-based removal options, and what to realistically expect from treatment in Gurgaon.
By the Profrea Editorial Team · Published July 2026
You cleared the breakout — but the skin still tells the story. Acne scars form when inflammation from a pimple damages the dermis, the deeper layer of skin responsible for collagen structure. Depending on how your skin heals, you may end up with depressed (atrophic) scars, raised (hypertrophic) scars, or flat dark patches that many people mistake for scars. Understanding which type you have is the single most important step before choosing any treatment.
According to a 2017 review published on PubMed Central, acne scarring affects up to 95% of people with acne vulgaris at some point in their lives, making it one of the most common dermatological concerns worldwide. Yet many patients spend years on over-the-counter creams that simply cannot reach the dermal layer where the real damage lies.
This is one of the most common points of confusion — and it matters enormously for treatment planning.
Acne marks (post-inflammatory hyperpigmentation or PIH) are flat, discoloured patches — red, pink, or brown — left after a pimple heals. They are not true scars. The skin texture is normal; only the pigment is uneven. These often fade on their own within 3–12 months, and topical agents like niacinamide, vitamin C serums, and azelaic acid can accelerate the process significantly.
Acne scars, by contrast, involve a physical change in skin texture — either a loss of tissue (atrophic scars such as ice-pick, boxcar, and rolling scars) or an excess of tissue (hypertrophic or keloid scars). These do not resolve on their own and require procedural intervention to achieve meaningful improvement.
If you are unsure which category your skin falls into, a consultation with a qualified plastic surgeon or dermatologist — such as Dr. Shikha Bansal at Profrea Gurugram, who holds an MCh in Plastic Surgery from SMS Medical College, Jaipur — is the most reliable starting point.
Common acne scar types and their dermal depth — a key factor in choosing the right treatment.
Ice-pick scars are narrow, deep, V-shaped pits that extend into the dermis. They are the hardest to treat because their depth makes surface-level resurfacing insufficient on its own.
Boxcar scars are wider, U-shaped depressions with defined edges. They respond well to fractional laser resurfacing and subcision.
Rolling scars create a wave-like, undulating texture caused by fibrous bands tethering the skin to deeper tissue. Subcision combined with dermal fillers or microneedling is particularly effective here.
Hypertrophic and keloid scars are raised, firm, and often itchy. They are more common on the chest, back, and jawline. Treatment typically involves intralesional corticosteroid injections, silicone sheets, or laser therapy.
There is no single "best" treatment — the right choice depends on your scar type, skin tone, downtime tolerance, and budget. Here is a breakdown of the most evidence-supported options available today.
Fractional CO₂ and Erbium lasers create thousands of microscopic treatment zones in the skin, stimulating collagen remodelling without ablating the entire surface. This makes them significantly safer for Indian skin tones than older ablative lasers, which carried a high risk of post-inflammatory hyperpigmentation. Most patients see 40–70% improvement in scar depth after a course of 3–5 sessions. Laser treatment for acne scars is widely considered the gold standard for moderate-to-severe atrophic scarring.
A device with fine needles creates controlled micro-injuries that trigger the skin's natural healing response, producing new collagen and elastin. Radiofrequency microneedling (RF microneedling) adds thermal energy to deepen the collagen stimulus, making it particularly effective for rolling and boxcar scars. It carries a lower risk of post-inflammatory hyperpigmentation than laser, making it a preferred first-line option for darker skin types (Fitzpatrick IV–VI). Typically 4–6 sessions spaced 4 weeks apart are recommended.
Medium-depth peels using trichloroacetic acid (TCA) or glycolic acid accelerate skin cell turnover, improving surface texture and reducing post-inflammatory hyperpigmentation. They are most effective for shallow scars and pigmentation rather than deep ice-pick or boxcar scars. TCA CROSS (chemical reconstruction of skin scars) — where high-concentration TCA is applied focally to individual ice-pick scars — is a highly targeted technique that can produce significant improvement in this notoriously difficult scar type.
A minor in-clinic procedure in which a fine needle is inserted under the scar to release the fibrous bands tethering it to deeper tissue. This is especially effective for rolling scars. Subcision is often combined with dermal fillers or PRP (platelet-rich plasma) to maintain the lift and support new collagen formation. Profrea's clinics offer day-care and minor surgery facilities across Gurugram, making procedures like subcision accessible without a hospital stay.
Hyaluronic acid or poly-L-lactic acid fillers can be injected directly beneath depressed scars to elevate them to the level of surrounding skin. Results are immediate but temporary (6–18 months depending on the filler used). Fillers are best used as an adjunct to laser or microneedling rather than a standalone solution.
PRP uses growth factors derived from your own blood to accelerate tissue repair and collagen synthesis. When combined with microneedling or laser, it can enhance results and reduce recovery time. It is a natural, low-risk adjunct that suits patients who prefer autologous (self-derived) treatments.
For very deep ice-pick scars, punch excision — where the scar is surgically removed and the wound closed with a fine suture — can convert a deep pit into a flat, barely visible line that subsequently responds well to laser resurfacing. These are minor surgical procedures best performed by a qualified plastic surgeon. Dr. Shikha Bansal, with 9+ years of experience and an MCh in Plastic Surgery, is well-positioned to assess whether surgical scar revision is appropriate for your case.
This is the question every patient asks — and the honest answer is: significant, long-lasting improvement is achievable, but the word "permanent" needs careful framing. Most procedural treatments can reduce scar visibility by 50–80%, and in many cases scars become virtually undetectable to the casual observer. However, the underlying skin structure has been permanently altered, and no treatment fully restores the dermis to its pre-acne state.
What is permanent is the collagen remodelling triggered by laser and microneedling — once new collagen is laid down, it does not disappear. The key is completing the recommended course of sessions and maintaining results with a good skincare routine and sun protection. Uncontrolled active acne can create new scars, so managing the underlying acne is equally important.
Session counts vary by treatment type and scar severity:
Fractional laser: 3–5 sessions, spaced 4–6 weeks apart
RF microneedling: 4–6 sessions, spaced 3–4 weeks apart
Chemical peels: 4–8 sessions, spaced 2–4 weeks apart (depending on depth)
TCA CROSS: 3–6 sessions, spaced 4–6 weeks apart
Subcision: 1–3 sessions, often combined with other modalities
PRP: 3–4 sessions as an adjunct, spaced 3–4 weeks apart
Visible improvement typically begins after the second or third session, with the full result apparent 3–6 months after the final session as collagen continues to mature. Patience is genuinely part of the treatment.
If speed is the priority, a combination approach — for example, subcision followed by fractional laser plus PRP — typically delivers the most dramatic improvement in the shortest timeframe. Ablative fractional CO₂ laser offers the most aggressive single-session collagen stimulus, with results visible in 4–6 weeks, though it requires 5–7 days of downtime.
For patients who cannot afford downtime, non-ablative fractional laser or RF microneedling with minimal recovery time is the next fastest option, though more sessions are required. A personalised assessment is essential — what is "fastest" for one scar type may be ineffective or even harmful for another.
Profrea's network of 7 clinic locations across Gurugram — including Sector 45, South City-I, and Sector 52 — means you can access a consultation and begin treatment without long waiting times. Video consultations are also available for an initial assessment before your in-clinic visit.
Indian skin (typically Fitzpatrick types III–V) is more prone to post-inflammatory hyperpigmentation (PIH) — meaning that aggressive treatments can temporarily darken the skin before it improves. This makes the choice of treatment modality and settings critically important.
Key principles for darker skin tones include: using non-ablative or fractional (rather than fully ablative) lasers; pre-treating with depigmenting agents for 4–6 weeks before laser; avoiding treatment during summer months when UV exposure is high; and always applying broad-spectrum SPF 50 sunscreen daily throughout the treatment course.
This is precisely why seeking acne scar removal in Gurgaon from a clinician experienced with South Asian skin — rather than relying on generic protocols — makes a meaningful difference to your outcome. Dr. Shikha Bansal's plastic surgery expertise at Profrea includes scar assessment and revision tailored to the specific needs of Indian patients.
A well-structured scar treatment plan typically follows these stages:
Diagnosis and scar mapping: A clinician photographs and classifies your scars by type and severity. This determines the treatment hierarchy.
Active acne control: No scar treatment is effective if new breakouts are continuously creating fresh damage. Acne must be well-controlled before or alongside scar treatment.
Skin preparation: A 4–6 week pre-treatment phase using retinoids, vitamin C, and sunscreen primes the skin and reduces PIH risk.
Procedural treatment course: Sessions are scheduled based on the chosen modality, with intervals allowing adequate healing.
Maintenance: Post-treatment skincare, sun protection, and periodic maintenance sessions preserve and extend results.
If you are also managing a chronic skin or metabolic condition alongside acne — for example, hormonal acne linked to insulin resistance — a multidisciplinary approach can be valuable. Profrea's integrated model means you can access Dr. Ladli Chatterjee, General Physician and Diabetologist, alongside aesthetic specialists, under one network.
While in-clinic procedures are the only way to address true structural scars, a consistent at-home routine can meaningfully improve post-inflammatory marks and support procedural results:
Retinoids (tretinoin 0.025–0.05%): Stimulate collagen synthesis and accelerate cell turnover. Prescription-strength tretinoin is significantly more effective than over-the-counter retinol.
Vitamin C serum (L-ascorbic acid 10–20%): Antioxidant that inhibits melanin production and supports collagen synthesis. Best applied in the morning.
Niacinamide (5–10%): Reduces PIH, strengthens the skin barrier, and has anti-inflammatory properties. Well-tolerated by most skin types.
Azelaic acid (10–20%): Particularly effective for PIH and redness; also has mild comedolytic properties to prevent new breakouts.
Broad-spectrum SPF 50 sunscreen: Non-negotiable. UV exposure darkens PIH and counteracts every other treatment you are doing.
What does not work: vitamin E oil (evidence is weak and it can cause contact dermatitis in some people), lemon juice (can cause chemical burns and worsen PIH), and most "scar creams" sold over the counter, which lack the concentration or penetration depth to affect true dermal scars.
Significant and long-lasting improvement — often 50–80% reduction in visibility — is achievable with the right combination of treatments. The collagen remodelling triggered by laser and microneedling is permanent, but the skin cannot be fully restored to its pre-acne state. Completing the full recommended course of sessions and maintaining results with good skincare gives the best long-term outcome.
A combination approach — such as subcision followed by fractional CO₂ laser with PRP — typically delivers the most dramatic improvement in the shortest timeframe. Ablative fractional laser offers the most aggressive single-session collagen stimulus, with visible results in 4–6 weeks, though it requires several days of downtime. The "fastest" option for your skin depends on your scar type and skin tone, which is why a personalised assessment is essential.
Yes — fractional laser resurfacing is widely considered the gold standard for moderate-to-severe atrophic acne scars. It stimulates collagen remodelling deep in the dermis, where topical products cannot reach. For Indian skin tones, non-ablative or fractional (rather than fully ablative) laser settings are preferred to minimise the risk of post-inflammatory hyperpigmentation. Results improve progressively over 3–6 months after each session.
It depends on the treatment and scar severity. Fractional laser typically requires 3–5 sessions; RF microneedling, 4–6 sessions; chemical peels, 4–8 sessions. Most patients notice visible improvement after the second or third session, with the full result apparent 3–6 months after completing the course as new collagen matures.
Acne marks (post-inflammatory hyperpigmentation) are flat, discoloured patches with normal skin texture. They often fade on their own over months and respond well to topical agents like vitamin C and niacinamide. Acne scars involve a physical change in skin texture — either depressed pits (atrophic) or raised tissue (hypertrophic) — and require procedural treatment to improve. A clinician can distinguish between the two during a skin assessment.
If you are dealing with persistent acne scars and want a personalised assessment from a qualified specialist, Profrea's multi-specialty clinics across Gurugram offer in-clinic and video consultations. You can also explore Dr. Soma Kumari's profile for hormonal acne concerns, or book a Profrea Health Screen to get a comprehensive baseline before beginning aesthetic treatment. For a detailed scar assessment and treatment plan, book a consultation with Dr. Shikha Bansal — Profrea's MCh-qualified Plastic Surgeon with 9+ years of experience in scar reduction and aesthetic surgery in Gurugram.
