First: is it a scar or a mark?
Many people call any mark left after a pimple a scar. The difference matters, because the treatment is different.
| What you see | What it is | Usual treatment |
|---|---|---|
| Flat brown or dark spots | Post-inflammatory pigmentation, not a true scar | Sun protection, creams, peels; fades over months |
| Flat red or pink spots | Healing redness | Time, sun protection |
| Pits or depressions | True atrophic scars | Procedures below |
| Raised, firm bumps on the jaw, chest or back | Hypertrophic scars or keloids | Steroid injections, silicone; see keloid treatment |
The rest of this article is about the pitted (atrophic) scars.
The three main acne scar types
- Ice pick: narrow, deep holes, like a needle prick. Common on the cheeks.
- Boxcar: round or oval pits with sharp edges, shallow or deep.
- Rolling: wide, soft dips with sloping edges that make the skin look wavy. They are tethered to deeper tissue by fibrous bands.
Most faces have a mix. The plan is drawn up scar type by scar type.
Treatments compared
| Treatment | Best for | Sessions | Downtime |
|---|---|---|---|
| Subcision | Rolling scars | 1–3 | 3–7 days of bruising |
| Microneedling (with or without PRP) | Shallow boxcar and rolling scars, texture | 3–6, a month apart | 1–3 days of redness |
| Fractional laser | Boxcar scars, texture | 3–5 | 3–7 days |
| Focal TCA peel (TCA CROSS) | Ice pick and narrow boxcar scars | 2–4 | About a week of scabs |
| Punch excision | Deep ice pick scars | 1 | Stitches for 5–7 days |
| Fillers | Rolling scars, volume loss | 1, repeated yearly or so | 1–2 days |
| Fat grafting | Wide depressed areas | 1–2 | 1–2 weeks of swelling |
Subcision
A fine needle is passed under the scar to cut the fibrous bands that pull it down, so the skin rises. It is done under local anaesthesia. Bruising for a few days is normal. It is often the first step for rolling scars, followed by microneedling.
Microneedling and PRP
A device makes many tiny punctures that trigger new collagen. Adding PRP, prepared from your own blood, may improve the result and speed recovery a little. Studies support the combination for mild to moderate scars. It is relatively safe on Indian skin types.
Fractional laser
Laser columns resurface the skin in small zones. It is effective for boxcar scars and texture. On brown skin the settings have to be conservative, because aggressive laser can leave dark patches (post-inflammatory hyperpigmentation). Strict sun protection before and after is essential.
Focal peels and punch excision
Deep ice pick scars rarely respond to needling or laser alone. A strong acid applied only inside each scar (TCA CROSS) builds the floor up over a few sessions. A very deep scar can be removed with a tiny round punch and closed with a stitch, leaving a fine line instead of a pit. Punch excision is a surgical skill, the same one used in scar revision.
Fillers and fat
Hyaluronic acid fillers lift soft rolling scars at once, and the effect lasts about a year. Where there is wider volume loss, your own fat can be grafted under the scars for a longer-lasting fill.
A typical combined plan
- Control active acne first, usually with a dermatologist. Treating scars while new pimples keep forming wastes money.
- Subcision for rolling scars, and TCA CROSS or punch excision for deep ice pick scars.
- A course of microneedling, with or without PRP, or fractional laser, a month apart.
- Fillers at the end for any area still sunken.
- Daily sunscreen throughout.
Who should wait
- Active acne or a skin infection
- Isotretinoin in the past year (discuss timing; see FAQs)
- A tendency to keloids, which changes the plan
- Pregnancy, for some treatments
- Unrealistic expectations of perfectly smooth skin
Cost in Ranchi
Cost depends on the scar types and number of sessions. On Dr. Vikrant Ranjan's price list, PRP starts at ₹4,000 per session, fillers at ₹18,000 per syringe and surgical scar revision at ₹25,000. A written plan with the total for your scars is given at the consultation. For other scar types, read scar revision: what can and can't be improved. Call 090656 39577 to book.
Common questions
Can acne scars be removed completely?
No treatment removes acne scars completely. Combined treatment usually makes scars clearly shallower and less visible in normal light. How much they improve depends on the scar type, depth and your skin.
How many sessions do acne scars need?
Most people need 3–6 sessions of microneedling or similar treatment, 4–6 weeks apart, often with one subcision session. Results build up over 3–6 months after the last session, as new collagen forms.
Should I wait after isotretinoin before acne scar treatment?
Tell the doctor if you have taken isotretinoin in the last year. The traditional advice was to wait 6–12 months before procedures. Newer studies suggest some gentle procedures may be safe sooner, but the decision depends on the treatment and is made at the consultation.
Do creams remove acne scars?
Creams can fade dark marks left after pimples and improve skin texture slightly, but they do not lift pitted or depressed scars. Those need procedures that release the scar or build new collagen.
Last reviewed: 2026-10-11
This page is general information, not a diagnosis or a treatment plan. Results and recovery differ between patients. Prices are starting prices and are confirmed after examination.