Understanding Acne Scars: Not All Scars Are the Same
One of the most important things to understand before beginning acne scar treatment is that "acne scars" is not a single condition — it is a category that encompasses several distinct scar morphologies, each requiring a different approach. Treating ice pick scars the same way you treat rolling scars is one of the most common mistakes in DIY skincare and even in under-equipped clinics.
At House of Aesthetics, every acne scar patient begins with a detailed clinical assessment under our MBBS doctors — because the right treatment depends entirely on what type of scarring you have.
Types of Acne Scars
- Ice Pick Scars: Deep, narrow, V-shaped pits that extend far into the dermis. They look like small holes in the skin — think tiny puncture marks. These are the hardest to treat because they are narrow and deep.
- Boxcar Scars: Wider, U-shaped depressions with sharp vertical edges, typically on the cheeks and temples. They are shallower than ice pick scars and respond well to resurfacing treatments.
- Rolling Scars: Broad, wave-like depressions caused by tethering of the skin to underlying tissue. They give skin a rolling, uneven texture. Subcision (breaking the tethering) is often part of the treatment.
- Hypertrophic and Keloid Scars: Raised scars where excess collagen was produced during healing. More common on the chest and back. Treated very differently from atrophic (depressed) scars.
- Post-Inflammatory Hyperpigmentation (PIH): Technically not a true scar but dark marks left after acne heals. Common in South Asian skin tones and responds well to chemical peels, vitamin C, and sun protection.
The Best Treatment Options Available in Lahore
1. Fractional Laser Resurfacing
Fractional CO2 or Er:YAG laser creates thousands of microscopic treatment zones in the skin, stimulating collagen remodelling and gradually plumping depressed scars from within. This is one of the most effective treatments for boxcar and rolling scars.
Results: 30–70% improvement per course. Typically 3–5 sessions, 4–6 weeks apart. Downtime: 3–5 days of redness and mild swelling. See our skin rejuvenation page for more information.
2. Microneedling (Collagen Induction Therapy)
Fine needles create controlled micro-injuries in the skin, triggering the body's natural wound-healing cascade and stimulating new collagen production. Effective for rolling and shallow boxcar scars. Less downtime than laser (mild redness for 24–48 hours).
Results: Best seen after 4–6 sessions monthly. Works well in combination with PRP for enhanced results.
3. PRP (Platelet-Rich Plasma) Therapy
PRP involves drawing a small amount of your own blood, centrifuging it to concentrate the growth factors, and either injecting it into scars or applying it topically immediately after microneedling. The growth factors in PRP accelerate collagen remodelling and tissue regeneration.
At House of Aesthetics, we combine microneedling with PRP for acne scar patients — this "vampire facial" approach delivers significantly better results than microneedling alone, with no risk of allergic reaction since it uses your own blood.
4. Chemical Peels
Medical-grade peels (TCA, glycolic acid, salicylic acid) remove the damaged outer layers of skin, accelerate cell turnover, and stimulate collagen. Particularly effective for PIH, surface texture, and shallow boxcar scars.
Light peels: no downtime, monthly sessions. Medium-depth peels (TCA 20–30%): 3–5 days of peeling, every 6–8 weeks. Our chemical peels treatment is performed by doctors, not beauticians — an important distinction for safety on South Asian skin.
5. Subcision
A minimally invasive procedure where a fine needle is inserted under rolling scars to break the fibrous tethers pulling the skin down. Immediately releases the depression. Often combined with filler or PRP injected at the same time to fill the space. Highly effective for rolling scars that have not responded to surface treatments.
Why a Combination Approach Works Best
No single treatment addresses all scar types simultaneously. The most effective acne scar treatment protocols combine 2–3 modalities based on your scar composition. A common protocol at HOA:
- Months 1–2: Chemical peels to address PIH and prepare skin
- Months 3–5: Microneedling + PRP sessions monthly
- Month 6: Fractional laser resurfacing for residual deeper scars
- Ongoing: Monthly HydraFacial maintenance + medical-grade SPF
HOA's Approach: MBBS Doctor Assessment First
At House of Aesthetics, we do not offer "acne scar packages" without first seeing your skin. Why? Because selling a 6-session laser package to someone with primarily PIH (which doesn't need laser) is both ineffective and unnecessarily expensive. Our MBBS doctors assess each patient and design a treatment sequence that addresses your actual scar types — nothing more, nothing less.
Timeline and Realistic Expectations
Acne scar treatment is a process of months, not weeks. Here is what a realistic timeline looks like:
- 4 weeks: Skin texture begins to smooth. PIH starts to fade.
- 3 months: Visible improvement in scar depth. Collagen remodelling is underway.
- 6 months: 40–70% improvement in most scar types with a consistent protocol.
- 12 months: Maximum results achieved. Maintenance sessions every 3–6 months to preserve results.
We document your progress with standardised photography — same lighting, same angle — at every visit, so you can see exactly how your skin is responding. Results are real and measurable, not just perceived improvement.
Ready to understand which treatments are right for your scars? Book a free consultation with our MBBS team, or explore our treatment pricing to understand the cost of different protocols. You can also see real-world results in our before and after gallery.