Acne is a very common inflammatory skin disease that is common in teenagers but can appear at any age. It often affects the sufferer’s self-esteem. Acne scarring is a treatment that we specialise in at The Norton Clinic. Acne scars can be difficult to treat and require a multi-model approach to achieve the best cosmetic results.

Acne scars fall into the following two main categories:

  • Those caused by a loss of tissue (atrophic scars); and
  • Those caused by excess of tissue (hypertrophic scars).

Atrophic scars are the most common type of scars and can be categorised into the following groups:


Ice Pick Scars are deep, less than 2mm wide, sharply demarcated and can extend into the deep dermis.

The skin looks as if it has been pierced by an ice pick or sharp instrument.

How they develop:
Ice pick scars develop after an infection from a cyst or other deep inflamed blemish works its way to the surface. Skin tissue is destroyed leaving a long, column like scar.


Boxcar scars are round or oval depressions with steep vertical sides. They are wider than ice pick scars and give the skin an uneven, pitted appearance.

How they develop:

When an inflammatory breakout destroys collagen, the tissue is lost. The skin over the area is left without support, creating a depressed area. Boxcar scars can be superficial to severe, depending on the amount of tissue lost.


This type of scarring causes rolling or wave like depressions across otherwise normal-looking skin. Rolling scars differ from Boxcar scars in that they are not clearly defined. The skin itself looks uneven and craggy.

How they develop:
Rolling scars arise when fibrous bands of tissue develop between the skin and the subcutaneous tissue below. The bands pull the epidermis, binding it to deeper structures of the skin. It is the pulling of the epidermis from within that creates the rolling appearance of the skin.


Hypertrophic scars are raised, firm scars that grow above the surface of the skin. Hypertrophic scars are caused by acne are most often found on the torso, especially in men, but they can happen anywhere on the body.

Keloids are more severe type of raised scars. They differ from Hypertrophic scars in that keloids grow larger than the original wound.

How they develop:
They develop because of an over production of collagen. In the case of keloids, it’s like the skin does not know that the wound has healed and continues to produce collagen.


Discolouration left on the skin after a pimple has healed isn’t a true acne scar, but rather post inflammatory hyperpigmentation is a flat area (neither raised nor pitted) that ranges in colour from pink to red, purple, brown or black depending on one’s skin type.

How it develops:
Post inflammatory hyperpigmentation develops when a wound, rash, pimple or other trauma causes skin inflammation. As the skin heals it produces too much melanin, leaving a darker area.


The appearance of both atropic and hypertrophic scars, are often highlighted by either erythema and/or hyperpigmentation. This aspect of acne scarring show should be managed early for the best results.

Please call (02) 8507 0896 or book online to organise a one on one complimentary consultation.


Treatment of individual scars may involve:

  • Subcision
  • Excision
  • Punch Graft
  • TCA Cross
    The chemical reconstruction of skin scars using a high concentration (70-100%) trichoracetic acid.
  • Platelet Rich Plasma Therapy (PRP)
    Platelet rich plasma is inherently rich with cytokines and growth factors, which work together to regenerate and stimulate the production of new collagen and elastin.
  • Chemical peels
    Superficial epidermal peels containing SCA/Glycolic lacti.c
  • Medium Depth Peels Jessner (10-25%)
  • TCA to the level of Papillary Dermis
  • Microdermabrasion
    A treatment that gently abrades the upper superficial layer of skin using a micro diamond needle to give immediate visible results.
  • Dermapen 4 Micro needling
    The most advanced needle cartridge innovation to vertically pierce the skin – DERMAPEN 4.
  • LED light therapy
    We combine all treatments with LED phototherapy to send light into deeper layers of the skin, to activate and stimulate cellular activity.
  • LASER – Pico Discovery Plus Laser, which is non-ablative fractional and pigment laser.
  • Vascular Laser – 585 Dye Laser – considered the gold standard for vascular treatments.

Please call (02) 8507 0896 or book online to organise a one on one complimentary consultation.

The Norton Clinic
64 Norton Street, Leichhardt
Phone: 02 8507 0896