The first thing to realize is that some conditions which look very much like scars are not in fact scars at all but are macules and other bumps which can occur following acne treatment. The redness which often accompanies macules and other bumps can last for up to a year but this is not permanent and these are not true scars.

True scars are produced by the healing process itself (often resulting from the creation of fibrous tissue) and represent a permanent change to your skin tissue. Permanent scarring often results from the action of your white blood cells as they attack the bacteria which causes acne and this 'battle' can produce permanent changes to the underlying cells of your skin.

Such damage is not however just limited to the cells below the skin surface and you can be left with such things as so-called icepick scars which are small pinholes formed in the surface of the skin. They are called icepick scars because they look as if the skin has been attacked with an icepick and they are often quite deep and thus unresponsive to such things as dermabrasion and laser resurfacing treatment.

Another common form of acne scarring are boxcar scars, which are similar to icepick scars but tend to be flatter on the bottom instead of narrowing to a point as icepick scars do. Boxcar scars are shallower than icepick scars and can be treatment using skin resurfacing techniques.

Finally, keloid scars, which tend to extend beyond the site of the original pimple injury, result from an excess production of collagen and are usually seen as a firm shiny pink or red scar.

In all cases the best way to avoid acne scars is to prevent then from developing in the first place but, where this has not proved to be effective, then there are several standard treatments including:

Dermabrasion. Dermabrasion is a form of treatment used to treat a wide range of different skin conditions, including mild (and sometimes moderate} acne scarring. After the application of a local anesthetic, a high speed brush is used to remove layers of skin. In many cases, once the skin heals naturally, acne scar disappear altogether and, where this is not the case, they are usually very much less evident.

A commonly alternative to dermabrasion today is microdermabrasion in which, instead of using a high speed brush, aluminum oxide crystals are moved rapidly across the surface of the skin using a form of vacuum hose. This is a little bit like a form of medical 'sand blasting' and is less invasive than dermabrasion and causes less trauma to the skin. Microdermabrasion can be effective in cases of very mild acne scarring but generally does not produce as good results as are seen with dermabrasion.

Laser Treatments. For some people laser treatment (often using CO2 lasers) is particularly effective and mild scarring can sometimes be removed with just a single treatment. When in the hands of a trained professional a laser can be used to remove scar tissue, or to alter the size of scars and change the contour of the skin to make scars very much less visible. This is however a fairly harsh treatment which effectively works by burning the surface of the skin and so it can produce redness which will persist for several weeks.

Surgery. Surgery, using a technique known as 'punching' is often used to remove some icepick scars. An icepick scar is cut out down to the subcutaneous fat layer and the resulting hole is then repaired either using sutures or a small skin graft. Scars can also be repaired using subcisions which involve lifting the scar tissue away from unscarred skin. This technique can be effective but at the moment results using this technique have been somewhat mixed.

Drug Treatment. Keloid scars do not respond well to any of the treatments described so far and indeed they will usually stimulate the formation of more keloids and make matters worse. In this case therefore it is common to either apply a topical retinoid cream or to inject steroid-type drugs directly into the skin around the site of the scar. Unfortunately, keloid scars are difficult to treat and results vary widely from one individual to the next.

Perhaps the most important advice which anybody can be given when it comes to treating acne scars is that you should start by getting a proper diagnosis from a professional dermatologist. Your dermatologist will not only be able to advise you about the treatments available for your particular type of scarring, but will also be able to advise you about both the benefits and risks of each type of treatment.