The Big Squeeze on Pimples: Get the Facts on Acne Scarring

(edited from the article “A Discussion About Acne Scars“)

We all aspire to have a smooth, clear complexion. When pimples arise, the urge to get rid of them by popping or squeezing can be irresistible. Unfortunately, this “quick fix” can lead to short and long-term skin problems such as persistent redness, hyperpigmentation (brown spots) and scarring.

Acne scars typically occur in cases of inflammatory acne. When pimples become irritated and inflamed, this causes damage to the deeper layers of skin. As the skin tries to heal itself, too much or too little collagen is created in a spot, which results in an uneven texture of the skin.

Squeezing or popping pimples only further irritates the skin and increases inflammation, which greatly increases the risk of developing permanent scars.

Types of Acne Scars

There are a number of types of scars caused by acne:

Ice pick scars:
These are the most common and classic forms of acne scarring. They typically appear as deep pits or indentations on the surface of the skin of 1-2 mm in diameter. The scars are very narrow and look like small holes or large open pores in the skin. They commonly appear on the cheeks.

Boxcar scars:
They typically appear as angular scars that are sunken, with well-defined edges. They usually occur on the temples and cheeks. Boxcar scars may be either superficial or deep and measure more than 3 mm in diameter.

Rolling scars:
These scars generally have a wide and shallow depth and occur when bands of tissue are formed between the skin’s surface and the deeper structures underneath. The bands of tissue pull at the top layer of skin, causing the surface of the skin to have a rolling and “wave-like” appearance.

Hypertrophic/keloid scars:
These are raised, smooth scars often seen along the jaw line or upper chest and back.


Keeping the skin clean and clear is helpful for preventing acne breakouts.

Consider a regimen that includes skin care products containing salicylic acid to help promote skin cell shedding and unclog pores, or a glucosamine complex to even out and brighten your skin tone. After cleansing, use an oil-free moisturizer to keep the skin adequately hydrated.

Another way to prevent acne is to use cosmetics specially designed for acne-prone skin that are either oil-free or non-comedogenic. Make sure your skincare products don’t contain isopropyl myristate, isopropyl esters, oleic acid, stearic acid, petrolatum and lanolin (especially acetylated lanolin, alcohols and lanolin fatty acids).

For severe or persistent cases of acne, the best course of action is to consult with a dermatologist to determine the right solution for your specific skin needs.

If you are currently experiencing an acne outbreak, the most effective way to prevent acne scars is to not irritate the skin.

  • Do not pick at or attempt to pop whiteheads, blackheads or pimples
  • Avoid astringents (containing alcohol) that may dry out and irritate the skin
  • Let scabs run their course – do not try to peel them. Let them fall off naturally
  • Use a non-greasy sunscreen when outdoors for extended periods of time

Non-Surgical Treatment Options For Acne Scars

If you already have acne scars, there are a number of treatment options out there that can help reduce the appearance of scars.

Skin Camouflage/Cover-up:
For individuals with active acne, skin discoloration and scars – an effective camouflage foundation can improve the appearance of the skin rapidly. Make sure to choose products that are labeled “non-comedogenic” or “non-acnegenic” and have your tones matched by a skin-care expert to achieve that matte, flawless appearance.

Topical Creams: (Tretinoin):

These medicated creams can improve acne symptoms, reduce hyperpigmentation and improve fine scars by causing gentle exfoliation and by encouraging collagen production.

Chemical Peels (AHA peels):
They are an effective solution for minor, superficial scarring. They can improve overall skin tone and luster; they tend to work best if you get a series of at least six peels, having one every 1-2 weeks.

Skin Fillers/injectables:
These are materials that are injected into the depressed area of the scar to elevate it to the level of the normal surrounding skin. This treatment is best for scars with smooth shoulders such as thumbprint or rolling scars. Common temporary and permanent fillers are: Artecoll®, Zyplast®, Restylane®, and HylaForm®.

Surgical Treatment Options For Acne Scars

Resurfacing treatments can be performed through laser therapy or microdermabrasion.

Laser resurfacing involves removing the surface layer of the skin via heat injury. The healing process stimulates the production of collagen and removes some of the damaged/scarred outer skin tissue.

Non-ablatative therapies using for example, pulsed dye lasers, can also help fill in some shallow depressed scars.

In most cases, punch grafting or punch elevation is also used for improved results. Punch elevation involves lifting the tissue instead of removing the scar. The tissue initially sits slightly higher than the surrounding skin, but retracts as it heals to become level with the remaining skin.

It’s best to remember that the best way to avoid acne scars is by taking good care of your skin and resisting the urge to pop at or pick your pimples. This simple advice can literally save your skin.