Acne scars are classified by size, shape and appearance they are identified as Icepick, Box car and Rolling. They are also tagged as early or permanent on the basis of their duration. Early scars respond well to topical medications. Permanent scars require surgical intervention. Presently, scars are treated with combinations of topical skin care medications in tandem with carefully selected surgical and skin resurfacing procedures.

At least a half dozen surgical procedures are also performed to repair acne scars. Each has benefits and pitfalls and a surgeon will closely examine the patient's age, sex, medical history, skin type and type of scarring before agreeing to perform surgery. Cost is also discussed, as it can be quite expensive.

When dermal fillers are used, a surgeon will inject fillers such as collagen and hyaluronic acid derivatives into the skin. This raises the base of the scar to the level of normal skin. The "punch excision" procedure is used in icepick and boxcar type scars and relies on making incisions in the skin with a punch biopsy tool and stitching the skin edges together. The new scar heals, leaving a clear skin. Punch excision with skin graft replacement is a variant of the punch excision method. Instead of suturing the skin after excision, surgeons use a skin graft to repair the scar.

Punch elevation is used on deep boxcar scars that have sharp edges and normal appearing bases. Here the base of the scar is excised and elevated to the surface of the skin. Sutures and glue are used to join the edges together. Subcutaneous Incision is used for treating rolling scars and centers on the use of a special beveled needle that is inserted under the skin and used to cut the binding tissue in the scar. The resulting bruises fade after about 1 week. Laser resurfacing is used to burn the top layer of the skin and reduce it to the same level as the base of the scars.