Acne/Acne Scarring

If you have acne, it might feel like you’ve been searching for the cure forever. Acne is the most common skin condition in the U.S., affecting up to 50 million people. Despite often being associated with adolescence, it can persist well into adulthood. Beyond the discomfort and self-esteem issues it can bring, acne can also give us stubborn scars that are difficult to treat. At Ava MD, we understand the profound impact that acne can have on your life, especially when you have lasting reminders in the form of scars.

What is Acne and Acne Scarring?

Acne is a common skin condition that occurs when hair follicles become clogged with oil and dead skin cells. This can lead to the formation of pimples, blackheads, and whiteheads—and in more severe cases, cysts or nodules.

Acne scarring, on the other hand, is caused by severe acne left in the skin after the lesions have healed. This leaves the skin uneven and pitted.. The severity and type of scarring varies greatly from person to person.

Types of Acne and Acne Scarring

Acne typically affects the areas where there is a higher concentration of oil glands, most notably the face, neck, back, and shoulders.. These include hormonal changes, genetics, diet, and skincare habits.

Types of Acne

Acne is a common skin condition that occurs when hair follicles under the skin become clogged. Sebum—oil that helps keep skin from drying out—and dead skin cells clog the pores, which leads to outbreaks of lesions, commonly called pimples or zits.

  • Acne Keloidalis Nuchae (AKN): Acne Keloidalis Nuchae (AKN), also known as folliculitis keloidalis or dermatitis papillaris capillitii, is a chronic skin condition characterized by the formation of firm, raised bumps or keloids on the back of the neck and lower scalp. This condition primarily affects individuals with curly or coarse hair, and it can cause discomfort, itching, and cosmetic concerns due to the appearance of keloid scars in the affected area.
    • Causes and Triggers: AKN is thought to develop due to chronic irritation or inflammation of hair follicles, leading to the formation of papules, pustules, and eventually keloid scars. Common triggers include friction from clothing or tight hairstyles, ingrown hairs, and bacterial infections of hair follicles.
    • Treatment Options: Treatment for AKN may include topical antibacterial or corticosteroid creams, oral antibiotics, intralesional corticosteroid injections, laser therapy, or careful surgical excision of keloid scars. Proper skincare practices, avoidance of irritants, and regular follow-ups with a skincare professional are essential for managing AKN effectively.
  • Cystic Acne: Cystic acne is a severe form of acne characterized by deep, painful cysts or nodules beneath the skin’s surface. These large, inflamed lesions are typically filled with pus and can cause significant discomfort, scarring, and emotional distress. Cystic acne often occurs in areas with a high concentration of oil glands, such as the face, chest, and back.
    • Causes and Triggers: Cystic acne is primarily caused by excess oil production, clogged hair follicles, and bacterial overgrowth on the skin. Hormonal fluctuations, genetic predisposition, dietary factors, and certain medications may also contribute to the development of cystic acne.
    • Treatment Options: Treatment for cystic acne may include retinoids, benzoyl peroxide, and salicylic acid, oral antibiotics, hormonal therapies (such as birth control or spironolactone), isotretinoin (Accutane), intralesional corticosteroid injections, and procedural interventions like drainage or extraction of cysts.
  • Hormonal Acne: Hormonal acne is a common type of acne influenced by hormonal fluctuations, particularly during puberty, menstruation, pregnancy, menopause, or hormonal imbalances. Hormonal changes can stimulate the production of sebum (skin oil) and promote the growth of acne-causing bacteria, leading to the development of breakouts, blackheads, and inflammatory lesions.
    • Causes and Triggers: Hormonal acne is triggered by fluctuations in androgen hormones, such as testosterone, which can increase sebum production and stimulate the proliferation of skin cells within hair follicles. Factors like stress, diet, genetics, and certain medications may also contribute to hormonal imbalances and acne development.
    • Treatment Options: Treatment for hormonal acne may include topical retinoids, benzoyl peroxide, salicylic acid, oral contraceptives (birth control pills), anti-androgen medications (such as spironolactone), hormonal replacement therapy (HRT), dietary modifications, stress management techniques, and lifestyle changes.
  • Pregnancy Acne: Pregnancy acne refers to the development of acne breakouts during pregnancy, which can occur due to hormonal changes, increased oil production, and heightened sensitivity of the skin. Pregnancy acne typically presents as comedones (blackheads and whiteheads), inflammatory papules, and pustules, primarily affecting the face, chest, and back.
    • Causes and Triggers: Pregnancy acne is primarily driven by hormonal fluctuations, particularly elevated levels of androgen hormones like testosterone, progesterone, and estrogen during pregnancy. These hormonal changes can stimulate the sebaceous glands to produce more oil, leading to clogged pores and acne formation.
    • Treatment Options: Treatment for pregnancy acne focuses on gentle skincare practices and the use of pregnancy-safe topical treatments, such as benzoyl peroxide, glycolic acid, azelaic acid, and topical antibiotics. Oral medications like isotretinoin and hormonal therapies are generally avoided during pregnancy due to potential risks to the developing fetus. Lifestyle modifications, dietary adjustments, and stress management techniques may also help manage pregnancy acne effectively.

At Ava MD, our experienced providers specialize in diagnosing and treating complex skin conditions like acne. We use effective treatment protocols tailored to your unique needs that combine medical expertise with advanced therapies to manage and improve your acne.

Types of Acne Scarring

Because there are many types of acne, each characterized by the appearance of the acne lesions, there are just as many types of scarring.

  • Atrophic Scars: Atrophic scars are depressions or pits in the skin and are the most common type of acne scars. They can be further categorized into:
    • Icepick Scars: Narrow, deep, V-shaped scars that resemble small ice pick holes.
    • Boxcar Scars: Broad, shallow depressions with well-defined edges, often resembling a box-like shape.
  • Rolling Scars: Wavy or undulating depressions that give the skin a rolling, uneven appearance.
  • Hypertrophic Scars: Hypertrophic scars are raised and can be red or pink. They form when there is an overproduction of collagen during the healing process. Keloid scars are a severe form of hypertrophic scarring, extending beyond the boundaries of the original acne lesion.
  • Post-Inflammatory Hyperpigmentation (PIH): Although not true scars, PIH results from an overproduction of melanin in response to inflammation. It appears as dark patches or discoloration on the skin and can persist long after the acne has healed.

Treatments for Acne and Acne Scarring

Safe and effective treatments for acne and acne scarring include topical medications, oral medications, chemical peels, microdermabrasion, dermal fillers, and laser therapy. Our acne treatments include:

Dynamis Pro: Acne

The Dynamis Pro is an Er: YAG laser with a multitude of treatment capabilities. Patients of various age groups and skin types are taking advantage of this incredible system to fight their acne. This treatment has the power to provide the desired results, while simultaneously maintaining a gentle approach for the most delicate of skin.


PDT (Photodynamic Therapy) has a proven ability to kill microbial cells, including bacteria, fungi, and viruses. PDT is popularly used in treating acne. It also is used clinically to treat malignant cancers.


Intracel is a Radio Frequency Microneedling used to treat acne scarring. With ultra-thin needles, Intracel creates tiny punctures in your skin to trigger the production of elastin and collagen. With radio frequency pulses focused safely underneath your epidermis, the collagen fibers are targeted to begin the regeneration process.


Tixel uses controlled heat to treat acne and improve skin texture. It works by creating microthermal zones on the skin’s surface, stimulating collagen production, and promoting skin rejuvenation.


Morpheus8 uses a minimally invasive fractional radiofrequency (RF) microneedling to stimulate collagen and elastin production, tightening the skin and improving its texture. As the micro-injuries heal, the body’s natural response helps remodel acne scars and improve overall skin health.

Contact Us

Our Acne Treatment Center is the premiere center to help patients solve both acute pimple issues and deal with scarring.

With advanced technologies and highly trained professionals, Ava MD can surely help pave the way to clear skin and prevent future breakouts.

We can customize a multi-modal approach that will lead to real short-term relief as well as permanent results. To learn more about acne scar treatment, call us at 310-843-9915 (Beverly Hills) or 310-828-2282 (Santa Monica).