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ACNE SCARS A scar results from the biologic process of wound repair in the skin and other tissues. They form when the dermis is damaged and the body forms new collagen fibers to mend the damage ACNE SCARS GLOBAL CLASSIFICATION Grade I – Macule – erythematous / hyper pigmented/ hypopigmented flat mark Grade II – Mild rolling, small, soft papular scar Grade III – Significant rolling, shallow boxcar, and mild- moderate papular / hypertrophic scar Grade IV – Punched out, atrophic deep boxcar, ice pick, bridges, tunnels, dystrophic, hypertrophic, keloidal scar Scars can be atrophic or hypertrophic.