Acne vulgaris is a common condition with a lifetime incidence of over 80%. Acne scarring is an unfortunate, yet, frequent sequela of acne. Any type of acneiform lesion, including comedones, papules, pustules, or nodulocystic lesions, may result in scarring. Although it is impossible to pinpoint exactly which patients with acne will develop scarring, there are some factors that put a patient at higher risk. Acneiform lesions that have been manipulated are more likely to result in scarring. Truncal acne scarring is more common in males than females, and Asian and Black patients are especially prone to keloidal scarring. More severe acne and especially acne conglobata, (Fig. 8.1) has a higher risk of leading to scarring.