Acne can affect people during their teenage years and adulthood. Pimples, blackheads, whiteheads and painful bumps may appear on the face, chest, shoulders and back. Even after active acne clears, some people are left with dark marks, uneven skin texture or permanent scars.
The good news is that several effective treatments can help control acne and make acne scars less noticeable. The right option depends on whether you have active breakouts, flat dark marks, depressed scars or raised scars. Treating acne early and avoiding picking or squeezing pimples can also reduce the risk of further scarring.
In This Article
- What are acne and acne scars?
- Acne marks vs acne scars
- What causes acne and scarring?
- Medical treatments for active acne
- A simple acne skincare routine
- Types of acne scars
- Acne scar treatment options
- Treatment for dark acne marks
- How to prevent new acne scars
- When to see a dermatologist
- Frequently asked questions
What Are Acne and Acne Scars?
Acne is a common skin condition that develops when hair follicles become blocked with oil and dead skin cells. Inflammation can cause pimples, pus-filled spots, deep painful lumps and other skin changes. Hormonal changes, genetics, certain medications and the products used on the skin can contribute to acne.
Acne scars develop when inflammation damages the skin and the healing process changes the structure of the tissue. Some scars leave depressions in the skin, while others are raised. Not every pimple causes a scar, but deep, painful or repeatedly inflamed acne increases the risk.
It is important to recognise the difference between an active pimple, a flat mark and a true scar. A treatment that helps one may not adequately treat the others.
Acne Marks vs Acne Scars: What Is the Difference?
Flat Red, Pink or Brown Marks
These marks often remain after a pimple heals. They are commonly caused by post-inflammatory changes in the skin’s colour. Brown or grey-brown marks are called post-inflammatory hyperpigmentation.
The skin surface is generally flat. Many of these marks gradually fade, although this can take months or longer.
Indented or Pitted Scars
These scars create a depression or uneven texture in the skin because the healing process has not restored enough supporting tissue.
They often need dermatologist-selected procedures, such as microneedling, subcision, chemical reconstruction or laser resurfacing.
Raised Scars
Raised acne scars develop when extra scar tissue forms during healing. Some stay within the boundaries of the original acne lesion, while keloids may grow beyond it.
These scars need a different approach from depressed scars and may be treated with specialist injections, silicone-based products or selected procedures.
Active Acne
Active acne includes blackheads, whiteheads, inflamed pimples and deeper lumps. New inflammation can cause new marks or scars.
Controlling breakouts is usually the first priority before planning treatment for established scars.
A simple way to think about it is that marks mainly change colour, while scars change the texture or structure of the skin. Both can occur together, and a dermatologist can examine your skin to identify which treatments are likely to help.
What Causes Acne and Acne Scarring?
1. Excess oil and blocked pores
Skin naturally produces sebum, an oily substance that helps protect the skin. When oil and dead skin cells block hair follicles, blackheads, whiteheads and inflammatory acne can develop.
2. Hormonal changes
Hormonal changes during puberty, menstrual cycles and adulthood can influence oil production. Some women experience acne that flares around their periods. Persistent acne together with irregular periods or increased facial hair may deserve medical assessment for a possible hormonal condition.
Learn more about PCOS symptoms and treatment options. Acne alone does not establish a diagnosis of PCOS.
3. Genetics
A family history of acne can increase the likelihood of developing acne or scarring. Some people are more prone to deeper inflammation or raised scars than others.
4. Picking, squeezing or scratching pimples
Picking or squeezing can increase inflammation, delay healing and raise the risk of infection, dark marks and scarring. Deep or painful pimples are better assessed by a healthcare professional than repeatedly squeezed at home.
5. Irritating or pore-clogging products
Heavy or unsuitable cosmetics, hair products and skincare products may contribute to breakouts in some people. Choose products labelled non-comedogenic when possible and stop using products that consistently irritate your skin.
Medical Treatments for Active Acne
The best acne treatment depends on how severe the acne is, the type of lesions, previous treatments, skin sensitivity, age, pregnancy status and other health considerations. Mild acne may respond to topical treatments, while deeper or scarring acne often needs prescription treatment.
1. Benzoyl peroxide
Benzoyl peroxide helps reduce acne-causing bacteria and inflammation. It is commonly used for inflammatory acne and may be combined with other treatments. It can cause dryness or irritation and may bleach fabrics, so follow the product instructions carefully.
2. Topical retinoids
Topical retinoids, such as adapalene or prescription tretinoin, help keep pores from becoming blocked and can reduce new breakouts. Some also help improve certain acne-related dark marks over time.
Irritation, dryness and peeling can occur, especially when treatment is introduced too quickly or combined with several other active products. A clinician can guide the appropriate product, strength and frequency.
Pregnancy safety: Topical retinoids should be avoided during pregnancy or when planning pregnancy unless a qualified healthcare professional gives specific guidance. Do not start acne medicines without checking their safety for your circumstances.
3. Azelaic acid and salicylic acid
Azelaic acid may help treat acne and post-inflammatory dark marks. Salicylic acid can help unclog pores and may be useful for some forms of mild acne. Both can irritate the skin, particularly when several active ingredients are used together.
Your dermatologist can help select a product that fits your skin and treatment goals. Avoid applying multiple strong exfoliating or acne products at the same time unless advised.
4. Prescription topical combinations
Dermatologists may combine treatments that work in different ways. For example, a retinoid and benzoyl peroxide may be used together as part of an acne treatment plan. Antibiotics may also be prescribed in selected cases, but antibiotic treatment should be managed carefully to limit antibiotic resistance.
Topical or oral antibiotics should not be used as unsupervised long-term treatments or shared with another person. Follow the duration and instructions prescribed by your clinician.
5. Oral medicines for moderate or severe acne
When acne is extensive, painful, resistant to topical treatment or causing scars, a dermatologist may consider prescription oral medicines. Depending on the patient, options may include an oral antibiotic for a limited course, hormonal treatment for suitable patients or isotretinoin for severe or treatment-resistant acne.
These medicines have different risks and suitability requirements. For example, isotretinoin can cause serious birth defects and requires strict pregnancy-prevention precautions for people who could become pregnant. Hormonal medicines may not be suitable for everyone either.
Do not start oral acne medication based on online advice. A clinician needs to review your medical history, medicines and, where appropriate, monitoring requirements.
How long does acne treatment take to work?
Acne treatment usually takes time. Some people notice early changes within several weeks, while a more reliable assessment often requires a consistent treatment course of around 8 to 12 weeks. Deeper acne may take longer and may need a change in treatment.
If your acne is worsening, painful, leaving scars or not improving with an appropriate plan, consult a dermatologist rather than repeatedly changing products on your own.
A Simple Daily Skincare Routine for Acne-Prone Skin
A skincare routine should support treatment without causing unnecessary irritation. You do not need to use a large number of products to look after acne-prone skin.
Morning routine
- Gentle cleanser: Wash with a mild cleanser suited to your skin. Avoid harsh scrubbing.
- Prescribed or suitable acne treatment: Use treatment according to its label or your clinician’s instructions.
- Moisturiser: Choose a non-comedogenic moisturiser if your skin feels dry or irritated.
- Sunscreen: Apply broad-spectrum SPF 30 or higher to exposed skin. Sunscreen is particularly helpful for preventing dark marks from becoming more noticeable.
Evening routine
- Gently remove sunscreen, makeup and daily dirt.
- Apply your prescribed night treatment as directed.
- Use a suitable moisturiser to support the skin barrier.
Introduce new active products gradually, particularly if your skin is sensitive. Burning, severe redness, swelling or persistent irritation is a reason to stop the irritating product and seek medical advice.
Types of Acne Scars
Different acne scars form in different ways. Identifying the type is important because no single acne scar treatment works equally well for every scar.
Ice Pick Scars
These are narrow, deep pits that extend into the skin. They may be difficult to improve with surface treatments alone.
Boxcar Scars
These scars are broader depressions with more clearly defined edges. Their depth and shape influence the procedure selected.
Rolling Scars
These create a wave-like or uneven skin surface. Fibrous bands beneath the skin can contribute to their appearance.
Hypertrophic Scars and Keloids
These are raised scars caused by excess scar tissue. Keloids can extend beyond the original acne lesion and may return after treatment.
A person may have more than one type of scar, along with dark marks and active acne. A dermatologist can assess the different changes and develop a plan tailored to them.
Acne Scar Treatment: What Are the Options?
Acne scar treatment aims to make scars less noticeable and improve skin texture. Results depend on the type and depth of scarring, the treatment selected, skin characteristics and individual healing. Complete removal cannot be guaranteed, and several treatment sessions or combined procedures may be needed.
1. Microneedling
Microneedling uses fine needles to create controlled punctures in the skin, encouraging a wound-healing response and collagen production. It may help improve selected depressed acne scars and uneven texture.
A clinician should determine whether microneedling is suitable, particularly if you still have active inflammatory acne, a tendency to form keloids, a skin infection or other relevant medical conditions. Home needling devices can injure the skin and increase the risk of infection or pigmentation changes.
2. Chemical peels
Chemical peels use selected acids to exfoliate the skin. Depending on the type and strength, they may help with acne, some superficial marks or selected acne scars. The correct formulation and depth matter.
Strong or incorrectly applied peels can cause burns, persistent darkening or lighter patches, particularly in skin that is prone to pigmentation changes. Professional advice is important before a peel intended to treat acne scars.
3. Laser resurfacing
Certain laser procedures can improve the appearance of depressed acne scars by resurfacing skin or stimulating collagen remodelling. Different devices have different levels of intensity, downtime and risk.
Laser treatment is not one-size-fits-all. Skin tone, the type of scar, the presence of active acne, previous treatments and healing history all influence the plan. Pigment changes, redness and other complications are possible.
4. Subcision
Subcision is a procedure in which a trained clinician releases fibrous bands beneath selected depressed scars. It may be useful for certain rolling scars that are tethered to deeper tissue.
It is not appropriate for every scar type, and bruising, swelling, infection or other complications can occur. The dermatologist determines whether it is suitable and whether it should be combined with another treatment.
5. TCA CROSS and other targeted procedures
TCA CROSS is a specialised procedure in which a clinician applies a high-concentration chemical solution to selected narrow scars. It may be considered for some ice pick scars. Because the treatment is highly targeted, it must be performed by an appropriately trained professional.
Incorrect use can cause burns, new scars or pigmentation changes. Strong acids should never be used as a do-it-yourself acne scar treatment.
6. Fillers and scar surgery
Selected fillers can raise certain depressed scars, although results may be temporary and touch-up treatment may be needed. Small surgical techniques can also be used for certain scars, including procedures that lift or release a depressed area.
The choice depends on the scar’s shape, depth, location and the patient’s goals. A dermatologist may combine more than one procedure to improve the result.
7. Treatment for raised acne scars
Raised scars need a different approach from depressed scars because they involve excess scar tissue. Depending on the case, treatment may include corticosteroid injections, selected prescription medicines, silicone-based products, laser treatment or other specialist procedures.
Keloids can be difficult to manage and may return after treatment. A dermatologist can explain which options are appropriate and what results may reasonably be expected.
How to Treat Dark Spots Left After Pimples
Dark spots that remain after acne are often caused by post-inflammatory hyperpigmentation. These marks are common in people with darker skin tones and may become more noticeable when acne is inflamed or repeatedly picked.
Flat dark marks are different from depressed or raised scars. They may gradually fade, but the process can take months and sometimes longer. Continuing to develop acne can create new marks before the old ones have faded.
Helpful approaches may include:
- Controlling active acne: Fewer inflammatory breakouts mean fewer opportunities for new marks to form.
- Daily sun protection: A broad-spectrum SPF 30 or higher can help reduce further darkening of exposed skin.
- Using suitable topical treatments: A clinician may recommend ingredients such as azelaic acid or a retinoid, depending on your skin and medical circumstances.
- Avoiding irritation: Harsh scrubs, repeated exfoliation and strong unregulated skin-lightening products may worsen pigmentation.
Do not use bleaching creams, strong peels or prescription skin-lightening medicines without appropriate medical guidance. Products containing topical steroids or other unlisted ingredients can cause complications when used incorrectly.
How to Prevent New Acne and Acne Scars
Not every scar can be prevented, but managing acne early can lower the risk. The aim is to reduce inflammation, avoid skin injury and maintain a treatment plan that prevents repeated breakouts.
- Do not pick or squeeze pimples: Picking increases inflammation and can damage surrounding tissue.
- Seek help for deep or painful acne: Nodules and cyst-like lesions are more likely to scar than mild surface pimples.
- Use treatments consistently: Acne medicines often take several weeks to show improvement.
- Avoid overly complicated routines: Too many active ingredients can irritate the skin and make treatment harder to tolerate.
- Choose suitable products: Non-comedogenic skincare and makeup may help reduce pore blockage in acne-prone skin.
- Protect your skin from the sun: Sunscreen helps prevent post-acne marks from becoming darker.
- Follow medical advice: Review treatment if acne is worsening or causing scars rather than repeatedly trying unverified home remedies.
Common Acne Treatment Mistakes to Avoid
Using too many products at once
Combining several strong acne products can cause dryness, burning and irritation. Start new treatments carefully and follow the label or your clinician’s instructions.
Expecting scars to disappear in a few days
Acne marks often fade gradually, while established scars may need several months of treatment and more than one procedure. A realistic plan helps avoid unnecessary irritation and disappointment.
Using toothpaste, lemon juice or harsh scrubs
These remedies are not evidence-based acne scar treatments. They can irritate or damage skin and may worsen pigmentation. Use products formulated for skin and seek professional advice for persistent problems.
Buying prescription medication without medical review
Oral antibiotics, hormonal medicines and isotretinoin have risks and suitability requirements. Using them without appropriate supervision can cause harm and may delay the correct diagnosis.
When Should You See a Dermatologist?
Consider a dermatologist appointment if acne is persistent, painful, spreading, leaving scars or affecting your confidence or emotional well-being. Early treatment is particularly important when deep inflammatory lesions or new scars are appearing.
Professional assessment is especially useful if:
- Over-the-counter treatments have not helped after a consistent trial.
- You have deep, painful nodules or cyst-like lesions.
- Acne is leaving pitted, raised or keloid scars.
- Dark marks are persistent or becoming more noticeable.
- Acne starts suddenly in adulthood or comes with irregular periods or increased facial hair.
- You are pregnant, planning pregnancy or breastfeeding and need help choosing a safe treatment.
- Acne is causing significant distress, low mood or social withdrawal.
A dermatologist can assess the type and severity of acne, review previous products and medicines, and decide whether topical treatment, oral medicine, scar procedures or a combination is appropriate.
Frequently Asked Questions
1. What is the best treatment for acne and acne scars?
The best treatment depends on whether you have active acne, dark marks, depressed scars or raised scars. Acne medicines help control breakouts, while procedures such as microneedling, selected peels, subcision or laser treatment may improve certain scars. A dermatologist can match the treatment to your skin.
2. Can acne scars be removed permanently?
Treatment can make many scars less noticeable, but complete removal cannot be guaranteed. Some scars improve substantially, while deeper scars or keloids may be more difficult to treat and can need repeated or combined procedures.
3. Do dark pimple marks count as acne scars?
Not always. Flat red, brown or grey marks often reflect post-inflammatory changes in skin colour rather than a structural scar. Depressed or raised areas indicate a change in skin texture and may need a different treatment.
4. How long does acne treatment take to work?
Many treatments need several weeks to show visible improvement, and a fuller assessment may take around 8 to 12 weeks. Persistent or severe acne may require longer treatment or a change in approach.
5. Does microneedling help acne scars?
Microneedling can improve some depressed acne scars by stimulating collagen production. Its suitability depends on scar type, active acne, skin condition and previous treatments. It should be performed by a trained professional rather than with an unregulated home device.
6. Is laser treatment suitable for every acne scar?
No. Laser treatment can help selected scars, but it is not appropriate for every scar type. The right option depends on skin tone, scar depth, active acne, medical history and the possibility of side effects such as pigmentation changes.
7. Can acne treatment be used during pregnancy?
Some acne treatments are not suitable during pregnancy. Retinoids and certain oral medicines must be avoided. Tell your healthcare professional if you are pregnant, trying to conceive or breastfeeding before starting or continuing acne treatment.
8. Does popping pimples cause scars?
Picking or squeezing can increase inflammation, damage skin tissue and raise the risk of scarring or dark marks. Avoid squeezing pimples, especially deep or painful lesions, and seek professional help if they are severe.
9. Can acne scars improve without treatment?
Flat dark marks often fade gradually over time. Established indented or raised scars are less likely to disappear completely on their own, although their appearance may change. A dermatologist can explain suitable options if they concern you.
10. When should I consult a dermatologist for acne?
Arrange an appointment if acne is persistent, severe, painful, leaving scars or not improving with a suitable treatment plan. Seek help early if deep lesions are developing because preventing additional inflammation can reduce future scarring.
Conclusion
Acne and acne scar treatment work best when the treatment matches the problem. Active pimples need an acne-control plan, flat dark marks need careful pigmentation management, and depressed or raised scars may require procedures selected by a dermatologist.
Protecting the skin barrier, avoiding picking, using suitable treatments consistently and wearing sunscreen can support better outcomes. If acne is persistent, painful or leaving scars, seek professional advice rather than relying on harsh home remedies or unverified products.
Medical disclaimer: This article is for general educational purposes only and is not a substitute for professional medical advice, diagnosis or treatment. Acne and scarring vary between individuals. Consult a qualified dermatologist for personalised treatment recommendations, especially before using prescription medicines or undergoing procedures.
