Acne Scars and Dark Marks: Types and Treatment Options

Acne usually clears with time and treatment, but for some people it leaves marks behind. It helps to know the difference between temporary discoloration, which fades on its own, and true scars, which change the skin’s texture and usually need professional treatment.

Marks that are not true scars

Post-inflammatory hyperpigmentation (PIH)

Flat brown or dark marks left after a spot heals. They are more common in medium and darker skin tones and usually fade over 3 to 12 months.

Post-inflammatory erythema (PIE)

Flat pink, red or purple marks, more common on lighter skin. They are caused by dilated blood vessels and also fade gradually.

What helps: daily broad-spectrum sunscreen (sun exposure darkens marks), plus ingredients such as azelaic acid, niacinamide, vitamin C and retinoids. For stubborn redness, dermatologists may use vascular lasers.

True acne scars

Atrophic (depressed) scars

Ice pick scars: narrow, deep pits.
Boxcar scars: wider depressions with sharp edges.
Rolling scars: broad, shallow depressions that give the skin a wavy look.

Hypertrophic and keloid scars

Raised, firm scars, more common on the chest, back, shoulders and jawline, and in people prone to keloids.

Professional treatments for scars

Microneedling: stimulates collagen to soften rolling and boxcar scars over several sessions.
Laser resurfacing: fractional lasers improve texture; settings must suit your skin tone.
Chemical peels: medium-depth peels can improve shallow scars and discoloration.
TCA CROSS: a targeted technique for ice pick scars.
Subcision: releases the bands that pull rolling scars down.
Dermal fillers: temporarily lift depressed scars.
Steroid injections or silicone gel: used to flatten raised and keloid scars.

Results usually come from a combination of treatments over several months. A dermatologist can recommend what suits your scar type and skin tone.

Preventing scars

Treat acne early, especially if you get deep or painful spots.
Do not pick, squeeze or pop pimples.
Use sunscreen daily to stop marks from darkening.
See a dermatologist if your acne is moderate to severe. Effective treatment is the best scar prevention there is.

What about home remedies for scars?

Over-the-counter retinoids and vitamin C can improve discoloration and fine texture over time, but no cream will fill in a deep scar. Be cautious with products that promise to “erase” scars, and avoid DIY acid peels or at-home devices that can burn the skin.