Usually, the mild form of acne occurring in most people does not produce scars, or if it does, the scarring fades naturally over time. But people suffering from severe forms of acne such as nodular cystic acne might be left with deep scarring in the skin.

There are also marks and pigmentation that relate to acne that are not precisely scars but resemble them in appearance. These disappear eventually but are visible enough to produce embarrassment. Macules are like pseudo- scars, which are usually left behind by an inflamed acne lesion. These flat red spots are just the last stage of any inflamed lesion. Unlike a scar, a macule might take time to fade, but once it vanishes, it leaves no marks behind.

A discoloration of the skin my occur following the curing of any inflamed acne lesion. It is more frequent in dark skinned people, but might take place in white skin also. This is named "post inflammatory pigmentation." It may need treatment by a dermatologist.

Finding solutions for different acne scars

According to the shape of tissue, acne scars are classified in two categories. One kind of scar consists of increased skin tissue, and the others are recognized by the decrease in tissue on the site of acne. Overgrowth of scar tissue is called Keloid and is more pronounced in African-Americans. The profound, linear scar created by acne is refered to as the ice-pick scar. These are very deep and removal of them is difficult.

Another cause of acne scarring is the pinching and squeezing of acne. This spreads the infection to surrounding skin and damages weakened tissue, which results in pit-like scars.

Treatment of acne scars ranges from simple acne scar cream to laser therapy, skin graft, and aggressive dermabrasion. Filling agents are also applied to eliminate acne scars. Most filling agents are provisional, like collagen. For deep ice-pick scars, the best treatment is to extract the scars and substitute them with a skin graft taken from behind the ear. This method is known as punch grafting.

Dermabrasion is virtually the opposite of the cutting down technique. Here, the healthy skin is eliminated to bring the acne scar to a lower level. This way the scar remains the same but the level of rest of the skin changes, making them shallower. It confers skin a smoother surface.

In acne scar therapy, another method is laser surgery. In this treatment, carbon dioxide is applied, which eliminates skin very finely, layer by layer, thus minimizing the damage to healthy tissue. Like dermabrasion, this procedure also leaves skin red for months.

In peeling therapies, chemicals are used to eliminate the external layer of skin, the epidermis. To reduce different types of scars, superficial peels, medium-depth peels, and deep peels are used. These are mostly helpful for shallow, external scars. Scars left by cystic acne and acne rosacea are treated by this procedure. Peeling is a long process that requires a preparation period of many weeks before the actual procedure.