Usually, the mild type of acne occurring in most people does not leave scars, or if it does, the scarring heals naturally over time. But people suffering from severe types of acne like nodular cystic acne can be left with noticeable scarring in the skin.

There are also marks and pigmentation that relate to acne that are not exactly scars but resemble them in appearance. These disappear eventually but are evident enough to cause embarrassment. Macules are similar to pseudo- scars, which are usually left behind by an inflamed acne pimple. These flat red spots are nothing but the last stage of any inflamed lesion. Unlike a scar, a macule can take time to disappear, but once it vanishes, it leaves no marks behind.

A discoloration of the skin my occur after the curing of any inflamed acne pimple. It is more frequent in dark skinned people, but can occur in white skin also. This is named "post inflammatory pigmentation." It can require treatment by a dermatologist.

Scar treatment possibilities

Based on the shape of tissue, acne scars are divided in two categories. One type of scar consists of increased skin tissue, and the others are recognized by the diminution 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 formed by acne is called the ice-pick scar. These are quite deep and eliminating them is difficult.

One more cause of acne scarring is the pinching and squeezing of acne. This expands the infection to surrounding skin and harms unhealed tissue, which results in pit-like scars.

Treatment of acne scars ranges from simple acne scar cream to laser therapy, skin graft, and painful dermabrasion. Filling agents are also applied to remove acne scars. Most filling agents are provisional, like collagen. For deep ice-pick scars, the most appropriate treatment is to extract the scars and substitute them with a skin graft taken from behind the ear. This technique is called punch grafting.

Dermabrasion is almost 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 gives 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 harm to healthy tissue. Like dermabrasion, this method also leaves skin red for months.

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