Acne Scars and Dark Marks are Two Different Things

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It’s amazing how many people mistakenly confuse the dark marks leftover from acne (post-inflammatory hyperpigmentation) with acne scars. I have clients walk through my doors that have done HUNDREDS of hours of research on acne and yet it seems the more information they have consumed, the less informed they are. Acne scars and dark marks are important to understand and be able to distinguish because if you suffer from acne, chances are you will experience one or both of these at some point on your acne journey. Understanding them can also help you take the necessary actions to prevent them in the first place.

How to tell the difference
Acne scars are textural changes in the skin that can be either indented or raised. Post-Inflammatory Hyperpigmentation looks like discoloration that may be red, brown, purple, or white but these marks are flat rather than textured. Scars and pigmentation may also appear together in the same area especially in cases of picking.

The causes
Acne scars and dark marks both occur in response to inflamed acne and picking but they are caused by two different mechanisms. Dark marks occur when inflammation triggers an increase in melanin which are pigment producing cells. Scars on the other hand occur when inflammation essentially eats away at the skin’s tissues causing the tissue to atrophy or overgrow.

Are they treatable?
Dark marks leftover from acne are usually treatable but , unfortunately, it’s nearly impossible to completely eliminate acne scars. There are treatments that can improve their appearance but it’s incredibly difficult to restore skin back to its natural state once the tissue has been damaged. Check out our post on dark marks for more information on how to treat them.

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Post-Inflammatory Pigmentation: Acne Marks and Discoloration Caused By Pimples

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What Is Post-Inflammatory Pigmentation?
Post-Inflammatory Pigmentation is the fancy term for skin discoloration caused by inflammation. Unlike acne scars, pigmentation usually resolves on its own and is highly treatable. If you read my post on the seven different types of acne, you know that there are four types of inflamed acne and any one of these can lead to discolored marks that last for weeks, months, and even years after the acne itself is long gone. You can even cause a non-inflamed acne lesion like a blackhead or whitehead to become inflamed by picking at it which is why leaving your hands off your face is so important. The most common type of discoloration causes the skin to turn darker or HYPER-pigment although, in rare cases, your skin might HYPO-pigment or turn lighter. There are three types of post-inflammatory pigmentation or discolored marks that can occur from inflamed acne or picking: Postinflammatory erythema which are pink or red marks, postinflammatory hyperpigmentation which are brown marks, and postinflammatory hypopigmentation which are white marks.

How To Prevent Pigmentation
The most effective and sustainable way to prevent pigmentation is to clear the acne itself. If your acne is still active though, there are two keys to preventing pigmentation:

  1. Reducing Inflammation: this is key because it is the inflammation rather than the acne itself that causes the pigmentation in the first place. The two main tools we use to reduce inflammation with our program are icing and using an effective and non-comedogenic benzoyl peroxide product like our Clearing Treatment.

  2. Avoiding abrasion and pressure: pressure and abrasion inflicted on the skin can send signals to our bodies that we are injured which can then set off the inflammatory response that leads to pigmentation. The best way to avoid this is to avoid picking or even resting against your hands or anything else that might put pressure on areas of your face or body that are broken out. Also, avoid any form of mechanical exfoliation (scrubs, exfoliating brushes, loofahs, microdermabrasion) which can tear and damage the skin.

How To Treat Pigmentation
Treating pigmentation should only be done once your skin is completely clear. If your skin is still broken out, you will likely be wasting your time and money treating the existing pigmentation because you will likely just have more pigmentation come up from future breakouts. The methods used to treat pigmentation also typically speed up the cell turnover process which can accelerate the rate of acne movement and trigger an inflammatory response that actually induces more pigmentation. Once your skin is completely clear, the most effective way to get rid of pigmentation is a combination of mild chemical peels and a daily product plan that helps purge the pigmented cells out of the skin. Our serums contain mandelic acid and lactic acid which are two of the most gentle and effective exfoliants for clearing acne and our acne facials include peels that contain a cocktail of ingredients meant to target acne and speed up the lifting and lightening of all three types of pigmentation.

How Long Does Pigmentation Treatment Take and What To Expect
Pigmentation usually takes longer than acne itself to clear out of the skin. With our program, most people see acne clear within 6-8 treatments over 3-4 months but it can take 3-4 times as long for the pigmentation to lift depending on how aggressive your product plan is and what type of peels your skin can tolerate.

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All About Acne Scars

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Acne scars are caused by tissue damage which create textural changes that cause the skin to appear raised or indented. Many people confuse acne scars with pigmentation but they are two different things as discussed in our post Acne Scars and Dark Marks are Two Different Things. Although pigmentation is usually reversible, scars are not since the skin’s tissues can never be completely restored to their original state but certain treatments may improve them. The best way to deal with scarring is to prevent them in the first place through an effective program that deals with acne at the root as well as its various symptoms including inflammation.

What Causes Acne Scars
Acne scars can be caused by two things: inflammation and picking. Inflamed acne types (papules, pustules, cysts, and nodules) and picking can both cause ruptures in the deeper layers of the skin that destroy the skin’s tissues or cause an overgrowth of tissue that is initiated in an effort to “patch up” the wounded area. Genetics largely determine our skin’s natural healing mechanisms and thus how likely we are to develop scarring. Genetics also determine what type of acne we are likely experience and if we suffer from the inflamed acne types, especially cystic and nodular acne, we are more likely to scar as well. Picking is the best way to create a scar and the types of scars that are created from picking are typically bigger, more uneven and less likely to respond to treatment.

Type Of Acne Scars
There are two categories of acne scars. Hypertrophic scars are raised, discolored bumps caused by tissue overgrowth and atrophic scars are caused by tissue loss. There are three types of atrophic scars:

Rolling Scars-depressions with smooth, sloping edges that look like wavy hills
Icepick Scars-small, circular indents in the skin that are shaped like icepicks
Boxcar Scars-depressed indents with sharp, angular edges

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