What Causes Acne Scars and Why Some Pimples Leave Marks
Acne scars happen when pimples cause deep inflammation that damages the skin’s inner layers. This damage messes up the healing process, leaving behind marks like dents, bumps, or dark spots. Not every pimple leaves a scar, but some do because of how the skin repairs itself after the inflammation.
Pimples start when pores get clogged with oil, dead skin, and bacteria. This leads to swelling and redness. If the inflammation stays mild and only affects the surface, the skin usually heals without a trace. But when pimples are severe, like cysts or nodules, the swelling digs deeper into the dermis, the skin’s tough middle layer. There, it harms collagen and elastin, the proteins that keep skin smooth and firm.[1][3][6]
During healing, the body rushes to fix the damage by making new collagen. Sometimes it makes too little, creating sunken spots called atrophic scars. These include ice pick scars that look like tiny pits, boxcar scars with sharp edges, and rolling scars that give skin a wavy look from pulled-down tissue.[3][5] Other times, it overproduces collagen, forming raised scars like hypertrophic or keloid types that stick out above the skin.[1][3]
Not all marks are true scars. Post-inflammatory hyperpigmentation shows up as flat brown or dark spots from extra melanin made during healing. This is common in darker skin tones. Post-inflammatory erythema leaves pink or red marks from broken blood vessels, often seen in lighter skin. These fade over time but can last months.[1][2][5]
Why do some pimples leave marks while others vanish? It depends on a few key things. Severe or cystic acne causes more damage because it penetrates deeper.[4][7] Picking or squeezing pimples worsens inflammation and pulls on skin tissue, making scars more likely. Delayed treatment lets swelling linger, giving damage time to set in.[2]
Genetics play a role too. Some people inherit a tendency for strong inflammation or poor collagen repair, so their skin scars easily even from smaller breakouts.[2][3] Skin type matters: darker tones get more pigmentation marks, while fair skin shows redness longer.[1][2] Things like hormones in adult acne, stress, sun exposure, or smoking slow healing and boost scarring risk.[4]
Adult acne often scars more than teen breakouts. It tends to form deep cysts on the jawline or chin from hormone shifts, leading to lasting dents or tethered skin.[4] In short, scars form from deep harm plus uneven repair, and everyday habits or genes tip the balance toward marks that stick around.
Sources
https://syraaesthetics.com/treatments/acne-scar-treatment-nyc/
https://sozoclinic.sg/acne-scars/
https://www.kins-clinic.com/blogs/what-are-the-main-acne-scar-types-a-skin-friendly-guide-with-treatment-options
https://www.london-dermatology-centre.co.uk/blog/adult-acne-scarring/
https://drhaach.com/treatments/acne-scars/
https://vitalskinderm.com/blog/laser-acne-and-scar-removal-guide/
https://rejuvadermatology.com/conditions/acne-scars-in-venice-fl/
https://urbanskinhairclinic.com/acne-scars/
https://dentalandfacialclinic.com.au/acne-scars-need-professional-care/
