Acne scars are marks left on the skin after acne heals poorly, often from deep inflammation that messes up the skin’s repair process. They happen when your body makes too much or too little collagen, the protein that keeps skin smooth and firm.
Acne starts when pores get clogged with oil, dead skin cells, and bacteria. This leads to pimples, redness, and swelling. If the swelling goes deep into the skin layers, it damages the tissue there. The skin then tries to heal, but sometimes it fails. Instead of going back to normal, it leaves behind dents, bumps, or color changes.[2][5]
Not all marks from acne are true scars. Red or pink spots called post-inflammatory erythema come from broken blood vessels under the skin. They fade over time and are common on lighter skin tones. Dark brown or black spots, known as post-inflammatory hyperpigmentation, happen when the skin makes extra pigment after injury. These are more common on darker skin and can last months if you do not protect from the sun.[3][6]
True scars come in a few main types. Atrophic scars are sunken or indented because the skin did not make enough collagen. Ice pick scars look like tiny deep holes, often from cystic acne on the cheeks or jaw. Boxcar scars have sharp edges and round shapes, like shallow pits. Rolling scars make the skin look wavy with soft, sloped borders.[7]
Raised scars form when the skin overproduces collagen. Hypertrophic scars are thick bumps that stay close to the original spot. They can happen anywhere but are more common on the back or chest.[1][6]
Several things make scars more likely. Severe cystic or nodular acne causes the worst damage because it pushes inflammation deep. Picking or scratching pimples worsens it by adding more injury. Delaying treatment lets the problem grow, so scars set in before you fix the acne.[3][5]
Your genes play a part too. If family members had bad acne, you might heal with more scars. Skin on the back and chest scars easier than the face. It is thicker, has more oil glands, and faces constant sweat, tight clothes, and friction from bags or sports gear. All this keeps inflammation going longer.[1][4]
To avoid scars, treat acne early and gently. Keep hands off spots, use sun protection, and see a doctor for bad breakouts. Once scars form, options like peels or lasers can help smooth them, but results vary by type and skin.[2][7]
Sources
https://www.london-dermatology-centre.co.uk/blog/acne-scarring-back-chest-treatment/
https://syraaesthetics.com/treatments/acne-scar-treatment-nyc/
https://sozoclinic.sg/acne-scars/
https://axisclinic.co.uk/acne/
https://www.pristyncare.com/consult/acne-scars-why-do-they-form-and-what-are-the-common-causes/
https://www.kins-clinic.com/blogs/acne-marks-or-acne-scars-understanding-the-difference-and-management-options
https://slmdskincare.com/blogs/learn/the-5-kinds-of-acne-scars-how-to-treat-each-type
https://alivewellnessnc.com/concern/what-causes-acne-scarring/
https://dentalandfacialclinic.com.au/acne-scars-need-professional-care/
