Acne scars are marks left on the skin after acne heals poorly, often due to deep inflammation that messes up the skin’s repair process. They happen when pimples, cysts, or nodules damage the deeper layers of skin, leading to dents, bumps, or color changes that do not fade easily.
Acne starts when hair follicles clog with oil, dead skin cells, and bacteria, causing swelling and redness. If this swelling goes deep into the dermis, the skin’s tough middle layer, it disrupts normal healing. The body rushes to fix the damage by making collagen, the protein that keeps skin smooth and firm. Sometimes it makes too little collagen, creating sunken spots. Other times it overproduces collagen, forming raised areas.[1][4][6]
Not all acne leaves scars. Mild pimples on the surface usually heal without a trace. Scars come from severe types like cystic acne, which digs deep and causes more harm. Areas like the back and chest scar worse because the skin there is thicker, has more oil glands, and faces constant rubbing from clothes, sweat, or backpacks. This makes inflammation spread further and healing take longer.[2][7]
Picking or squeezing pimples makes things worse. It adds extra injury, spreads bacteria, and guarantees scars by destroying more collagen. Even stress or habits like scratching itchy spots can turn simple breakouts into lasting damage.[2][5]
Scars come in a few main types. Ice pick scars are narrow, deep pits that look like tiny holes from lost collagen. They often hit the cheeks from cystic acne. Boxcar scars are wider, round dents with sharp edges, like old chicken pox marks, usually from inflamed pimples on the cheeks or temples. Rolling scars create wavy, uneven skin because bands of scar tissue pull the surface down. Raised scars, like hypertrophic or keloid types, build up extra collagen into firm bumps that may itch or stay red.[1][6][7][9]
Dark spots after acne are not true scars. These are flat brown or gray patches from extra pigment made during healing. They fade over months with sun protection and time, unlike real scars that change the skin’s texture.[6]
Genetics play a part too. If your family had bad acne, you might make more oil or heal slower, raising scar risk. Hormones from puberty, periods, or stress also boost oil and trigger deep breakouts.[3]
Sources
https://syraaesthetics.com/treatments/acne-scar-treatment-nyc/
https://www.london-dermatology-centre.co.uk/blog/acne-scarring-back-chest-treatment/
https://axisclinic.co.uk/acne/
https://www.pristyncare.com/consult/acne-scars-why-do-they-form-and-what-are-the-common-causes/
https://liniaskinclinic.com/acne-excoriee/
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/
