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July 31, 2023

Acne (pimple) Scars: The Permanence of Skin Imperfections


Acne is a common skin condition that affects millions of people worldwide, primarily during their teenage years and into adulthood. While many experience temporary outbreaks, others suffer from the lasting aftermath of acne in the form of scars. Acne scars, unfortunate reminders of a previous battle with acne, are often a cause of distress for those affected. This article explores the types of acne scars and delves into why some of these scars are permanent, causing individuals to seek various treatments for improving their appearance and self-confidence.

Types of Acne Scars

Acne scars are classified into two primary categories based on their appearance and formation: atrophic scars and hypertrophic scars.

Atrophic Scars: These scars result from a loss of tissue during the healing process of acne lesions. There are three main subtypes of atrophic scars:

a. Icepick scars: Small, deep holes that resemble puncture wounds on the skin.

b. Boxcar scars: Broad depressions with well-defined edges.

c. Rolling scars: Wavy or undulating appearance caused by fibrous bands pulling the skin downward.

Hypertrophic Scars: Unlike atrophic scars, hypertrophic scars form due to an excess of collagen during the healing process. These scars appear raised and can be firm or tender to the touch.

Why Are Some Acne Scars Permanent?

Not all acne scars are permanent, as some may fade or improve over time with the body's natural healing mechanisms. However, certain factors contribute to the permanence of acne scars:

Damage to the Dermis: Atrophic scars, particularly icepick and deep boxcar scars, are formed when the acne lesion damages the dermal layer of the skin. The dermis is responsible for the structural integrity of the skin, and when it is compromised, the body struggles to rebuild the damaged tissue, leading to the permanent formation of scars.

Collagen Disruption: Collagen is a crucial protein responsible for maintaining skin elasticity and support. Acne breakouts can disrupt the production and arrangement of collagen fibers during the healing process. This can lead to hypertrophic scars, which are often more challenging to treat and have a higher likelihood of becoming permanent.

Delayed or Inadequate Treatment: Timely and appropriate treatment of acne can significantly reduce the chances of scarring. Failure to address severe or persistent acne can result in more extensive damage to the skin, leading to permanent scars.

Skin Type and Genetics: Some individuals are more prone to developing severe acne scars due to their skin type and genetic predisposition. People with lighter skin tones tend to have a higher risk of developing atrophic scars, while those with darker skin tones may be more susceptible to hypertrophic scars and post-inflammatory hyperpigmentation.

Treatment Options for Acne Scars

While some acne scars may be permanent, several treatments can help improve their appearance and reduce their visibility. These treatments aim to stimulate collagen production, resurface the skin, and promote healing. Common treatment options include:

Laser Therapy: Fractional laser treatments can help stimulate collagen production and improve the texture of the skin.

Chemical Peels: Chemical peels can exfoliate the skin, encouraging the growth of new, healthier skin cells.

Microneedling: This procedure involves using tiny needles to create controlled micro-injuries in the skin, promoting collagen production and skin rejuvenation.

Dermal Fillers: Fillers can temporarily plump and elevate depressed scars, making them less noticeable.

Punch Excision: This surgical technique involves removing individual icepick scars and suturing the wound to allow for more controlled healing.

Different Types of Acne Scars and Their Lasting Effects

The type of acne (Dermatology) scar a person develops depends on various factors, including the type of acne they had, the depth and extent of the inflammation, and their skin's ability to heal. There are several types of acne scars, each with its own lasting effects:

Ice Pick Scars: These are deep, narrow scars that create small, V-shaped pits in the skin. They often extend into the deeper layers of the skin and can be challenging to treat effectively.

Keloid Scars: Similar to hypertrophic scars, keloid scars are raised and extend beyond the original area of the acne. They result from an overgrowth of scar tissue and can be more challenging to treat.

Post-Inflammatory Hyperpigmentation (PIH): Not technically a scar, PIH is a temporary darkening of the skin that occurs after the inflammation of acne has resolved. It can last for weeks to months before fading away.

The lasting effects of acne scars can vary depending on their type, depth, and individual factors. Some scars may fade over time, while others may persist indefinitely. In severe cases, acne scars can cause emotional distress and impact a person's self-esteem. Fortunately, there are several treatments available to help improve the appearance of acne scars, including:

Topical Treatments: Certain creams and gels containing ingredients like retinoids, alpha hydroxy acids (AHAs), or vitamin C may help fade mild scars and improve skin texture.

Microdermabrasion: This procedure involves exfoliating the outer layer of the skin with tiny crystals or a diamond-tipped wand, which can help improve skin texture and reduce the appearance of shallow scars.

Surgical Procedures: In some cases, surgical options like punch excision or subcision may be used to treat specific types of acne scars.

It's essential to consult a dermatologist or a skincare professional to determine the most suitable treatment option based on the type and severity of your acne scars. Early intervention and appropriate treatment can significantly improve the appearance of acne scars and help restore skin confidence.

Acne scars can be broadly categorized into two types based on their permanence:

Temporary or Temporary-Permanent Scars: These scars may fade over time and become less noticeable, but they can still linger for a long time or even be considered permanent in some cases. Examples include:

Red or Purple Marks (Post-inflammatory Erythema): These are discolorations that remain after acne has healed. They often fade on their own, but it can take several weeks to months for them to go away completely.

Brown Marks (Post-inflammatory Hyperpigmentation): These are dark spots left behind after acne has healed. Like red marks, they may fade over time but can take months to fade significantly.

Small, shallow Depressed Scars: Some shallow indents or depressions left by acne may improve over time and become less noticeable, especially with good skincare and treatments. These are often referred to as atrophic scars.

Permanent Scars: These are scars that typically do not go away on their own and require more intensive treatments to improve their appearance. Examples include:

Deep Ice Pick Scars: These are deep, narrow, and pitted scars that often resemble small holes in the skin.

Hypertrophic Scars and Keloids: Raised, thickened scars that form due to excessive collagen production during the healing process.


Acne scars occur due to the skin's natural healing process after significant inflammation and tissue damage caused by acne lesions. Despite advancements in dermatological procedures and technologies, certain types of scars, particularly deep and atrophic ones, may remain relatively resistant to complete removal. This permanence of acne scars underscores the importance of early and effective acne management to prevent severe lesions that are more likely to result in permanent scarring.


Is there any way to speed up the healing of acne scars?

  1. While the healing process of acne scars can vary from person to person, maintaining good skincare practices, protecting the skin from sun exposure, and following dermatologist-recommended treatments can aid in speeding up the healing process.

Can people with darker pores and skin tones go through zits scar remedies?

  1. Yes, many acne scar treatments are suitable for individuals with darker skin tones. However, certain procedures, such as laser therapy, may carry a higher risk of pigmentation changes in darker skin, so it's important to consult a skilled dermatologist experienced in treating diverse skin types.

Are acne scar treatments effective?

  1. The effectiveness of acne scar treatments varies depending on the type and severity of scars, as well as individual skin response. Some treatments can yield significant improvements, while others may have limited results.

Can over-the-counter products completely remove acne scars?

  1. Over-the-counter products, such as creams and ointments, may help improve the appearance of mild acne scars and reduce redness or discoloration. However, they are generally not powerful enough to eliminate deep or permanent scars.

Are there any dangers or side results related to acne scar treatments?

  1. However, potential risks include temporary redness, swelling, and irritation. In some cases, more invasive procedures may carry a higher risk of complications.


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