Commonly, the mild type of acne occurring in most people does not produce scars, or if it does, the scarring heals naturally over time. But people suffering from severe forms of acne such as nodular cystic acne can be left with deep scarring in the skin.

There are also marks and pigmentation that relate to acne that are not exactly scars but resemble them in appearance. These disappear eventually but are evident enough to cause embarrassment. Macules are like pseudo- scars, which are sometimes left behind by an inflamed acne lesion. These flat red spots are nothing but the final stage of any inflamed lesion. Unlike a scar, a macule can take time to disappear, but once it vanishes, it leaves no marks behind.

A discoloration of the skin my occur after the curing of any inflamed acne lesion. It is more frequent in dark skinned people, but can occur in white skin also. This is called "post inflammatory pigmentation." It can require treatment by a dermatologist.

Finding solutions for different acne scars

Based on the shape of tissue, acne scars are classified in two categories. One type of scar consists of increased skin tissue, and the others are recognized by the decrease in tissue on the site of acne. Overgrowth of scar tissue is called Keloid and is more noticeable in African-Americans. The deep, linear scar created by acne is called the ice-pick scar. These are very deep and eliminating them is difficult.

One more cause of acne scarring is the pinching and squeezing of acne. This spreads the infection to nearby skin and damages weakened tissue, which results in pit-like scars.

Treatment of acne scars varies from simple acne scar cream to laser treatment, skin graft, and aggressive dermabrasion. Filling agents are also used to eliminate acne scars. Most filling agents are temporary, like collagen. For deep ice-pick scars, the best treatment is to extract the scars and replace them with a skin graft taken from behind the ear. This technique is called punch grafting.

Dermabrasion is almost the opposite of the cutting down technique. Here, the healthy skin is eliminated to bring the acne scar to a lower level. In this case the scar remains the same but the height of rest of the skin varies, making them shallower. It confers skin a softer surface.

In acne scar treatment, another option is laser surgery. In this treatment, carbon dioxide is used, which eliminates skin very finely, layer by layer, thus minimizing the harm to healthy tissue. Like dermabrasion, this procedure also leaves skin red for months.

In peeling treatments, chemicals are used to eliminate the external layer of skin, the epidermis. To reduce different types of scars, superficial peels, medium-depth peels, and deep peels are used. These are mostly useful for shallow, external scars. Scars produced by cystic acne and acne rosacea are treated by this procedure. Peeling is a long procedure that requires a preparation period of several weeks before the actual intervention.