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  • Your dermatology provider prescribes your formula

  • Apply nightly for happy, healthy skin

What to do about post-inflammatory hyperpigmentation and acne scars

Help bid blemish scars goodbye! Tips to help heal skin after acne

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Curology Team
Apr 11, 2018 · 6 min read

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We’re here to share what we know — but don’t take it as medical advice. Talk to your medical provider if you have questions.
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  3. > What to do about post-inflammatory hyperpigmentation and acne scars

Scars can be an unfortunate lasting effect of acne, even after your breakouts clear up completely. And while not everyone experiences post-acne spots that appear after their skin heals from stubborn blemishes—be it acne scars or post-inflammatory hyperpigmentation (which are often confused!)—many people unfortunately do.

True scars will not resolve with a topical skincare product alone, but daily use of your Curology Custom Formula can help speed up the fading of post-acne pigmentation. Acne scars may be more difficult to treat, but there are options out there.

Icepick scars acne in the cheek of a woman

What are acne scars?

The simple answer: acne scars are marks left behind from an acne lesion. The scar forms as a result of the wound healing process (an extremely complex process!).¹ Acne marks can be raised, shallow, or deep, depending on the pimple and how it heals.

What are the types of acne scars?

Your acne scar may appear different depending on the type. There are two major categories of acne scars: atrophic and hypertrophic.²

Types of Acne Scars Infographic

Atrophic acne scars

Also called depressed scars, atrophic scars come in several different forms³:

  • Ice pick. These scars resemble the shape of their name; ice pick scars are wide on the surface and narrow to a point as they go deeper into the skin.

  • Rolling. Characterized by sloped edges, these scars mostly appear on your cheeks and jawline.

  • Boxcar. These scars are indents with sharp edges and are common on the cheeks and jaw.

Hypertrophic acne scars

These acne scars are raised as a result of collagen and fibrosis tissue growing more than necessary. They remain within the borders of the original lesion. Keloids are similar to hypertrophic scars, but they extend beyond the border of the original lesion. They can be itchy and painful to the touch.⁴

What is the difference between acne scars and post-inflammatory hyperpigmentation?

Post-inflammatory hyperpigmentation is a common skin condition that is often incorrectly referred to as “acne scars”. The difference is that post-inflammatory hyperpigmentation appears as dark spots on your skin rather than indents or raised scars. 

Hyperpigmentation is caused by many different things, including sun damage, past skin injuries (such as acne),⁵ genetics, and hormonal changes.⁶

There are a variety of treatments available for post-inflammatory hyperpigmentation, including over-the-counter ingredients such as vitamin C, prescription medications such as tretinoin, and chemical peels.⁷

Acne Spots Post-inflammatory hyperpigmentation

What are the medical scar treatments available?

If you’re wondering how to get rid of or improve the appearance of acne scars, we need to be honest with you. Depressed, hypertrophic, and keloid scars will not go away with topical treatments (although certain topical medications may help in the long term due to their collagen-boosting effect!). Keep in mind, though, that dermatologists and other healthcare professionals can perform many different in-office procedures that can help improve scarring.⁸

  • Injections. If you have a raised acne scar, an injection of corticosteroids directly into the scar may help flatten the tissue. You might need to have multiple injections for one scar to see a significant difference. If the scar isn’t improving after several injections, you may be better off seeking another type of treatment. 

  • Microneedling (aka collagen induction therapy). This method of treating acne scars stimulates your skin to produce more collagen to heal the scars. The treatment consists of a roller with many small needles going over the affected area to stimulate collagen production over a larger area rather than just a targeted scar.⁹

  • Skin tightening. Dermatologists may use radiofrequency on the skin to reduce the appearance of depressed acne scars. With this treatment, you’ll need multiple appointments and may notice some side effects, including burning and sensitivity to the sun. After a skin tightening appointment, make sure to apply SPF 30 or higher of a broad-spectrum sunscreen to help block harmful UV rays.¹⁰

  • Filler. If you have a depressed acne scar, a dermatologist may use filler to make the indentation less noticeable.¹¹ The filler may be made of collagen or fat from your own body. Keep in mind, though, that filler is typically a temporary treatment.

  • Resurfacing procedures. A common way to fade the appearance of acne scars is through chemical peels, microdermabrasion, and laser skin resurfacing treatments.¹² The procedures work just as the name suggests; they remove layers of skin with the goal that your skin grows back with less prominent scarring. This treatment typically only works for shallow scars, and you may need to try another method to tackle those deeper persistent marks.

  • Surgery. While this might sound drastic, if you have a very noticeable scar you want to fade, and nothing else is helping, a dermatologist may surgically break up the scar tissue to make it less noticeable as it heals.¹³ The surgery is minor, so no need to fear, but this may be the last resort for fading acne scars.

How to help prevent acne scars

The best way to help prevent acne scars is to prevent acne itself. Here are our dermatologist-approved tips on how to help avoid scarring from your blemishes:

  • Hands off! Yes, we know it can be super tempting to pick at those stubborn pimples. But the truth is it’s best to just leave them alone. Picking and popping blemishes can cause damage to the skin that leads to scarring. 

  • Use acne-fighting ingredients. Salicylic acid and benzoyl peroxide are two ingredients that target acne. If you’re prone to breakouts, benzoyl peroxide fights the bacteria that contribute to acne, and salicylic acid unclogs pores (and helps keep them that way!)

  • See a dermatologist for especially large blemishes. If you have an inflamed pimple that just won’t go away, a dermatologist may be able to offer treatment that could help prevent scarring, like the ones discussed above.

  • Stick to your skincare routine. When it comes to acne treatment, consistency and patience are key. A simple skincare routine can help prevent breakouts. It might seem like it’s taking too long for your routine to work, but keep calm and be consistent. Clear skin doesn’t happen overnight!

Helping to prevent acne scars can be tricky, but Curology makes it easier with customized skincare. With Curology, you get a personalized Custom Formula made for your unique skin type by licensed dermatology providers. Sign up for a 30-day free trial for just $4.95 + tax (to cover shipping and handling).*

FAQs

What are acne scars?

Acne scars are marks left behind from an acne lesion. The scar forms as a result of the wound healing process (an extremely complex process!). Acne marks can be raised, shallow, or deep, depending on the pimple and how it heals.

What are the types of acne scars?

Atrophic acne scars

Also called depressed scars, atrophic scars come in several different forms:

  • Ice pick. These scars resemble the shape of their name; ice pick scars are wide on the surface and narrow to a point as they go deeper into the skin.

  • Rolling. Characterized by sloped edges, these scars mostly appear on your cheeks and jawline.

  • Boxcar. These scars are indents with sharp edges and are common on the cheeks and jaw

Hypertrophic acne scars

These acne scars are raised as a result of collagen and fibrosis tissue growing more than necessary. They remain within the borders of the original lesion. Keloids are similar to hypertrophic scars, but they extend beyond the border of the original lesion. They can be itchy and painful to the touch.

What is the difference between acne scars and post-inflammatory hyperpigmentation?

Post-inflammatory hyperpigmentation is a common skin condition that is often incorrectly referred to as “acne scars”. The difference is that post-inflammatory hyperpigmentation appears as dark spots on your skin rather than indents or raised scars. 

Hyperpigmentation is caused by many different things, including sun damage, past skin injuries (such as acne), genetics, and hormonal changes.

What are the medical scar treatments available?

  • Injections. If you have a raised acne scar, an injection of corticosteroids directly into the scar may help flatten the tissue. You might need to have multiple injections for one scar to see a significant difference. If the scar isn’t improving after several injections, you may be better off seeking another type of treatment. 

  • Microneedling (aka collagen induction therapy). This method of treating acne scars stimulates your skin to produce more collagen to heal the scars. The treatment consists of a roller with many small needles going over the affected area to stimulate collagen production over a larger area rather than just a targeted scar.

  • Skin tightening. Dermatologists may use radiofrequency on the skin to reduce the appearance of depressed acne scars. With this treatment, you’ll need multiple appointments and may notice some side effects, including burning and sensitivity to the sun.

  • Filler. If you have a depressed acne scar, a dermatologist may use filler to make the indentation less noticeable. The filler may be made of collagen or fat from your own body. Keep in mind, though, that filler is typically a temporary treatment.

  • Resurfacing procedures. A common way to fade the appearance of acne scars is through chemical peels, microdermabrasion, and laser skin resurfacing treatments.

  • Surgery. While this might sound drastic, if you have a very noticeable scar you want to fade, and nothing else is helping, a dermatologist may surgically break up the scar tissue to make it less noticeable as it heals. The surgery is minor, so no need to fear, but this may be the last resort for fading acne scars.

Get your personalized skincare routine with Curology

Subject to consultation. 30-day trial. Just cover $4.95 in S&H.
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Curology is here for your whole skin journey. Ask your Curology provider if you want to adjust your formula to help more with a post-acne routine. If your acne is in remission, we can update your formula to focus more on other skin concerns, like fading hyperpigmentation. That’s because Curology is made for your unique skin goals.

P.S. We did the research so you don’t have to:

  1. Fabbrocini, G., et al. Acne scars: pathogenesis, classification and treatment. Dermatology research and practice. (2010).

  2. Gozali, Maya Valeska, and Bingrong Zhou. Effective treatments of atrophic acne scars.The Journal of clinical and aesthetic dermatology. (May 2015). 

  3. Jacobs C.I., et al. Acne Scarring: A classification system and review of treatment options. Clinical Review. (2001, July 10).

  4. Fabbrocini, G., et al. Acne scars: pathogenesis, classification and treatment. Ibid.

  5. Chaowattanapanit, S., et al. Postinflammatory hyperpigmentation: A comprehensive overview: Treatment options and prevention. Journal of the American Academy of Dermatology. (2017).

  6. Resnik, S S. Melasma and other skin manifestations or oral contraceptives.Transactions of the New England Obstetrical and Gynecological Society vol. 21 (1967, n.d.)

  7. Chaowattanapanit, S., et al. Postinflammatory hyperpigmentation: A comprehensive overview: Treatment options and prevention. Ibid.

  8. American Academy of Dermatology, Acne Scars: Diagnosis and Treatment, (n.d.).

  9. Gozali, Maya Valeska, and Bingrong Zhou. Effective treatments of atrophic acne scars. The Journal of clinical and aesthetic dermatology. Ibid.

  10. American Academy of Dermatology, Acne Scars: Diagnosis and Treatment, (n.d.).

  11. American Academy of Dermatology, Acne Scars: Diagnosis and Treatment, (n.d.).

  12. American Academy of Dermatology, Acne scars: Diagnosis and Treatment, (n.d.).

  13. Gozali, Maya Valeska, and Bingrong Zhou. Effective treatments of atrophic acne scars. Ibid.

This article was originally published on April 11, 2018, and updated on May 06, 2022.

We’re here to tell you what we know. That’s why our information is evidence-based and fact-checked by medical experts. Still, everyone’s skin is unique—the best way to get advice is to talk to your healthcare provider.

*Cancel anytime. Subject to consultation. Results may vary.

• • •
Our medical review process:We’re here to tell you what we know. That’s why our information is evidence-based and fact-checked by medical experts. Still, everyone’s skin is unique—the best way to get advice is to talk to your healthcare provider.
Curology Team Avatar

Curology Team

Allison Buckley Avatar

Allison Buckley, NP-C

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