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  • Share your skin goals and snap selfies

  • Your dermatology provider prescribes your formula

  • Apply nightly for happy, healthy skin

What causes pockmarks? Here’s what skincare experts say

Acne scars won’t go away, but you can treat them to help minimize their appearance.

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Curology Team
Sep 26, 2022 · 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 causes pockmarks? Here’s what skincare experts say

Pockmarks are concave scars that result from damage to the deeper skin layers from acne, trauma, or infection. They’re sometimes used as a general term for atrophic acne scars (icepick scars, rolling scars, and boxcar scars). Pockmarks don’t disappear on their own, but there are treatments to reduce their appearance. And the sooner you begin treatment, the better results you’ll get. 

We’ll discuss how to get rid of pockmarks with in-office procedures and reveal if home remedies actually work. But first, let’s dive into what pockmarks are and what causes pockmarks in the first place. 

What are pockmarks?

Lesions caused by severe acne and other types of infections or injuries can damage the tissue below the skin. Severe acne can cause acne scars (often atrophic scars) during the healing process. These often appear as depression or indent resulting from inflammatory damage to the deeper layers of the skin. The result is often an uneven skin tone with small crater-like indents where a spot, like a pimple, once existed. Many people find they tend to become more noticeable with age.¹ In the case of these deep depressions, the skin lacks sufficient collagen to return to its preexisting condition.²,³

Why do I have pockmarks on my skin?

Pockmarks can be frustrating! But knowing what causes pockmarks on the face is the first step toward understanding how to help prevent them from happening in the first place. Some of the more common causes include:

  • Acne. These can occur with acne that damages the deeper layers of the skin. Atrophic acne scars are divided into three types of scars: ice pick, boxcar, and rolling scars. Ice pick scars are narrow, deep-penetrating scars resembling puncture wounds. Boxcar scars are round or oval depressions with sharply demarcated edges. Rolling atrophic scars are wider and rolling in appearance. 

  • Infectious diseases. Chickenpox and other infectious diseases that leave blemishes on your face and body can also cause pockmarks. Scratching or picking at blisters that form can aggravate the skin or cause infection, leading to scar tissue. Smallpox famously left behind pockmarks, but this disease has been eradicated with vaccines. 

  • Trauma. Injuries, burns, or surgery can cause pockmarks after healing.

How to treat atrophic acne scars?

Although there aren’t great options for pockmark treatments at home, there are some in-office procedures that effectively treat pockmarks to help reduce their appearance. You’ll need to work with an in-person dermatology provider or skincare specialist. But it’s definitely worth the consult! 

The American Academy of Dermatology cautions that treatments can reduce the size and visibility, but it takes time for acne scars to fade. The results you receive depend on the skill and knowledge of your provider.

  • Dermabrasion and microdermabrasion. Think of dermabrasion as the big sibling to microdermabrasion. More specifically, it works by removing the top and middle skin layers, which requires various forms of anesthesia. While microdermabrasion can be completed by a skin care specialist, and both microdermabrasion and dermabrasion use abrasives to remove skin cells, dermabrasion is a more invasive procedure that must be done by a medical provider. Microdermabrasion often works best with smaller surface scars and typically needs to be repeated regularly to see results. Dermabrasion, on the other hand, uses devices such as a sanding machine to remove skin cells from the epidermis and upper dermis layers of the skin, but it isn’t necessarily always effective for eliminating deep scars. While microdermabrasion typically has minimal risks, dermabrasion can possibly lead to new scars, enlarged pores, infection, and blotchy skin tone.⁴

microneedle therapy on woman
  • Microneedling. This is often referred to as collagen induction therapy. Microneedling encourages your body to produce new collagen by gently puncturing your skin with a handheld needle-studded roller. Collagen is produced during the healing process, although the results are gradual. Side effects typically diminish within a few days. Those with depressed scars often report noticeable results from microneedling.⁵ 

  • Chemical peels. Acids like glycolic acid, salicylic acid, and trichloracetic acid (TCA) are often used to treat small, depressed scars but may not be effective for treating deeper scars. They can boost cell regeneration. In-office peels are deep exfoliation treatments. Side effects can include peeling, redness, and burning. But they’re not usually a one-and-done treatment. You’ll probably need to get multiple chemical peels to see a difference.⁶

  • Dermal fillers.⁷ Fillers are great options for many people. Fillers may include collagen or fat-based substances injected directly into the affected area. They work by plumping depressed areas to help even skin texture.⁸ There are temporary, semi-permanent, and permanent fillers. For temporary and semi-permanent fillers, results usually last between six to 18 months. 

  • Ablative and non-ablative laser resurfacing. Whitney Tolpinrud, a board-certified dermatologist at Curology says, “Collectively, these types of lasers work by stimulating collagen remodeling which can help rejuvenate the skin. Ablative resurfacing lasers remove the surface of the skin and are considered more aggressive than non-ablative lasers. There can be downtime—usually a week or two—but the results can be seen after just one treatment and may last up to a few years. Some side effects may include oozing, redness, pigmentation changes, and even some scarring. Non-ablative laser resurfacing is the little sister to ablative treatment. These lasers work by heating up the skin without affecting the surface of the skin. It often requires multiple sessions and is typically not as effective as an ablative treatment.”

Are pockmarks permanent?

Pockmarks are scars left behind often from infected blemishes. While they are permanent, there are treatment options to minimize their appearance.⁹ Timely prevention and acne scar treatment are key. In the meantime, avoid aggravating acne or other blemish-related conditions or infections.

  • Avoid popping your pimples. Picking, popping, and squeezing can lead to permanent acne scars.¹⁰ 

  • Avoid scratching chickenpox. You want chickenpox to heal on its own without exacerbating the condition. As difficult as it may be, try not to scratch! 

  • Treat acne properly. If you have moderate to severe acne, see a dermatologist for treatment. Prescription-strength acne creams might be your best option for preventing pockmarks. 

Expert dermatology guidance at your fingertips

Dealing with severe acne is a pain in the you-know-what and can feel like a stab in the dark. Getting professional guidance from a dermatology provider eliminates the guesswork, so you have healthier-looking skin faster. Curology is a service-first custom skincare company built around providing expert guidance to licensed dermatology providers. We’re not going to sell you something that doesn’t work. We want to be partners with you along your skincare journey.  

Get your personalized skincare routine with Curology

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We know the best way to treat acne scars is to stop them before they occur. That’s why we focus on how to prevent pockmarks using proven effective ingredients like tretinoin, clindamycin, and spironolactone to treat acne. Once paired with a dermatology provider, we’ll create a personalized prescription formula for you—depending on your unique skin type and condition. 

Sign up for a free 30-day trial of Curology to get your customized skincare routine and expert guidance. Just pay $4.95 (plus tax) to cover shipping and handling on your first box.*

FAQs

What are pockmarks?

Lesions caused by severe acne and other types of infections or injuries can damage the tissue below the skin. Severe acne can cause acne scars (often atrophic scars) during the healing process. These often appear as depression or indent resulting from inflammatory damage to the deeper layers of the skin. The result is often an uneven skin tone with small crater-like indents where a spot, like a pimple, once existed.

Why do I have pockmarks on my skin?

Knowing what causes pockmarks on the face is the first step toward understanding how to help prevent them from happening in the first place. Some of the more common causes include:

  • Acne. These can occur with acne that damages the deeper layers of the skin.

  • Infectious diseases. Chickenpox and other infectious diseases that leave blemishes on your face and body can also cause pockmarks.

  • Trauma. Injuries, burns, or surgery can cause pockmarks after healing.

Are pockmarks permanent?

Pockmarks are scars left behind often from infected blemishes. While they are permanent, there are treatment options to minimize their appearance. Timely prevention and acne scar treatment are key. In the meantime, avoid aggravating acne or other blemish-related conditions or infections.

• • •

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

  1. American Academy of Dermatology. Scars: Signs and symptoms. (n.d.).

  2. Tara Jennings, et al. Acne scarring-pathophysiology, diagnosis, prevention and education - Part 1. J Am Acad Dermatol. (2022, July 2).

  3. Gabbrocini, G., et al. Acne scars: Pathogenesis, classification, and treatment.Dermatology Research and Practice. (2010, October 14).

  4. Rivera, A.E. Acne scarring: A review and current treatment modalities.Journal of the American Academy of Dermatology. (2008, July 28).

  5. Deirdre Connolly, et al. Acne Scarring—Pathogenesis, Evaluation, and Treatment Options. J Clin Aesthet Dermatol. (September 2017).

  6. Vijay Kumar Garg et al. Glycolic acid peels versus salicylic-mandelic acid peels in active acne vulgaris and post-acne scarring and hyperpigmentation: a comparative study. Dermatol Surg. (January 2009).

  7. Deirdre Connolly, et al. Acne Scarring—Pathogenesis, Evaluation, and Treatment Options. Ibid.

  8. American Academy of Dermatology. Acne scars: Diagnoses and treatment. (n.d.).

  9. American Academy of Dermatology. Scars: Will my scar go away? (n.d.).

  10. American Academy of Dermatology. Pimple popping: Why only a dermatologist should do it. (n.d.).

* Subject to consultation. Subscription is required. 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

Meredith Hartle, DO

Meredith Hartle, DO

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