Usually, the mild type of acne occurring in most people does not leave scars, or if it does, the scarring fades naturally over time. But people suffering from severe forms of acne like nodular cystic acne might be left with noticeable scarring in the skin.

There are also marks and pigmentation that relate to acne that are not exactly scars but resemble them physically. These disappear eventually but are visible enough to cause embarrassment. Macules are similar to pseudo- scars, which are sometimes left behind by an inflamed acne pimple. These flat red spots are just the final stage of any inflamed lesion. Unlike a scar, a macule might take time to disappear, but once it vanishes, it leaves no marks behind.

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

Treatment options for scar varieties

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

Another cause of acne scarring is the pinching and squeezing of acne. This expands the infection to surrounding skin and damages weakened tissue, which results in pit-like scars.

Treatment of acne scars ranges from simple acne scar cream to laser therapy, skin graft, and painful dermabrasion. Filling agents are also used to remove acne scars. Most filling agents are temporary, like collagen. For deep ice-pick scars, the best treatment is to cut the scars and substitute them with a skin graft taken from behind the ear. This technique is known as 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. This way the scar remains the same but the level of rest of the skin varies, making them shallower. It confers skin a smoother surface.

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

In peeling therapies, chemicals are used to remove the outermost layer of skin, the epidermis. To diminish different types of scars, superficial peels, medium-depth peels, and deep peels are used. These are mostly useful for shallow, superficial scars. Scars left by cystic acne and acne rosacea are treated by this procedure. Peeling is a long procedure that requires a preparation period of many weeks before the actual procedure.