Usually, the mild form of acne occurring in most people does not produce scars, or if it does, the scarring heals by itself over time. But people suffering from aggressive forms of acne such as nodular cystic acne might be left with deep scarring in the skin.

There are also spots and pigmentation related with acne that are not exactly scars but resemble them in appearance. These disappear with time but are evident enough to cause embarrassment. Macules are such pseudo-scars, which are sometimes a consequence of an inflamed acne lesion. A macule is nothing but a flat, red patch that is the final stage of any inflamed lesion. Unlike a scar, a macule can take time to fade, but once it vanishes, it leaves no trace behind.

Then there is the skin's discoloration after the healing of any inflamed acne lesion. It is more common in dark skinned people, but can happen in white skin also. This is known as "Post inflammatory pigmentation". It may require treatment by a specialist.

Based on the shape of tissue, acne scars are divided in two categories. One type of scar consists of increased skin tissue, and the others are characterized by the decrease in tissue on the site of lesion. An exaggerated growth of scar tissue is known as Keloid and is more noticeable in African-Americans. The deep, linear scar derived from acne is known as the ice-pick scar. These are very deep and their removal is difficult.

Different Responses to Acne Scars

In some people scars heal quickly while some others form permanent scars. Psychologically, people demonstrate different reactions to acne scarring. Some people think about scarring as something normal, while there are others who are alarmed about even the smallest mark and go to great lengths to reduce acne scars.

More frequent are acne scars caused by the loss of tissue. These are like the scars left by chicken pox. These scars include ice-pick scars, soft tissue scars and depressed fibrotic scars. Ice-pick scars usually appear on the cheek. These are small but with steep, jagged edges which makes their healing or treatment difficult. Sometimes these tiny scars become quite large and steep, with sharp edges, which are then called depressed fibrotic scars. Then there are soft scars, both superficial and deep. These are small with rolling edges merging with the healthy skin. They are either circular or linear in shape.

Pinching and squeezing acne can also lead to acne scarring. This spreads the infection to surrounding skin and harms unhealed tissue, which results in pit-like scars.