A doll head with acne spots

Dealing with acne can be such an ordeal, and unfortunately it doesn’t end there. You also have to deal with the scars and marks they leave behind. The skin damage that acne leaves may confuse most of us. Sometimes what seem like deep scars are actually superficial marks that will heal over time. It is imperative to know the difference between scarring and post-inflammatory pigmentation, also called PIH. Spots that are usually pinkish, reddish, or purple-colored are post-inflammatory erythema or PIE.
PIH and PIE are both discoloration conditions and are not technically acne scarring. However, the term “scars” is often used to refer to them. Hyperpigmentation and erythema issues, and acne scars require different treatment methods, so it is crucial to know how they differ.
The Difference
If you want to test whether you are dealing with an acne mark or a scarring, you can try stretching the surface of the skin. If you slightly stretch your skin and the spots disappear for a moment, what you have are acne spots that will fade over time, and not scars.
Acne Marks
Those who have light or pale skin tones may notice that their acne marks are red, pink, or purple. This condition is called erythema. Acne sufferers who have darker skin tones may find their acne marks turn brown or black. This is called post-inflammatory hyperpigmentation. Erythema and hyperpigmentation can be frustrating and unsightly, but the good news is they will eventually fade with time. To help with the healing, you may find these tips helpful:
  • Whenever possible, avoid the sun’s harmful ultraviolet rays as they can darken already pigmented spots on your skin.
  • If you have to be exposed to the sun, make sure to use a high SPF broad spectrum sunscreen diligently and correctly. Do not make the mistake of skipping the sunscreen just because it is overcast or the sky is gray.
  • To speed up the healing process, use retinols and dark spot treatment options.
  • Popping or picking at pimples may cause scarring. Do not do it.
  • Be patient as acne marks may take 3 to 24 months to fade.
Acne Scars
Scarring from acne involves damage or indentations in the skin. Acne scars run deeper because the damage breaks down the support structure in deeper layers of the skin. Deep scarring affects the underlying collagen of the skin, which causes the skin to heal with fibrous tissue instead. In the process of repairing the damage, the skin creates new collagen fibers, which causes scars to form and the repaired skin to not appear as smooth or soft as it once was. Don’t despair, though, as scarring can be treated and does not have to be a lifelong condition. There are proactive, surgically-invasive, and less invasive treatment procedures for acne scars that can reverse abnormalities and skin indentations. 
This article is a revised version of and an excerpt from the “Ultimate Guide to Scars from Pimples and Cystic Acne,” which can be found here.

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