Commonly, the mild form 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 types of acne like nodular cystic acne can be left with deep scarring in the skin.

There are also marks and pigmentation associated with acne that are not precisely scars but resemble them in appearance. These disappear eventually but are evident enough to cause embarrassment. Macules are similar to pseudo- scars, which are usually 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 can take time to fade, but once it vanishes, it leaves no trace behind.

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

Treatment options for scar varieties

Based on the shape of tissue, acne scars are divided in two categories. One kind of scar consists of increased skin tissue, and the others are specified by the diminution in tissue on the site of acne. Overgrowth of scar tissue is called Keloid and is more pronounced in African-Americans. The profound, linear scar created by acne is called the ice-pick scar. These are quite deep and eliminating them is difficult.

One more cause of acne scarring is the pinching and squeezing of acne. This expands the infection to surrounding skin and harms unhealed tissue, which results in pit-like scars.

Treatment of acne scars ranges from simple acne scar cream to laser treatment, skin graft, and painful dermabrasion. Filling agents are also applied to remove acne scars. Most filling agents are provisional, 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 called punch grafting.

Dermabrasion is almost the opposite of the cutting down technique. Here, the normal skin is removed to bring the acne scar to a lower level. In this case the scar remains the same but the height of rest of the skin changes, making them shallower. It confers skin a softer surface.

In acne scar treatment, another method is laser surgery. In this treatment, carbon dioxide is applied, 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 treatments, chemicals are used to remove the external layer of skin, the epidermis. To reduce different kinds 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 needs a preparation period of several weeks before the actual procedure.