Red Marks & Acne Scars: What's the Difference?

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Acne is enough of an issue on its own, so it's not fair that long after the blemish has healed you're left with red or brown marks where the breakout once was. There are skin care steps you can take to prevent these marks (to the extent possible) and, more important, help them go away faster than they would on their own. We'll also explain the difference between an actual scar and the type of post-breakout discoloration many refer to as a scar.
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Red Marks & Acne Scars: Know the Difference

A common point of confusion for those with acne is knowing the difference between an actual acne scar and a post-breakout red mark or discoloration. Some people who ask us about solutions for acne scars are actually referring to the superficial pink, red, or brown marks from a blemish, which heal over time; others are referring to a genuine acne scar that is the result of deeper damage the blemish left behind. What's the difference?

A scar results when there is damage to the deeper layers of your skin (that is, the skin below what you see on the surface) that has broken down the skin's support structure.

Moderate to severe acne can damage the deeper layers of skin, causing the breakdown of collagen and elastin. This leaves you with an actual indented or "ice-pick" scar. Physical scarring of skin cannot be improved without the aid of medical treatments.

A mild to moderate breakout often leaves a red, pink, or brown discoloration, which eventually fades over time. Although people often refer to such marks as acne scars, they are really post-inflammatory hyper-pigmentation marks, which appear as your body heals. Luckily, such marks are not really scars at all, and it is rare for them to be associated with permanently damaged skin. That means there are steps you can take to speed up their healing and return to clear, even-toned skin!

A quick note: If you have the bad habit of picking at blemishes—don't!—because that can further damage your skin and turn a blemish into a permanent scar, when it could have been just a red mark that diminishes over time. For the details on how to pop a pimple the right way, see our article, How to Pop, Treat, & Conceal a Blemish and consider using a professional comedone extractor tool.

OK, now that we've defined the difference between a post-breakout discoloration and an acne scar, let's talk about the solutions for each!

Treating Red Marks & Acne Scars: What Works (and What Doesn't)

With very few exceptions, skin-care products claiming to eliminate post-breakout discolorations don't work as promised. There are indeed skin-lightening treatments that contain hydroquinone and slow down melanin (which is responsible for giving color to hair, skin, and eyes) production, which reduces the appearance of sun-damaged areas of skin (i.e., brownish discolorations).

However, the pink to red acne marks are not related to melanin, which means that using hydroquinone or other types of skin-lightening ingredients is largely unhelpful. The one exception is for those with darker skin tones where post-acne marks are brownish in color from the skin's pigment, melanin. In those cases, hydroquinone is an option to fade their appearance.

At-home treatments, such as rubbing lemon juice or other citrus fruits on your face, don't work—they can't exfoliate skin properly and their acidic juices are potent skin irritants that can prolong the healing process. Don't fall for that one! There are no solutions in the kitchen for this skin issue.

Following are five ways to fade post-acne discolorations (and treat the underlying causes that lead to breakouts) that work for any skin tone or ethnicity.

Tip No. 1: Use only well-formulated, gentle skin-care products. It's tempting to try abrasive scrubs and all manner of irritating treatments in a desperate effort to get rid of acne discolorations, but irritation only causes more harm, which impedes your skin's ability to heal itself. Scrubs tear into the skin, delaying healing, and products with irritating ingredients also impede healing. Stick to the products we've reviewed and recommended on Beautypedia (or look up ingredients in our research-based Ingredient Dictionary). Of course, all Paula's Choice products are formulated to be gentle and they are all free of irritants.

Tip No. 2: Use an AHA or BHA exfoliant daily. The benefits of a well-formulated AHA or BHA, especially BHA, can be truly impressive. A BHA (beta hydroxy acid, active ingredient salicylic acid) used daily not only exfoliates the surface of the skin but also penetrates oil so it can reach inside the pore, dissolving the clogs that lead to breakouts. BHA is also a potent anti-inflammatory that reduces redness. Thus, in one step, you reduce the likelihood of developing a breakout and you speed the fading of the post-acne marks you have now.

Alpha hydroxy acids (AHAs, like glycolic acid) work on the surface of the skin, which absolutely can help fade discolorations, just like a BHA. However, AHAs cannot penetrate oil and exfoliate inside the pore like BHA, so they are not as adept at treating breakouts or clogged pores.

Tip No. 3: Use a broad-spectrum SPF 15+ product every day, without exception. Unprotected exposure to UV light (which will get to your skin whether it's sunny or cloudy) hurts your skin's ability to heal, which means the red marks from acne will stick around longer. UV exposure damages skin cells (even if you aren't "tanning" or sunburned), making healing slower and less efficient. Protecting your skin from UV exposure every day is critical to fading discolorations, plus it keeps your skin healthier-looking longer!

Paula's Choice has several excellent SPF-rated daytime moisturizers for any skin type! For the face, Paula's Choice Skin Balancing Ultra-Sheer Daily Defense Broad Spectrum SPF 30 is a great choice, as is SkinCeuticals Physical Fusion UV Defense SPF 50.

Looking for an all-over formula for face and body? Try Paula's Choice Extra Care Non-Greasy Sunscreen SPF 50 or Peter Thomas Roth's Uber-Dry Sunscreen Cream SPF 30.

You also can consider combining a foundation or tinted moisturizer rated SPF 15+, and a pressed powder with SPF 15+ as your sunscreen! That can be a great option.

Tip No. 4: Use products loaded with antioxidants and cell-communicating ingredients. Those two categories of beneficial ingredients—antioxidants and cell-communicating ingredients—help defend your skin from further damage, while also "communicating" with your cells to help them speed up their ability to repair damage. The result is reduced inflammation and a shorter healing time for your discolorations. Using a toner, serum, and/or moisturizer formulated with a variety of these ingredients (and in stable packaging; that is, no jars or clear containers) is the best way to get their skin-repairing benefits.

Some types of cell-communicating ingredients, such as niacinamide and retinol, are particularly beneficial in the fight to fade your post-acne annoyances. Two targeted Paula's Choice products to consider are Resist Anti-Aging Clear Skin Hydrator and the super charged Resist Intensive Wrinkle-Repair Retinol Serum. Each is loaded with those cell-communicating powerhouse ingredients, in addition to other complexion improvers like vitamins C and E!

Tip No. 5: Consider professional help. Research shows that post-inflammatory pigmentation—red or brown discolorations where a breakout once was—responds well to a series of Intense Pulsed Light (IPL) treatments. So, if you're desperate, have an imminent social event, and need the discolorations gone sooner than a skin-care routine can accomplish, IPL treatments may be your solution (for those with deeper skin tones, speak with your dermatologist about alternatives laser options to the IPL.) Another option is prescription tretinoin, (Retin-A, Renova), as is a monthly BHA or AHA peel performed by a cosmetic dermatologist.

For true acne scars (the pitted, indented kind), treatment options aren't as easy. Due to the extensive damage to and loss of collagen, no skin-care product can reverse their appearance. Dermal fillers can plump up the indentations, and you can combine dermal fillers with AHA or BHA peels or a series of fractional laser treatments for best results.

Microdermabrasion also is an option, but has much greater risks of damage to skin than laser treatments or higher-strength AHA or BHA peels, and the results aren't as impressive.

Each of the options described above has its advantages and disadvantages, so it is important to discuss them with your dermatologist.

The Bottom Line

Patience, protecting your skin from sun damage, and treating the cause of your breakouts is the best approach to fading post-acne red marks (and reducing the risk of being left with a permanent scar). Following our research-supported tips will help you shorten your skin's healing time, and that means fewer weeks spent with that reminder of breakouts past!

Sources: The Journal of Clinical and Aesthetic Dermatology, December 2013, pags 28-36; British Journal of Dermatology, February 2012, Epublication; Acta Dermato- Vernerologica, October 2011, Epublication; Lasers in Surgery and Medicine, September 2011, pages 787–791; and January 2011, pages 1–7; Journal of Drugs in Dermatology, May 2011, pages 483–489; and Dermatologic Surgery, January 1999, pages 18–22.

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