Skin Care

Dark Marks and Acne Scars: Your Complete Guide

A top dermatologist breaks down what these spots are, why they appear, and how to treat them.

Just like watching Game of Thrones, the physical and emotional effects of acne can last long after an episode disappears. A breakout (or five) is annoying enough, but the dark acne marks and scars it leaves behind are often worse. While there isn't a magic wand that can get rid of them overnight, New York City-based dermatologists Sejal Shah, M.D. and Whitney Bowe, M.D. share how to handle marks and bumps, from prevention to treatment.

What's the difference between acne marks versus acne scars?
In order to treat acne marks and scars, it's helpful to learn how to distinguish between the two. "Patients often mistake dark spots for acne scars but they're actually very different," says Dr. Bowe. "Post-inflammatory hyperpigmentation are red or brown marks that usually go away when you gently stretch out the skin," says Dr. Shah. "These marks can take 3-6 months to go away on their own, and you can expedite the process with a diligent treatment of topical retinoids, vitamin C serums, sunscreen, and over-the-counter brighteners." True acne scars, however, are permanent indentations from collagen damage and can come in many shapes and forms, says Dr. Bowe, and laser treatments and temporary dermal fillers are the only ways to treat the issue. Some scars are thick, raised hypertrophic scars that stick out above the skin; others are keloid, which are scars with over-produced skin tissue. Then, there are atrophic scars that appear as depressions in the skin and they're the most challenging to treat. The three main categories of atrophic scars are:




What causes acne marks and scars?
"The dark spots that remain on skin—called post-inflammatory pigmentary alteration—are caused by inflammation during the skin's healing process. When your skin is opened up, like when you pop a pimple, and then closes back together, you can get abnormal pigmentation, texture, and tone that looks different from the rest of your skin. Sometimes broken blood vessels that remain after an acne lesion fades can result in a mark that appears more red or purple than brown. These are commonly seen in people who are more fair/light skinned," says Dr. Bowe. Since it's so difficult to know what causes one person to scar more than another, the best way to avoid it is to treat acne with a great skin care routine — and that means you need to resist picking, poking, or touching a pimple.


Some acne marks and scars are completely within your control while others are pre-determined. "People with deeper skin tones may develop darker marks or hyperpigmentation, while people with lighter skin tones may notice redness," explains Dr. Bowe. Aside from genetics, there are several lifestyle habits that can make dark marks and scars worse. "Sun exposure can supercharge melanocytes, or pigment-producing cells, causing marks and scars to darken. And, of course, picking or squeezing pimples creates further inflammation and can ultimately lead to more damage," says Dr. Bowe.

How to treat acne dark marks:
"The discoloration from dark marks will usually fade over time," says Dr. Shah. "But there are a number of treatment options to help speed up the process."

Sunscreen: "Sun exposure makes scarring appear more prominent," says Dr. Shah. "And sunlight can even penetrate through your clothing so it's important to be diligent about applying it everywhere, every day." And don't worry about the thought of breaking out from a pore-clogging sunscreen; the latest formulas are more innovative and acne-friendly than ever. Elta MD UV Clear Broad-Spectrum SPF 46 is a top derm-approved favorite. It contains niacinamide, which is an anti-inflammatory that helps reduce redness.

Topical vitamin C serum: "Vitamin C can help build collagen and promotes healing," says Dr. Shah. "SkinCeuticals C E Ferulic serum is a combination of pure L-ascorbic acid, which is vitamin C and absorbs into the skin so that it continues working even long after it dries."

Retinoids: "Retin-A is a superficial treatment that helps with acne marks by causing your skin cells to divide more rapidly and pushing out the cells with the discolored pigment," says Dr. Shah. Retinoids make your skin sensitive to the sun, so it's best to apply a treatment like RoC Retinol Correxion Sensitive Night Cream before you go to sleep.


Skin lighteners: "For marks that are more brownish in color, skin lightening ingredients like retinol, vitamin C, hydroquinone, kojic acid, or licorice could help. Try L'Oréal Paris Youth Code Dark Spot Correcting & Illuminating Serum Corrector, which helps to reverse hyperpigmentation and prevent further discoloration. Skin lightening ingredients don't work as well for pink or red acne marks that are not related to the skin's pigment or melanin. These should be treated with sun protection and can be lightened significantly using a laser called a pulsed-dye laser that targets hemoglobin (red pigment). It usually takes three treatments to make them go away completely but they can lighten up significantly even after just one treatment," says Dr. Bowe.

"If you're not seeing improvement within three months from using over-the-counter treatments, it might be time to see your derm to see if a stronger topical prescription or a laser treatment is an option," says Dr. Shah.

How to treat acne scars:





There you have it! The bad news is that you're probably going to have to deal with dark marks or acne scars at some point in your life, but the good news is that technology has come a long way in making them temporary and treatable. As with any skin condition, it's best to consult your regular dermatologist to see what the best option is for you.

Watch to learn how you can cover up acne scars and dark marks:


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