It can be tough to tell the difference between acne marks and scars right off the bat. They’re both blemishes that appear on the skin’s surface, and they typically appear in the aftermath of a breakout.

But acne scars and marks have different causes, symptoms, and treatments. Plus, one is much more likely to be a permanent lesion than the other. In order to seek effective treatment, it’s important to be able to identify which one you may have. So how can you tell the difference? We’ve got you. Here, we’ll cover everything you need to know about acne marks and scars and how they differ.

What is the difference between acne marks and acne scars?

Acne marks and scars may sound like the same thing, and it can be difficult to tell the difference between the two at first glance. Before exploring treatment options, let’s learn a little about what separates these different kinds of skin lesions.

What are acne marks?

Acne marks are also known as dark marks, dark spots, and post-inflammatory hyperpigmentation.¹ When the skin produces too much melanin—a dark pigment that causes our skin to tan—it spreads to surrounding skin cells and shows up as acne marks. Typically, these blemishes are caused by inflamed skin leading to overproduction of melanin, although there are other causes, too.²

If the extra melanin occurs in the epidermis (the outermost layer of the skin), acne marks can look tan, brown, or dark brown. If it manifests in the dermis, the layer just below, you’ll typically see marks with a blue-gray hue.³

Acne marks are more common in darker-skinned people—one study found that 65.3% of African-American, 52.7% of Hispanic, and 47.4% of Asian people evaluated got them.⁴ However, they can happen to anyone!

What are acne scars?

Acne scars are caused by inflamed lesions. These scars occur when the wall of a follicle (the area of our skin that lies beneath a pore) breaks. Typically, this happens when a pore swells because of too much oil or bacteria. Smaller acne scars may heal fairly rapidly, while bigger ones can affect surrounding tissue and lead to further scarring of the skin.⁵

There are two main types of acne scars: atrophic and hypertrophic. You can get atrophic scars after losing too much collagen, while hypertrophic scars can come from too much collagen production. The vast majority of acne scars (up to 90%) are atrophic.⁶ 

Atrophic acne scars can be categorized as rolling, ice pick, or boxcar scar. Treatment options depend on which type you have. The most common type are ice pick scars, followed by boxcar and then rolling.⁷

Unlike acne marks, acne scars are more likely to be permanent. It can be tricky to figure out which type you have, so it’s helpful to consult a licensed dermatology provider, like those at Curology, to learn more.

What causes acne marks?

Acne marks are primarily caused by inflamed skin. However, you may get them for a few different reasons, including:⁸

• Allergic reactions from bug bites or contact with allergens

• Psoriasis

• Fungal infections

• Reactions to medications

• Exposure to irritating substances

• Cuts

• Burns

• Cosmetic procedures

• Razor bumps

• Acne

• Eczema

• Impetigo (a skin infection)

Plus, acne marks can get worse with UV exposure (sun exposure) or recurring inflammation. Protect your skin with Curology’s sunscreen, which reflects UVA and UVB rays without clogging pores, and Curology’s Acne Cleanser, which uses benzoyl peroxide to help shut down persistent pimples while being kind to your skin.

Treatment options for acne marks

It is possible for acne marks to go away on their own. However, you may also want to investigate the following treatment options, some of which require a professional’s help.

Topical depigmenting agents and photoprotection

Since acne marks typically result in dark spots (i.e., pigmentation), a depigmenting agent may be able to help treat them. Common examples include kojic acid, hydroquinone, soy, niacinamide, and some licorice extracts. Photoprotection, in the form of an effective sunscreen, should be used in conjunction with depigmenting agents to make sure acne marks don’t get worse.⁹

Topical retinoids & other ingredients

A variety of ingredients that may be able to help:¹⁰ ¹¹

1. Tretinoin can help prevent acne marks from worsening and can help improve post-inflammatory hyperpigmentation.

2. Azelaic acid is a depigmenting agent that helps improve dark spots. 

3. Niacinamide is a form of vitamin B3 with antioxidant activity and can help fade dark spots.

4. Tranexamic acid has been shown to reverse hyperpigmentation by helping to slow down the enzymes that produce melanin.

We currently offer all of the above ingredients at Curology. If you would like more information about these ingredients, consult one of our licensed dermatology providers, who can answer questions you may have about these ingredients.

Chemical peels and laser treatments

Chemical peels with glycolic acid, salicylic acid, trichloroacetic acid, or Jessner’s solution (a superficial peeling solution) may help with hyperpigmentation. Laser treatments like Nd:YAG laser therapy, blue light photodynamic therapy, and fractional photothermolysis have also been shown to improve the appearance of acne marks.¹²

If you’re interested in these types of therapies, seek professional help in-person. 

What causes acne scars?

Typically, acne scars are caused by severe breakouts that affect the deeper layers of the skin. When we heal, we sometimes produce too much or too little collagen. Here are a few different reasons why collagen dysregulation can happen:¹³

• Inflammation

• Excess oil production

• Improper wound healing

• Blocked hair follicles

In these instances, acne scars are more likely to occur:¹⁴

• If you pick or pop your pimples

• If acne scars run in your family

• If you put off or don’t get treatment for your acne

• If you get acne cysts or nodules, which affect deeper layers of the skin

And remember, everyone’s skin is different—the severity and likelihood of developing acne scars can vary person-to-person. The same applies to recovery speed, but as a general rule, proper and timely treatment can help minimize the scar’s longevity and promote better healing.

Treatment options for acne scars

Acne scars typically require treatment from professionals—here are a few examples of treatments they may recommend.

Topical tretinoin

Topical retinoids, like tretinoin, stimulate the production of collagen, according to Curology board-certified family nurse practitioner Melissa Hunter. Over time, they can help diminish the appearance of acne scars.

Laser skin resurfacing

Multiple-pass carbon dioxide laser skin resurfacing can help treat photodamaged and acne-scarred skin and may help people with darker skin in particular. However, it can come with potential side effects like skin redness and discoloration.¹⁵

Dermabrasion

While dermabrasion has mostly been replaced by resurfacing lasers, this technique can help soften scar edges. And it’s important to note that side effects like further scarring can occur, and the healing process can be lengthy and sometimes painful.¹⁶

Chemical peels

Chemical peels speed up the healing process by getting rid of the affected outer layers of the skin. They tend to be more effective on some types of lesions than others. However, ice pick and rolling acne scars won’t go away completely with a peel, so in some cases, they should be paired with topical retinoids and AHAs to help increase efficacy.¹⁷ These treatments should always be administered by an in-person provider, never at home without a professional’s help.

In general, it’s ideal to treat inflammation from acne early to prevent acne scars. The longer inflammation occurs, the more serious the scar can get.¹⁸

Curology treats acne

While acne scars can be more severe and long-lasting than acne marks, both can be difficult to deal with and may require professional help to treat. If you’re not sure which kind of lesion you’re experiencing, it’s a good idea to consult a licensed dermatology provider, like those at Curology. Prevention is key—and luckily, Curology also treats acne!

Get your personalized skincare routine with Curology

Get your personalized skincare routine with Curology

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Early treatment can help prevent the marks and scars that can come after a breakout, and a licensed dermatology provider at Curology can meet with you one-on-one to create your personalized treatment plan. All you have to do is sign up* and share your skincare history, along with a few pictures of your skin concerns. You’ll get your questions answered, and your customized skincare sent straight to your door.

P.S. We did the homework, so you don’t have to:

1. Davis, E., et al. Postinflammatory hyperpigmentation: a review of the epidemiology, clinical features, and treatment options in skin of color. J Clin Aesthet Dermatol. (2010, July). 

2. Davis, E. et al. Postinflammatory Hyperpigmentation. J Clin Aesthet Dermatol. (2010, July). 

3. Davis, E. et al. Postinflammatory Hyperpigmentation. J Clin Aesthet Dermatol. Ibid.

4. Davis, E. et al. Postinflammatory Hyperpigmentation. J Clin Aesthet Dermatol. Ibid.

5. American Society for Dermatologic Surgery. Acne Scars. (2023).

6. Fabbrocini, G., et al. Acne Scars: Pathogenesis, Classification and Treatment. Hindawi. (2010, October 14).

7. Fabbrocini, G., et al. Acne Scars: Pathogenesis, Classification and Treatment. Hindawi. Ibid.

8. Davis, E. et al. Postinflammatory Hyperpigmentation. J Clin Aesthet Dermatol. Ibid.

9. Davis, E. et al. Postinflammatory Hyperpigmentation. J Clin Aesthet Dermatol. Ibid.

10. Davis, E. et al. Postinflammatory Hyperpigmentation. J Clin Aesthet Dermatol. Ibid.

11. Alsharif, S., et al. Efficacy and Best Mode of Delivery for Tranexamic Acid in Post-Inflammatory Hyperpigmentation: A Systematic Review. Clin Cosmet Investig Dermatol. (2022). 

12. Davis, E. et al. Postinflammatory Hyperpigmentation. J Clin Aesthet Dermatol. Ibid.

13. Fabbrocini, G., et al. Acne Scars: Pathogenesis, Classification and Treatment. Hindawi. Ibid.

14. American Academy of Dermatology Association. Acne Scars: Who Gets and Causes. (2023).

15. Alster, T., et al. Single-pass CO2 laser skin resurfacing of light and dark skin: extended experience with 52 patients. J Cosmet Laser Ther. (2003, April).

16. Hession, M., et al. Atrophic Acne Scarring. J Clin Aesthet Dermatol. (2015, January).

17. Fabbrocini, G., et al. Acne Scars: Pathogenesis, Classification and Treatment. Hindawi. Ibid. 

18. Fabbrocini, G., et al. Acne Scars: Pathogenesis, Classification and Treatment. Hindawi. Ibid.

19. American Academy of Dermatology Association. Acne Scars: Who Gets and Causes. Ibid.

20. American Academy of Dermatology Association. Acne Scars: Who Gets and Causes. Ibid.

Meredith Hartle is a board-certified Family Medicine physician at Curology. She earned her medical degree at Kirksville College of Osteopathic Medicine in Kirksville, MO.

*Cancel anytime. Subject to consultation. Results may vary.

Written by

Curology Team

Medically reviewed by

Meredith Hartle, DO