Acne Marks and Scars

Welcome back, DERM Community!

Last week, we explored male alopecia, a condition often dismissed as “just aging,” but in reality reflecting deeper genetic, hormonal, and psychosocial dimensions.

This week, we’re shifting focus from the scalp back to the skin:

Acne Marks and Scars

We’ve covered acne itself before, but today we’re going beyond breakouts into what really drives residual pigmentation and scarring, and how to recognize, prevent, and manage these with confidence.

Often brushed off as “cosmetic,” post-acne changes are far more than skin-deep.

They mirror inflammatory pathways, wound-healing dynamics, and genetic susceptibility. And for patients, they can leave a lasting imprint on self-image, mental health, and social functioning.

Featured on This Week’s Chapter:

Understanding and Managing Acne Marks & Scars

• Distinguishing between post-inflammatory erythema, hyperpigmentation, and true scars

• The role of inflammation, collagen remodeling, and individual healing responses

• Diagnostic considerations: recognizing high-risk lesions and early intervention windows

• Evidence-based treatments: from topical depigmenting agents to lasers, microneedling, and combination approaches

• Addressing the emotional and psychosocial burden of post-acne sequelae

When patients come in asking, “Will this go away?”, they’re not only talking about active acne, but the marks and scars it leaves behind. This is where our role shifts from simply treating breakouts to addressing long-term sequelae.

Here are the essentials beyond the basics:

• Timing matters: PIE and PIH can fade, but early control of inflammation is the best prevention. Nodules and cysts left untreated are the number one driver of permanent scarring.

• Not all scars are the same: Subtype recognition (icepick vs. rolling vs. boxcar) directly determines treatment strategy. One-size-fits-all approaches fail patients.

• Skin type guides therapy: For example, PIH risk is higher in Fitzpatrick IV–VI, meaning laser choices and topical regimens must be adapted.

• Combination is key: Most patients require a layered approach: topicals for pigment, energy devices or peels for texture, and sometimes surgery for focal scars.

• Psychosocial impact is underestimated: Patients often understate how much these marks affect them. Normalizing these concerns and offering treatment options builds trust and adherence.

Clinical Features & Red Flags

While some post-acne marks fade over time, others warrant proactive intervention. Red flags include:

• Nodulocystic lesions: High scarring potential → treat aggressively and early.

• Discoloration lasting >6 months: Indicates need for targeted therapy.

• Scarring subtype identification: Critical for treatment matching

• Psychological distress: Patients may underreport symptoms but struggle deeply, screening is key…

Need more than just an infographic?

The FREE guides are BACK! 🥳
Acne scars aren’t just “leftovers from pimples.”

Learn about the hidden drivers of scar formation and the interventions that actually work:

Want to Explore More Cases of Acne & Scarring?

Our Acne Module provides case-based learning that strengthens skills in recognizing, treating, and preventing post-acne sequelae across skin types:

Looking for a job?

Whether you’re actively exploring new opportunities or just curious about what’s available, now is the perfect time to discover dermatology roles focusing on lymphatic and vascular skin conditions.

Why browse now?

• Find positions with specialized wound and lymphatic care focus

• Discover roles offering leadership and innovation in multidisciplinary teams

• Explore telemedicine and research opportunities advancing lymphatic medicine
  

Explore new locations, new teams, or new modalities (hello, AI-driven diagnostics!)

👋🏻 See you next Thursday, DERM community!

Acne marks and scars may look like “just cosmetic changes,” but their impact goes deeper, shaping identity, confidence, and quality of life.

As dermatology providers, our role is to blend science and compassion: preventing scars where possible, treating effectively, and supporting patients through the journey.

If today’s insights sharpened your approach to acne scars, share them with your colleagues, trainees, or teams.

— The Derm for Primary Care Team