What Causes Acne Scars on the Face?

by Adam Friedman, M.D., FAAD

The 4 “Don’ts” That Can Prevent Acne Scarring

What Causes Acne Scars on Face - La Roche-Posay

“Why are acne scars more likely to form if acne is left untreated?” “What behaviors aggravate the risk of scarring?” “Is my skin more prone to scarring?” “How to get rid of acne scars?”

Questions about acne scars are as common as questions about acne clearing. Acne at its simplest is inappropriately turned on inflammation in the skin. And, the inflammation exists even before the distinguishing "pimple" rises to the surface – not only visibly disrupting your flawless skin routine, but also doing serious damage to the key foundational support structures of healthy skin. As the pimple progresses (gets bigger), more and more damage occurs, which can have a permanent effect in the form of a persistent red mark, dark mark, or scar.

How you treat the pimple now impacts how long it lingers into your skin’s future. Supposed “quick fixes” like picking and over-scrubbing can intensify the already present inflammation and increase the chance for scarring.

Just like how everyone's skin is different (think skin type and skin tones), its ability to heal or the severity of inflammation associated with someone's acne means the likelihood of scarring is different for each individual. The appearance of "acne left-overs" will vary broadly -- even between different skin tones -- with a greater likelihood for discoloration in darker skin and persistent red marks in lighter skin.

Like all skin issues, the best treatment is prevention:

1. Don't pick.

2. Don't overwash or over-scrub with harsh physical abrasives.

3. Don’t skimp on moisturizer. Apply an oil-free moisturizer to damp skin, as hydration helps balance skin and maintain a healthy skin barrier.

4. Don’t skimp on SPF because you think it’s greasy or clogs pores. Apply a mattifying, non-comedogenic sunscreen DAILY to protect against UV radiation that can worsen the appearance of scars and dark marks.

If you’re already struggling with signs of scarring, see a dermatologist to talk to him or her about acne scar treatment. He or she will likely recommend a topical vitamin A derivative (known as a retinoid), which has been shown to help visibly reduce the appearance of post-acne scarring. Facial peels using a combination of alpha hydroxy acids (such as glycolic acid) and beta hydroxy acids (such as salicylic acid), as well as laser resurfacing treatments have demonstrated some success in evening skin tone and diffusing the appearance of acne scars. For pitted, depressed acne scars, cosmetic fillers are an option that help smooth and even the skin’s surface.