In the simplest terms, acne scars are marks left on the skin after a pimple heals. There are three main types of acne scars: indented scars, raised scars, and dark spots. Indented scars are also known as atrophic scars and are sometimes referred to as "pockmarks" or "icepick scars." Raised scars are referred to as hypertrophic scars and aren’t quite as common.^I Dark spots, on the other hand, aren’t really scars. They’re a form of hyperpigmentation that appears as small, flat dark marks on the skin and may be left behind after a breakout.^II

Whether they’re flat, depressed, or raised, the basics of why an acne scar appears will remain the same. Certain types of acne penetrate the skin more deeply, and the result is that they damage the surrounding tissue. The actual blemish will go away with the right treatment or enough time, and your skin attempts to repair the damage. One key component of this is your body producing collagen. This is a process that requires more precision than you might have thought. If the right amount of collagen isn’t produced (either too much or too little), a scar will form in the wake of your breakout. How much collagen is made will determine whether the resulting scar is depressed or raised.^III

An excess of collagen will cause a hypertrophic or raised scar, while too little collagen will result in an atrophic or depressed scar.^III

Acne marks are known as post-inflammatory hyperpigmentation (PIH) and occur when the skin over-produces melanin. Studies show inflammation induces damage to cells in the epidermis, which causes them to release large amounts of melanin. A common cause of the inflammation that leads to this chain of events is none other than acne. This is especially common for people of color and those with darker skin tones.^IV

Acne scars don’t appear after every breakout and aren’t dealt with by everyone. If you have inflammatory acne, the likelihood of scarring increases. Acne scars often develop after an inflammatory acne breakout that includes cysts and nodules. The reason being, this type of acne penetrates deep into the skin. The longer someone has this type of inflammatory acne, the more likely it is to leave a scar.

Like many other skin concerns, your genes can also play a role. Having a relative with acne scars could make you more prone to experiencing them.

While you can’t control your genes or dictate that you never want to get inflammatory breakouts, there is one thing that’s in your hands—quite literally—that can impact whether you get acne scars: pimple popping. If you squeeze, pop, or pick at your acne, which we know can be tempting, it causes inflammation and can lead to scarring.^III So, remember to keep your hands off.

Determining the best treatment for acne scars is dependent mainly upon the type of scar you have. Raised or indented scars are difficult to remove, and as such, are often addressed with medical or cosmetic procedures, such as laser resurfacing or microdermabrasion.^V Flat dark spots, on the other hand, can be addressed with skincare products and ingredients shown to improve skin tone and texture, such as vitamin C.^VI Ahead, we’ve put together a skincare routine designed to help reduce hyperpigmentation and dark spots left behind after a breakout. Keep reading to learn how to fade acne scars and marks for a smoother, clearer, more even complexion.