Acne Scars: The Real Story Behind Those Lingering Marks

Clearing acne is a huge victory—but if you’ve won that battle only to be left with stubborn scars, it can feel like you’re still stuck in the fight. You’re not alone. Many people finally get their breakouts under control and are left wondering: Why does my skin still look uneven? Why won’t these dark spots fade? And are these dents permanent?

The truth is, acne can leave behind more than just memories. Depending on how your skin healed—and how deep the inflammation ran—you might be dealing with textural changes, dark marks, or raised bumps that don’t seem to go away no matter how many serums you try.

At CLEAR Acne Treatment Centers, we talk to clients every day who are navigating this exact situation. Understanding the type of scarring you have is the first step toward treating it. So let’s walk through the most common types of acne scars, how they form, and what can actually help.

WHY ACNE LEAVES SCARS IN THE FIRST PLACE

Acne is an inflammatory skin condition. That inflammation can damage the deeper layers of your skin, especially if you’re dealing with cystic or nodular acne—the kind that feels deep and painful. When your body tries to repair that damage, it produces collagen. Sometimes it doesn’t produce enough, and the result is a little dip in the skin. Other times, it produces too much, and you’re left with a raised scar.

There’s also the matter of pigment. Even if your skin’s texture bounces back, you might still have flat, discolored spots where breakouts used to be. These aren’t technically scars—but they definitely look like the aftermath of acne, and they can stick around for months (or even longer) without help.

THE MAIN TYPES OF ACNE SCARS

When we’re looking at post-acne skin, we’re generally dealing with a few different things: indentations, raised bumps, or discoloration. Each behaves a little differently—and each responds to different treatments.

INDENTED SCARS (ATROPHIC SCARS)

These are the most common, especially for people who’ve had inflammatory or cystic acne. Indented scars form when your skin loses tissue as it heals.

ICE PICK SCARS

These are deep and narrow—almost like someone poked a pin into your skin. They’re usually found on the cheeks and are tough to treat because they go deeper than they look.

BOXCAR SCARS

Boxcar scars are wider and more defined. Think of them like little craters with sharp edges. They often show up on the lower cheeks and jawline and can be more noticeable when light hits your face from the side.

ROLLING SCARS

Rolling scars don’t have sharp edges—they’re soft and sloped, giving the skin a wavy texture. These tend to show up in larger patches and can make your skin look uneven or pitted, especially under makeup or certain lighting.

RAISED SCARS (HYPERTROPHIC KELOID)

These are less common but more likely to show up on the body—think chest, shoulders, or back. Instead of losing collagen during the healing process, your skin makes too much, leading to thick, raised scars.

HYPERTROPHIC SCARS

These stay within the boundary of the original breakout but feel bumpy or firm to the touch. They can be red, pink, or even skin-colored, and they don’t always go away on their own.

KELOID SCARS

These are like hypertrophic scars taken a step further. They’re raised, but they also grow beyond the area where the breakout happened. Keloids can continue to grow over time and sometimes become itchy or uncomfortable.

DARK MARKS (POST-INFLAMMATORY HYPERPIGMENTATION)

These aren’t technically scars—but they’re a big reason people seek help after acne. You’ll notice them as flat red, brown, or purple marks that linger long after a breakout has healed. They’re especially common in people with medium to deep skin tones, and they can take months (or years) to fade on their own—especially without sun protection.

HOW TO TREAT ACNE SCARS

Not all scars are created equal—and that’s exactly why a one-size-fits-all treatment approach rarely works. At CLEAR, we always suggest waiting until your acne is fully under control before treating scars. Otherwise, you’re just playing whack-a-mole: treating one scar while new ones form.

Once your skin is clear, here’s what you might explore:

FOR INDENTED SCARS

Treating ice pick, boxcar, or rolling scars often involves stimulating new collagen growth to fill in the lost tissue. That can mean:

• Microneedling to trigger your skin’s natural healing.

• Chemical peels to resurface the top layers of skin.

• Laser resurfacing to target texture and tone (best done with an experienced provider, especially for darker skin tones).

• Subcision, which breaks up the fibrous bands pulling rolling scars down.

• Dermal fillers, which can “lift” certain scars temporarily or even long-term depending on the product.

FOR RAISED SCARS

With hypertrophic and keloid scars, the goal is to soften and flatten the tissue.

• Steroid injections can shrink the scar over time.

• Silicone gels or sheets help smooth the surface with consistent use.

• Laser treatments (especially vascular lasers) can calm redness and reduce bulk.

• In rare cases, surgical removal might be recommended—but that comes with its own risks and isn’t for everyone.

FOR DARK SPOTS

If you’re mostly dealing with discoloration, a different toolbox is needed:

• Topical retinoids help fade marks and keep new breakouts away.

• Azelaic acid is great for calming inflammation and evening out tone—without irritating sensitive skin.

• Vitamin C brightens and helps protect against further damage.

• And of course—SPF every single day. Sun exposure makes dark marks darker and harder to treat.

CAN YOU PREVENT ACNE SCARS?

There’s no guaranteed way to prevent every scar—but you can reduce your chances significantly by:

• Starting treatment early, before inflammation runs deep.

• Avoiding the temptation to pop or pick.

• Using gentle, consistent skincare.

• Treating your acne at the root—not just the surface.

WHY WE START WITH AVICLEAR®

Here’s the thing: before we ever talk about scar treatments, we want to make sure you’re no longer breaking out.

At CLEAR Acne Treatment Centers, we specialize in AviClear®, the first FDA-cleared laser that actually targets the oil glands that cause acne. It’s a series of three treatments—and for most of our clients, it delivers long-term results without the side effects of Accutane® or antibiotics.

Once your skin is stable and breakouts are no longer forming, you can turn your attention to smoothing and brightening what’s left behind.

READY TO TALK ABOUT YOUR SKIN?

If you’re still dealing with breakouts, the best place to start is by getting those under control. Treating scars while new acne is still forming can feel like an uphill battle—and that’s where we come in.

At CLEAR Acne Treatment Centers, we specialize in helping clients finally stop the cycle of breakouts with AviClear®, the first ever FDA-cleared laser that targets acne at the source. Once your skin is clear and stable, that’s when scar treatments can truly make a lasting difference.

If you’re ready to get to the root of your acne and start moving toward smoother, healthier skin, we’d love to help you explore whether AviClear® is the right next step.

🚀 Get your Treatment Estimate: https://www.clearacne.com/estimate

⏰ Book a Free Consultation: https://www.clearacne.com/schedule