After a breakout clears, you might notice marks that linger, but not all of them are true scars. Some are discolourations, while others are changes to the skin’s texture. Knowing the difference between acne scars and pigmentation is crucial for choosing the right treatment.
If you’ve been trying topical products or considering acne scar treatment, it’s important to first understand what you’re actually treating. This article breaks down the biological causes, appearance, and treatment strategies for both acne scars and post-inflammatory pigmentation, helping you make more informed skincare decisions.
What Is Post-Inflammatory Pigmentation (PIH)?
Post-inflammatory pigmentation is the medical term for dark or red marks left behind after acne heals. It’s a result of inflammation triggering excess melanin production (in darker skin) or visible redness due to broken blood vessels (in lighter skin).- Colour: Usually brown, purple, or red, depending on your skin tone.
- Texture: The skin remains smooth to the touch.
- Cause: More common in moderate acne or after picking/squeezing lesions.
- Healing Time: Fades gradually over months with sun protection and topical agents.
What Are Acne Scars?
Unlike pigmentation, acne scars are permanent structural changes in the skin caused by tissue loss or excess collagen during wound healing. They develop when inflammation damages skin tissue deeper in the dermis.- Types:
- Atrophic scars: Depressed, including ice pick, boxcar, and rolling scars.
- Hypertrophic/keloid scars: Raised, often found on the chest, jawline, or shoulders.
- Texture: Noticeable indentations or raised areas.
- Healing Time: Do not resolve without medical treatment.
Key Differences at a Glance
What Helps Pigmentation Fade?
Over-the-counter treatments and daily habits can make a big difference when it comes to pigmentation:
Topical Ingredients
- Niacinamide: Helps regulate pigment and calm inflammation.
- Vitamin C: Brightens the skin and inhibits melanin production.
- Azelaic Acid: Reduces redness and dark spots.
- AHAs (e.g. glycolic acid): Promote skin cell turnover.
- Retinoids: Speed up fading by accelerating cell renewal.
Daily Sunscreen Use
UV exposure can worsen pigmentation or make it last longer. A broad-spectrum sunscreen (SPF 30 or higher) is essential.What Helps Improve Acne Scars?
Since acne scars are structural, topical products alone are unlikely to make a significant impact. Professional treatments are often recommended:In-Office Procedures
- Microneedling: Stimulates collagen production for indented scars.
- Laser Resurfacing: Targets both texture and pigmentation.
- Subcision: Breaks fibrotic bands under rolling scars.
- TCA CROSS: Treats ice pick scars with chemical reconstruction.
- Dermal Fillers: Temporarily lift depressed scars for a smoother texture.
Why It Matters to Know the Difference
Using the wrong treatment can waste time, money, and potentially aggravate your skin. For example:- Treating scars with a lightening cream may yield no result.
- Using strong exfoliants on scarred skin may cause more irritation.
Final Thoughts
Understanding the difference between acne scars and pigmentation is the first step to achieving clearer skin. While pigmentation often fades with consistent topical care and sun protection, true acne scars usually require a more structured, professional approach.Instead of guessing, assess your skin's texture and history—or better yet, consult a qualified provider who can recommend an evidence-based plan. Whether you’re looking to fade dark marks or address deeper indentations, knowing what you’re dealing with will help you choose the right path forward.
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