Skin Concern Comparison
Acne Scars vs Acne Marks
Most of what people call “acne scars” are flat marks: brown or red patches left behind as inflammation settles. These usually fade with time, sun protection and the right skincare. True scars change the skin’s texture, either sunken or raised, and rarely go away without treatment from a dermatologist.
If the spot is flat and only the color is different, it is a mark: brown post-inflammatory hyperpigmentation (PIH) or red post-inflammatory erythema (PIE). Marks usually fade over months with sunscreen, patience and ingredients such as azelaic acid. If the skin is dented, pitted or raised, it is a scar, and lasting improvement usually needs procedures from a dermatologist. Whatever you have, controlling active acne comes first, because it prevents new marks and scars.
- Flat brown or red spots are marks, not scars, and they usually fade with time and daily sunscreen.
- Sunken, pitted or raised skin is a true scar and rarely improves much without dermatologist procedures.
- Treating active acne early and avoiding picking is the best way to prevent both.
At a glance
How acne marks and acne scars differ
The key question is simple: has only the color changed, or has the surface of the skin changed too?
| Factor | Acne marks (PIH and PIE) | Acne scars |
|---|---|---|
| What it is | A flat color change left after inflammation: extra pigment (PIH) or lingering small blood vessels (PIE). | A change in skin texture from collagen loss (sunken) or excess collagen (raised). |
| How it looks | Flat brown, gray-brown, pink, red or purple patches. | Pits, dents or rolling hollows, or firm raised bumps. |
| How it feels | Smooth, level with the surrounding skin. | Uneven to the touch; you can feel or see the edge in side lighting. |
| Who gets it more | PIH is more common in medium to deep skin tones; PIE is more visible in lighter skin. | Anyone with inflamed acne; keloids are more common in deeper skin tones. |
| Does it fade alone? | Usually, over months; deeper pigment can take much longer. | Rarely; scars tend to persist. |
| What helps | Daily sunscreen, treating acne, and ingredients such as azelaic acid, niacinamide or retinoids. | Dermatologist procedures such as lasers, microneedling, peels, fillers, subcision or surgery. |
| Role of skincare | Central; often enough on its own. | Supportive only; it cannot rebuild lost collagen. |
Evidence profile
How confident is this comparison?
Confidence is shown in plain categories, not a numerical score.
Dermatology sources agree that flat color changes are not scars and that texture change defines a true scar.
Sun protection and early acne control are consistently recommended for PIH. Evidence for individual brightening ingredients is often limited, especially in deeper skin tones.
A 2022 systematic review found 18 studies on post-acne redness; lasers were studied most, and some topical agents showed promise. More trials are needed.
Resurfacing, lifting and excision methods help, often combined over several sessions. Results vary by scar type and depth.
Surface brown marks may fade in months, while deeper gray-blue pigment can last years or be permanent. Timelines differ widely between people.
Choose by goal
What should you do in your situation?
Find the description closest to what you see, then start with the least invasive step that fits.
Flat brown spots where pimples were
This is post-inflammatory hyperpigmentation. Daily sunscreen plus azelaic acid or niacinamide can help it fade.
Lean toward: Skincare and sunscreen
Flat pink or red spots that linger
This is post-inflammatory erythema. It often fades slowly; stubborn redness can respond to vascular lasers.
Lean toward: Patience, then a dermatologist
Small, deep pits or dents
These are atrophic acne scars, such as ice pick or boxcar scars. Skincare cannot fill them.
Lean toward: Dermatologist procedures
Firm bumps where acne healed
These may be hypertrophic scars or keloids. Injections, lasers or silicone are typical options from a dermatologist.
Lean toward: Dermatologist assessment
New spots keep appearing
Get acne under control first, as scar treatments usually start once breakouts are managed. See the acne-prone skin routine.
Lean toward: Treat active acne
Pregnant, trying to conceive or breastfeeding
Avoid retinoids and hydroquinone. Azelaic acid is often suggested in pregnancy, and many procedures are best postponed. Check with your clinician.
Lean toward: Azelaic acid and sunscreen
Strengths and limits
What each one means, and how far skincare can go
Acne marks (PIH and PIE)
Where it does well
- Usually fade on their own over time
- Respond to sunscreen and skincare
- Not a permanent change in skin structure
Where it falls short
- Can take months, or longer in deeper skin tones
- Sun exposure and picking make them last longer
- Deeper pigment may be very slow or permanent
Acne scars
Where it does well
- Can improve meaningfully with the right procedures
- Many options suit different scar types
- Combining treatments often gives better results
Where it falls short
- Rarely go away on their own
- Skincare alone cannot rebuild lost collagen
- Usually need several sessions and recovery time
- Raised scars and keloids can recur
Mark or scar?
How to tell which one you have
Run a finger over it
If it feels level with the skin around it, it is likely a mark. A dip or bump suggests a scar.
Use side lighting
Hold a light to the side of your face. Shadows in dents or around bumps reveal texture that color hides.
Note the color
Brown or gray-brown suggests PIH. Pink, red or purple suggests PIE. Scars may also be discolored.
Give it time and sunscreen
Marks tend to fade over months with daily sunscreen. A texture change that persists is a scar worth showing a dermatologist.
Both at once and what comes first
Can you have both, and what comes first?
Having both at once
Yes, it is very common. A scar can also be red or brown, so it may look worse at first and improve partly as the color fades. Treat the color first, then judge the texture.
What comes first
Control active acne, use sunscreen daily and stop picking. Then fade marks with skincare. Scar procedures usually come once acne is under control.
When procedures from a dermatologist are worth it: skincare cannot rebuild collagen, so dents, pits and raised scars need in-clinic treatment. Options include laser resurfacing, microneedling, chemical peels, fillers, subcision (releasing bands that pull scars down), punch excision and, for raised scars, steroid injections. Dermatologists often combine methods, and deeper skin tones need careful choices to avoid new pigment.
Safety and professional-help boundaries
When marks and scars need professional care.
- See a dermatologist for any dented, pitted or raised scars you want to improve; skincare cannot correct them.
- Raised scars that grow beyond the original spot may be keloids and should be assessed.
- Ongoing inflamed or cystic acne needs treatment early to prevent more scarring.
- Avoid retinoids and hydroquinone during pregnancy, while trying to conceive and while breastfeeding unless a clinician advises otherwise.
- Use a broad-spectrum SPF 30 or higher daily; sun exposure darkens marks and slows fading.
Frequently asked questions
Short answers to common questions
How do I know if I have acne scars or just marks?
Run a finger over the spot and look at it in side lighting. If it is flat with only a color change, it is a mark; if it is sunken or raised, it is a scar.
Do acne marks go away on their own?
Usually, yes. Brown and red marks tend to fade over months, and sunscreen helps, but deeper pigment can take much longer, especially in deeper skin tones.
What is the difference between PIH and PIE?
PIH is post-inflammatory hyperpigmentation, a brown or gray-brown mark from extra pigment. PIE is post-inflammatory erythema, a pink or red mark linked to small blood vessels, and it is more noticeable in lighter skin.
Can skincare remove acne scars?
Skincare can improve marks and support skin, but it cannot fill dents or flatten raised scars. Those usually need procedures from a dermatologist.
What treatments work for atrophic acne scars?
Dermatologists use laser resurfacing, microneedling, chemical peels, fillers, subcision and punch excision, often in combination. The best option depends on the scar type and depth.
How do you get rid of red acne marks?
Red marks often fade slowly on their own. For stubborn redness, vascular lasers such as pulsed dye laser have been studied most, and some topical treatments show promise.
Should I treat acne scars while I still have acne?
Usually not. Dermatologists generally control active acne first, because ongoing breakouts create new marks and scars.
Editorial Record
- Editorial status
- reviewed
- Medical reviewer
- Dr. Abdurrahman Efem
- Practical reviewer
- Merve Akkaya
- Last reviewed
- November 13, 2026
Related pages
Continue from here
Sources reviewed
Evidence behind this comparison
- American Academy of Dermatology: Acne scars overview.
- American Academy of Dermatology: Acne scars treatment.
- DermNet: Acne scarring (Wong V, 2023).
- Davis EC, Callender VD. Postinflammatory hyperpigmentation: a review of the epidemiology, clinical features, and treatment options in skin of color. Journal of Clinical and Aesthetic Dermatology, 2010.
- Bae-Harboe YSC, Graber EM. Easy as PIE (postinflammatory erythema). Journal of Clinical and Aesthetic Dermatology, 2013.
- Kalantari Y, Dadkhahfar S, Etesami I. Post-acne erythema treatment: a systematic review of the literature. Journal of Cosmetic Dermatology, 2022.
- Chien AL, et al. Treatment of acne in pregnancy. Journal of the American Board of Family Medicine, 2016.
Sources support the general editorial conclusions shown here. They do not replace personal medical advice from a qualified clinician, and they do not prove that every product containing these ingredients will perform the same way.