Commonly, the mild form of acne observed in most people does not leave scars, or if it does, the scarring heals naturally over time. But people suffering from aggressive forms of acne such as nodular cystic acne might be left with severe scarring in the skin.

Some spots and pigmentations can apparently be very similar to scars, without being a real one. These disappear eventually but are visible enough to cause uneasiness. Macules are such pseudo- scars, which are sometimes left behind by an inflamed acne lesion. A macule is just a flat, red spot that is the final stage of every inflamed lesion. Unlike a scar, a macule can take time to fade, but once it does, it leaves no trace behind.

Then there is the discoloration of skin after the healing of any inflamed acne lesion. It is more frequent in dark skinned people, but can happen in white skin also. This is called "Post inflammatory pigmentation." It may need treatment by a specialist.

According to the shape of tissue, acne scars are classified in two groups. One type of scar consists of augmented skin tissue, and the others are specified by the decrease in tissue on the site of lesion. An exaggerated growth of scar tissue is called Keloid and is more pronounced in African-Americans. The deep, linear scar derived from acne is called the ice-pick scar. These are very deep and their removal is difficult.

Response to Acne Scars Varies

In some people scars heal easily while some people carry scars for a lifetime. Psychologically, people demonstrate different responses to acne scarring. Some people think about scarring as something normal, while there are others who are alarmed about even the smallest scar and go to great lengths to get them eliminated.

More frequent are acne scars resulting from the loss of tissue. These are similar to scars left by chicken pox. These scars include ice-pick scars, soft tissue scars and depressed fibrotic scars. Ice-pick scars commonly occur on the cheek. These are small but with steep, jagged edges which makes them difficult to treat or cure. Sometimes these small marks become quite large and steep, with sharp edges, which are then called depressed fibrotic scars. Then there are soft scars, both superficial and deep. These scars are small with rolling edges merging with the normal skin. They are either circular or linear in shape.

Pinching and squeezing acne can also lead to acne scarring. This spreads the infection to nearby skin and damages unhealed tissue, resulting in pit-like scars.