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

There are also spots and pigmentation related with acne that are not exactly scars but resemble them in appearance. These disappear with time but are visible enough to cause uneasiness. Macules are such pseudo- scars, which can be left behind by an inflamed acne lesion. A macule is nothing but a flat, red spot that is the final stage of every inflamed lesion. Unlike a scar, a macule might take time to fade, but once it does, it leaves no trace behind.

Then there is the discoloration of skin after the resolution of any inflamed acne lesion. It is more frequent in dark skinned people, but might take place in white skin also. This is called "Post inflammatory pigmentation." It may require treatment by a specialist.

According to the shape of tissue, acne scars are divided in two groups. The first type of scar consists of increased skin tissue, and the others are characterized by the diminution in tissue on the site of acne. An exaggerated growth of scar tissue is called Keloid and is more pronounced in African-Americans. The deep, linear scar formed by acne is called the ice-pick scar. These are very deep and removal of them 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 accept scarring as normal, while there are others who are alarmed about even the smallest scar and go to great lengths to get them eliminated.

More common are acne scars caused by the loss of tissue. These are similar to scars produced by chicken pox. These scars include ice-pick scars, soft tissue scars and depressed fibrotic scars. Ice-pick scars commonly appear on the cheek. These are small but with steep, jagged edges which makes their healing or treatment difficult. Sometimes these tiny scars 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 are small with rolling edges merging with the healthy skin. They can be circular or linear in shape.

Pinching and squeezing acne can also lead to acne scarring. This action spreads the infection to surrounding skin and harms unhealed tissue, which results in pit-like scars.