Read Part I: Depressed Acne Scars Here >>
Read Part II: Raised Acne Scars >>
Acne marks or acne pigmentation scars refer to the discoloration that remains after a nasty pimple or a severe acne breakout. These marks, technically known as macules, are neither raised nor pitted. They are flat spots of discolored pigmentation. Acne marks can vary in color from pink to black.
What are Acne Marks or Acne Pigmentation Scars?
The first thing to know about pigmented acne scars: they are not actually scars. Acne marks or pigmentation scars are referred to as “pseudo scarring” because they leave a mark that can last for a significant amount of time, but do not result as a response to tissue damage like traditional scars.
What Causes Acne Marks?
Unlike depressed acne scars, caused by the underproduction of collagen following tissue damage, and raised acne scars, caused by the overproduction of collagen following tissue damage, acne marks are caused by the over production or underproduction of melanin following an inflammatory injury, such as acne. Acne marks may also be vascular injuries, caused by broken capillaries.
There are three types of acne marks
- Post Inflammatory Hypopigmentation
- Post Inflammatory Hyperpigmentation (PIH)
- Post Inflammatory Erythema (PIE)
Acne Marks: What is Post Inflammatory Hypopigmentation?
Hypopigmentation is the least comon type of acne marks and can be one of the most difficult types of discoloration to treat. Hypopigmentation following an inflammatory injury results from the underproduction of melanin. This leaves the affected skin looking lighter than the surrounding skin. Post Inflammatory Hypopigmentation can manifest as white macules.
Acne Marks: What is Post Inflammatory Hyperpigmentation (PIH)?
Post Inflammatory Hyperpigmentation (PIH) is caused by the body’s overproduction of melanin in response to an inflammatory injury, such as acne. Melanin is the dark pigment our skin uses to protect itself. During inflammatory injuries to the epidermis, such as acne, the skin synthesizes more melanin causing accumulations of dark pigment that discolor the skin.
PIH manifests as dark macules that are brown or black. Although PIH can occur in all skin types, it is more prevalent in darker skin tones. PIH typically dissipates on its own, but can take months to years to do so. Sun exposure can exacerbate PIH.
Acne Marks: What is Post Inflammatory Erythema (PIE)?
PIE Post inflammatory erythema is not caused by the overproduction or underproduction of melanin following inflammatory injury such as Post Inflammatory Hyperpigmentation or Post Inflammatory hypopigmentation. Instead, post inflammatory erythema is caused when capillaries, below the skin’s surface, are injured and rupture. This triggers the body’s immune system to increase blood flow to the site of the injury.
PIE can be exacerbated by picking or popping pimples. PIE manifests as pink, red, or purple macules. They occur more comonly in people with skin phototype I – III (light skin.) Like other acne marks, Post Inflammatory Erythema can last for several months and can develop into PIH, if left untreated.
