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Commonly, the mild type of acne occurring in most people does not leave scars, or if it does, the scarring fades naturally over time. But people suffering from severe types of acne such as nodular cystic acne might be left with noticeable scarring in the skin.

There are also marks and pigmentation that relate to acne that are not precisely scars but resemble them in appearance. These disappear eventually but are evident enough to cause embarrassment. Macules are similar to pseudo- scars, which are usually left behind by an inflamed acne pimple. These flat red spots are just the last stage of any inflamed lesion. Unlike a scar, a macule might take time to fade, but once it vanishes, it leaves no marks behind.

A discoloration of the skin my occur after the curing of any inflamed acne pimple. It is more usual in dark skinned people, but might take place in white skin also. This is named "post inflammatory pigmentation." It may need treatment by a dermatologist.

Treatment options for scar varieties

Based on the shape of tissue, acne scars are divided in two categories. One type of scar consists of augmented skin tissue, and the others are recognized by the decrease in tissue on the site of acne. Overgrowth of scar tissue is known as Keloid and is more noticeable in African-Americans. The deep, linear scar formed by acne is refered to as the ice-pick scar. These are very deep and removal of them is difficult.

One more cause of acne scarring is the pinching and squeezing of acne. This expands the infection to nearby skin and harms unhealed tissue, which results in pit-like scars.

Treatment of acne scarring varies from simple acne scar cream to laser treatment, skin graft, and painful dermabrasion. Filling agents are also applied to eliminate acne scars. Most filling agents are provisional, like collagen. For deep ice-pick scars, the most appropriate treatment is to extract the scars and replace them with a skin graft taken from behind the ear. This method is called punch grafting.

Dermabrasion is almost the opposite of the cutting down method. Here, the normal skin is eliminated to bring the acne scar to a lower level. This way the scar remains the same but the height of rest of the skin varies, making them shallower. It confers skin a softer surface.

In acne scar treatment, another option is laser surgery. In this treatment, carbon dioxide is applied, which removes skin very finely, layer by layer, thus reducing the harm to healthy tissue. Like dermabrasion, this method also leaves skin red for months.

In peeling treatments, chemicals are used to eliminate the external layer of skin, the epidermis. To reduce different kinds of scarring, superficial peels, medium-depth peels, and deep peels are used. These are mostly helpful for shallow, external scars. Scars produced by cystic acne and acne rosacea are treated by this method. Peeling is a long procedure that requires a preparation period of several weeks before the actual procedure.