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Post-acne marks, scars and uneven skin texture
Acne may settle while red or brown marks, depressions or raised scars remain. These changes are often grouped under the term “post-acne”, although they develop differently and require different approaches. A product that gradually improves pigmentation cannot rebuild a deep atrophic scar. Likewise, a resurfacing procedure may not be the first step while inflammatory acne is still active.
At IYA Clinic in Kyiv, treatment planning begins with a medical assessment. The clinician considers ongoing breakouts, scar type and depth, skin tone, previous acne treatment, tendency to pigmentation and the amount of downtime a patient can accommodate. The aim is not to select the most popular device, but to choose a sequence appropriate for the individual skin condition.
What can remain after acne?
Red or pink marks
Post-inflammatory erythema is associated with small-vessel changes during healing. It is usually more visible in lighter skin tones. These flat marks are not true scars and may fade, although this can take several months or longer.
Brown or grey marks
Post-inflammatory hyperpigmentation develops when inflammation triggers excess or uneven melanin production. It can be more persistent in darker skin tones, and ultraviolet exposure may increase the contrast between a mark and the surrounding skin.
Atrophic scars
Atrophic scars are depressions caused by loss of structural support during healing. They may be described as ice-pick, boxcar or rolling scars. Several patterns often coexist, which is why one procedure applied uniformly to the whole face may not address every scar.
Hypertrophic and keloid scars
Raised scars result from excessive scar-tissue formation. They are more common around the jaw, chest, shoulders and upper back. Procedures intended to stimulate collagen in depressed scars must not automatically be used for raised scars.
| Change | Typical appearance | Texture affected? | What the clinician assesses |
|---|---|---|---|
| Post-inflammatory erythema | Flat pink or red mark | Usually no | Vascular component, duration and active inflammation |
| Post-inflammatory hyperpigmentation | Flat brown or grey mark | Usually no | Skin tone, pigment depth, tanning and sun protection |
| Atrophic scar | Depression with defined or sloping edges | Yes | Pattern, depth, mobility and location |
| Hypertrophic or keloid scar | Firm tissue raised above the skin | Yes | Growth tendency, activity and location |
Why does post-acne affect some people more than others?
Risk is influenced by the depth and duration of inflammation, individual healing, delayed acne treatment and mechanical trauma. Picking or squeezing lesions can increase inflammation and infection risk. Nodular and cystic acne is more likely to scar, but even smaller lesions may leave persistent colour changes.
Active acne generally needs to be brought under control first. Otherwise, new scars may develop while older ones are being treated. Current acne medication also matters: the clinician needs to know about prescription retinoids and other therapies before planning a peel, laser or energy-based procedure.
Can skincare remove post-acne changes?
Skincare may gradually improve colour and support the skin barrier, but its limits depend on the type of change. A clinician may recommend retinoids, azelaic acid, niacinamide or other ingredients after considering sensitivity, pregnancy, current medication and season.
Daily broad-spectrum sun protection is particularly important when hyperpigmentation is present or treatment increases sun sensitivity. Sunscreen does not fill a scar, but it helps reduce UV-related darkening of marks.
Deep atrophic and raised scars cannot be levelled with a cream. Concentrated acids, abrasive scrubs and home needling devices may cause irritation, burns or infection and can worsen pigmentation or scarring.
Procedures that may be used in a post-acne plan
Light-based treatment for colour changes
When vascular or pigmented marks predominate, a clinician may consider BBL HERO. Settings depend on the colour and depth of the mark, skin tone, recent tanning and skin reactivity. Correct diagnosis is important because not every brown facial spot is post-acne pigmentation.
Laser treatment for texture
Lutronic laser procedures may be considered for uneven texture, selected scars or pigment changes. Laser type, density and depth influence both the response and downtime. More than one session may be necessary, and stronger treatment is not automatically better.
Radiofrequency microneedling
Morpheus8 Ignite combines controlled microneedling with radiofrequency energy. It may be considered for atrophic scars, enlarged pores and uneven texture. Depth and energy must be individualised. RF microneedling is a medical procedure with potential adverse effects and should be performed by a trained healthcare professional using an appropriate device and protocol.
Chemical peels
Superficial or medium-depth peels may be used for pigmentation, dull tone and selected superficial changes. The acid, concentration, exposure time and skin preparation all affect safety. Deeper peeling does not guarantee a more suitable result.
Local and injectable techniques
Selected tethered scars may require subcision, fillers or another local intervention. Raised scars need a different strategy that may include medicine injections or specific laser protocols. PRP/PRF therapy may sometimes complement another procedure rather than serve as a universal stand-alone solution.
| Approach | Main role | Important limitation |
|---|---|---|
| Skincare and sun protection | Acne control, barrier support and gradual colour improvement | Cannot remodel deep scars |
| BBL or another light protocol | Selected vascular or pigmented marks | Requires attention to diagnosis, skin tone and tanning |
| Laser resurfacing | Texture and selected scar patterns | Downtime and pigment risk vary with the laser and settings |
| RF microneedling | Atrophic scars, pores and texture | Requires individual depth, energy and medical oversight |
| Peel | Superficial pigmentation and texture | Strength must match the skin condition and phototype |
| Subcision or local correction | Selected tethered or deep scars | Not suitable for every scar and may be combined with other methods |
Why combined treatment is common
A patient may have redness, pigmentation and several scar types at the same time. No single device is required to solve all of these problems. A staged plan may first control acne and restore the skin barrier, then address colour, and later work on texture. Adequate healing intervals are part of treatment rather than lost time.
Response varies with scar depth, skin tone, previous treatment and tissue healing. The realistic goal is to make marks or scars less noticeable and improve overall skin quality. Complete removal cannot be guaranteed.
Preparing for a consultation
Tell the clinician about current and previous acne medication, retinoids, procedures, recent tanning, cold sores and any history of keloids or post-inflammatory pigmentation. Bring a list of skincare products and, if available, photographs showing how the acne evolved.
Following assessment at IYA Clinic, the clinician can explain which changes may fade over time, which require treatment, the expected recovery for each step and why a particular sequence is being suggested.
Frequently asked questions
Are marks after spots the same as scars?
Not necessarily. Flat red and brown marks are usually colour changes. A scar alters the surface by forming a depression or raised area.
When can scar procedures begin?
Active acne is normally addressed first. Timing also depends on medication, skin integrity, tanning and the selected procedure.
How many sessions will I need?
There is no standard number. Flat marks and mixed deep scars require different plans, and the schedule may be adjusted according to healing.
Is laser or Morpheus8 better for acne scars?
Neither is universally better. Scar type, skin tone, active acne and acceptable downtime guide the decision. In some plans the methods are used at different stages.
Can treatment be performed in summer?
Some protocols may be possible with strict sun protection, while others are better postponed. Recent tanning, skin tone and treatment intensity must be assessed.
This article is for information only and does not replace a medical consultation.
Sources for medical review
- American Academy of Dermatology. Acne scars: consultation and treatment.
- NICE NG198. Acne vulgaris: management, section 1.8.
- DermNet. Acne scarring.
- Niaz G et al. Fractional Radiofrequency Microneedling as a Monotherapy in Acne Scar Management. 2025.
- FDA. Potential Risks with Certain Uses of Radiofrequency Microneedling. 2025.
