Once a breakout has settled, the marks it leaves behind can be just as frustrating as the spots were. It’s one of the things we’re asked about most: how long until these marks fade, and is there anything that actually speeds it up? The honest answer depends on whether you’re looking at temporary discolouration or a true, structural scar, because the two behave very differently. Knowing which one you’re dealing with is the first step to doing something useful about it.
What’s the difference between acne marks and true scars?
It helps to separate two things that are often confused. The flat red, pink or brown marks left after a spot heals are usually post-inflammatory pigmentation or erythema (redness). They aren’t scars, and in most cases they settle on their own over a number of months without any treatment at all.
True acne scars are different. They involve more structural changes in the skin, usually the deeper layers, and show up as pitted, depressed or occasionally raised areas. These don’t fade by themselves, and no amount of waiting will smooth them out. Working out whether you have scarring or not, and if so which type you have, is the part that really matters, because it changes the entire approach.
True scars tend to fall into a few recognised types:
- Icepick scars, which are small and deep, like narrow pits in the skin.
- Boxcar scars, which are broader depressions with more defined edges.
- Rolling scars, which create a gentle, wave-like unevenness across the surface.
- Raised scars, known as hypertrophic or keloid scars, which are less common than the depressed types above.
Which type is present makes a real difference to which treatment is likely to help, and is why an assessment matters before starting any treatment.
It’s worth remembering that acne itself is a medical condition, not simply a cosmetic one, which is why treating it early – before scarring even becomes a concern – is recommended, if possible.
When is acne medical rather than cosmetic?
Here I explain why acne is treated as a medical condition rather than simply a cosmetic one, given its potential to scar and its effect on confidence, and why stepping in early matters.
Why active acne must be treated before scarring
Before getting into what improves the look of scarring, the active acne underneath has to be brought under control. There’s no sense resurfacing skin that’s still actively breaking out. Performing scar treatments while spots are still coming through can inflame the skin further and, in some cases, leave you with more scarring than you started with.
There’s a prevention point here too. Ongoing, untreated inflammation is usually what drives the scarring process in the first place, so treating acne early does more than clear the spots; it reduces the risk of lasting scars forming at all. We settle the acne first with the right oral or topical treatment for the severity of the case, and only once the skin is stable do we move on to addressing the texture of the skin.
This is why acting promptly matters so much for younger patients in particular, where treating acne early can prevent scarring before it has a chance to set in.
Can teenage acne cause permanent scarring?
In this short video I explain that untreated acne inflammation is usually what leads to scarring, and why early assessment and a clear treatment plan can significantly reduce the risk of long-term damage.
Which clinical treatments improve acne scarring?
When there’s genuine structural damage, or when surface marks simply won’t budge, several treatments can help re-texturise the skin. As a specialist dermatology clinic, we can draw on a wide range of options for both active acne and scarring.
Once the acne itself is fully under control, scar treatment is delivered through London Real Skin, our aesthetic dermatology department. The right choice depends on the type and depth of the scarring, and typically involves one or more of the following:
- Prescription-strength topical therapy that can be used at home.
- Medical-grade peels, to repair the upper layers of skin and target surface discolouration.
- Medical microneedling, to stimulate the skin to make new collagen and soften the depth of depressed scars.
- Radiofrequency medical microneedling which also adds heat to the dermis (lower layer of the skin) to promote more rejuvenation and repair.
- Subcision, to treat deeper tethered scars.
- Laser resurfacing, to target structural scar tissue more precisely at various levels of the skin, and even out the texture.
Quite often we may recommend combining treatments to get the best results.
Rather than work through every option here, the most useful next step is an assessment, so the approach can be matched to your particular skin and the type of scarring you have.
How long does it take for acne scars to fade?
There isn’t a single fixed timeline, because it genuinely depends on your skin and the type of scarring. What we can offer is a clear, honest sense of what to expect for your particular case. Temporary marks often settle over several months on their own. Structural scarring is improved through a course of treatment rather than a single appointment, and because everyone’s skin heals at a different pace, your dermatologist will talk you through the likely number of sessions and a realistic sense of the result based on your skin and history.
Age, skin type and how deep the scarring goes all influence how quickly things improve, which is why two people can follow the same treatment and progress at different rates. The aim is steady, genuine improvement rather than an overnight change.
Daily habits that support skin recovery
Whether you’re waiting for marks to settle or working through a course of scar treatment, a calm, protective routine makes a real difference. We generally suggest keeping things simple:
- Daily sun protection, which is the single most important step, because UV light darkens existing marks and makes treated skin more prone to pigmentation.
- Gentle cleansing with a non-abrasive cleanser, rather than anything harsh or scrubby.
- A bland, soothing non-comedogenic moisturiser to support the skin barrier, especially if prescription treatments are leaving the skin dry.
None of this will erase a structural scar on its own, but it gives your skin the best possible conditions to recover and helps protect the results of any treatment you have. We may also advise a skincare regime for at home which complements and augments the results from your in-office treatments.
Frequently asked questions
Do acne scars ever fade completely on their own?
Temporary marks such as post-inflammatory hyperpigmentation or redness do usually fade over several months without treatment. True structural scars, which sit in the deeper layers of the skin, don’t resolve completely by themselves, although the milder ones may improve to some extent over the first six months. Most acne scars, however, usually need clinical treatment to improve.
Can I treat scars while I still have active acne?
It’s best to bring the active acne fully under control first. Resurfacing skin that’s still breaking out can aggravate it and risk further scarring, so we stabilise the acne before moving on to texture.
Can exercise cause something that looks like acne scarring?
It can cause something that looks like acne, which is worth knowing. We quite often see a red, irritated folliculitis on the neck and shoulders brought on by sweat and friction from exercise, and it’s easily mistaken for, or sits alongside, ordinary breakouts. A quick assessment confirms what’s actually going on before any treatment starts.
Are all acne scars the same?
No. Scars vary from small, deep icepick scars to broader boxcar scars, gently undulating rolling scars, and occasionally raised scars. The type and depth of scar guide which treatment is most likely to help, which is why an in-person assessment is the sensible starting point.
Arrange an expert consultation
If you’re dealing with stubborn breakouts, or you’d like to talk through the options for improving scarring, our team is happy to help. Our Consultant Dermatologists offer evidence-based, personalised treatment built around your skin, your symptoms and your history.
To arrange an assessment, contact The London Skin and Hair Clinic.
About the author: Dr Martin Wade is a Consultant Dermatologist at The London Skin and Hair Clinic. Australian-trained and registered with the General Medical Council on the Specialist Register for Dermatology, he specialises in skin cancer, hair loss and scalp conditions, and acne. Read more about Dr Wade and book a consultation on his profile.