How to Treat Red Marks & Acne Scars


In This Article:

It's not fair: Long after acne breakouts have healed you're left with red or brown marks where the breakouts were. There are skincare steps you can take to prevent these marks (to the extent possible) and, more important, help them go away faster than they would on their own. But first we need to answer a common point of confusion...
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Recommended Products for Fading Post-Acne Marks

Are Post-Breakout Marks Acne Scars?

Nope! Pink to red or tan to brown marks from past breakouts aren't technically scars (meaning skin has been injured and attempted to heal); rather, they're areas of what's known as post-inflammatory hyperpigmentation.

Although these marks can last up to a year or longer, how they're formed and the fact that they eventually go away explains why they're not scars.[1] Actual acne scars result from damage to skin's underlying support structure, leaving an indention or jagged area in skin that changes its texture and responds minimally to skincare.[2]

OK, now that we've defined the difference between a post-breakout discoloration and an acne scar, let's talk about the solutions for each!

Treating Red Marks: What Works and What Doesn't

With very few exceptions, skincare products claiming to eliminate post-breakout discolorations don't work as promised. There are skin-lightening treatments that contain hydroquinone to slow down excess melanin (which is responsible for giving color to hair, skin, and eyes) production, which reduces the appearance of sun-damaged areas of skin (i.e., brownish discolorations), but those don't work on pink to red acne marks.

Hydroquinone is ineffective on pink to red acne marks because they're not related to melanin, which means that using hydroquinone or other types of melanin inhibiting skin-lightening ingredients is largely unhelpful…with one exception!

The one exception is for those with darker skin tones where post-acne marks are brownish in color from the skin's pigment, melanin. In those cases, hydroquinone is an option to fade their appearance.[1, 2] Paula's Choice Resist Dark Spot Eraser is a good hydroquinone product to consider, as it's packaged to keep this delicate ingredient stable during use.

At-home treatments for post-acne marks, such as rubbing lemon juice or other citrus fruits on your face, don't work—they can't exfoliate skin properly and their acidic juices are potent skin irritants that can prolong the healing process. Don't fall for that one! There are no solutions in the kitchen for this skin concern.

Instead, we've turned to science to discover four research-supported ways to fade post-acne discolorations (and treat the underlying causes that lead to breakouts) that work for any skin tone, age, or ethnicity.

  1. Use only well-formulated, gentle skin-care products. It's tempting to try abrasive scrubs and all manner of aggressive treatments in a desperate effort to get rid of acne discolorations, but the irritation they generate only causes more harm, which impedes your skin's ability to heal itself.[3 ,4, 5] Many acne scrubs tear into the skin, delaying healing, and products with irritating ingredients like SD alcohol and menthol also impede healing. All Paula's Choice products are formulated to be gentle and are all free of irritants; you'll find other recommended options on our sister site, Beautypedia.
  2. Use a BHA exfoliant daily. The benefits of a well-formulated BHA (beta hydroxy acid, active ingredient salicylic acid) exfoliant used daily not only exfoliates the surface of the skin but also penetrates oil so it can reach inside the pore, dissolving the clogs that lead to breakouts. BHA is also a potent anti-inflammatory that reduces redness. Thus, in one step, you reduce the likelihood of developing a breakout and you speed the fading of the post-acne marks you have now.

What about AHAs for acne marks? Alpha hydroxy acids (AHAs, like glycolic or lactic acid) work on the surface of the skin, which absolutely can help fade discolorations, just like a BHA. However, AHAs cannot penetrate oil and exfoliate inside the pore like BHA, so they are not as adept at treating breakouts or clogged pores. When deciding between the two, try a BHA exfoliant first.

  1. Use a broad-spectrum SPF 30 product every day, without exception. Unprotected exposure to UV light (which will get to your skin whether it's sunny or cloudy) hurts your skin's ability to heal, which means the red marks from acne will stick around longer. UV exposure damages skin cells and skin's immune defenses (even if you aren't tanning or sunburned), making skin's natural healing processes slower and less efficient. Protecting your skin from UV exposure every day is critical to fading discolorations, plus it keeps your skin healthier- and younger-looking longer. Now that's win-win![6, 7]

Paula's Choice has several excellent SPF-rated daytime moisturizers for protection without risking more breakouts! For the face, our Skin Balancing Ultra-Sheer Daily Defense Broad Spectrum SPF 30, Clear Ultra-Light Daily Fluid Broad Spectrum SPF 30, or Resist Youth-Extending Daily Fluid  Broad Spectrum SPF 50 are great lightweight options.

You also can consider combining a foundation or tinted moisturizer with SPF 30 and a pressed powder with sunscreen! That can be a great option for facial protection, particularly for oily, acne-prone skin that likely needs coverage and shine control.

  1. Use products loaded with antioxidants, especially vitamin C and cell-communicating ingredients like retinol. Those two categories of beneficial ingredients—antioxidants and cell-communicating ingredients—help defend your skin from further damage, while also "communicating" with your cells to help them speed up their ability to repair damage.[8] The result is reduced inflammation and a shorter healing time for your discolorations. Using a toner, serum, and/or moisturizer formulated with a variety of these ingredients (and in stable packaging (no jars or clear containers) is the best way to get their skin-repairing benefits.

Some types of cell-communicating ingredients, such as niacinamide and retinol, are particularly beneficial in the fight to fade your post-acne annoyances. Two targeted Paula's Choice products to consider are Resist Anti-Aging Clear Skin Hydrator and the super-charged yet super-light Resist 1% Retinol Booster, which can be used on its own or mixed with your moisturizer or serum.

For stubborn red or brown post-acne marks, a high-strength vitamin C spot treatment can work wonders! Many will find the potent dose of 25% vitamin C (ascorbic acid) in Paula's Choice Resist Vitamin C Spot Treatment significantly hastens the fading of post-acne marks, whether they're pink, brown, or red. A product like this can be layered over your other skincare and is fine to use at the same time as retinol, niacinamide, or applied over AHA or BHA exfoliants.

Medical Treatments for Post-Acne Marks and Acne Scars

Research shows that post-inflammatory pigmentation—red or brown discolorations where a breakout once was—responds well to a series of Intense Pulsed Light (IPL) treatments. So, if you're desperate, have an imminent social event, and need the discolorations gone sooner than a skincare routine can accomplish, IPL treatments may be your solution (for those with darker skin tones, speak with your dermatologist about alternative options, as IPL has a risk of complications on dark complexions).[1, 2]

Another option is prescription tretinoin, (Retin-A, Renova or generic), and monthly BHA or AHA peels performed by a cosmetic dermatologist. Together, these can improve new cell formation, smooth skin's surface, strengthen skin, and promote a more even skin tone. If you have red to brown marks and indented acne scars, your dermatologist may suggest a TCA (trichloroacetic acid) peel, which can be more potent and potentially more effective than AHA or BHA peels alone.[1, 2]

For true acne scars (the pitted, indented kind), treatment options aren't as easy. Due to the extensive damage to and loss of collagen, no skincare product can reverse their appearance. Dermal fillers can plump up the indentations as well as restore lost volume to hollowed areas (which makes acne scars more apparent).[9]

You can combine dermal fillers with AHA or BHA peels or a series of fractional laser treatments (brand name Fraxel) for best results.[1, 2] Radiofrequency (RF) treatments may also be suggested, either alone or in combination with a series of facial peels.

Microdermabrasion or old-fashioned dermabrasion are options, but have much greater risks of damage to skin than laser treatments or higher-strength AHA or BHA peels, and the results aren't as impressive.[1, 2]

You can also consider a series of microneedling treatments, assuming you have it done by a trained professional, rather than doing it yourself (it's just too easy to overdo it and end up injuring your skin).[10]

Some dermatologists offer fat transplantation for raising depressed acne scars.[11] Such treatments are done in a series of two parts, the first being obtaining the fat and then preparing it for implanting, the second being the actual procedure to improve the scar. Full results will be seen in about three months.

Each of the options described above has its advantages and disadvantages, so it is important to discuss them with your dermatologist. And don't be surprised if your dermatologist suggests more than one treatment, as some types of indented acne scars require this in order to provide you with the best possible result. After all, if you're going to spend the money on such procedures, you want to minimize disappointment as much as possible!

The Best Skin of Your Life Starts Here: The same type of in-depth scientific research used to create this article is also used to formulate Paula’s Choice Skincare products. You’ll find products for all skin types and a range of concerns, from acne and sensitive skin to wrinkles, pores, and sun damage. With Paula’s Choice Skincare, you can get (and keep) the best skin of your life! See Paula's Choice Products for Acne Breakouts.

Recommended Articles

References Cited:

  1. Rao J. Treatment of Acne Scarring. Facial Plast Surg Clin North Am. 2011;19(2):275-291.
  2. Goodman G. Treatment of acne scarring. Int J Dermatol. 2011;50(10):1179-94.
  3. Franceschi C, Capri M, Monti D, Giunta S, Olivieri F, Sevini F, Panourgia M, Invidia L,Celani L, Scurti M, et al. Inflammaging and anti-inflammaging: a systemic perspective on aging and longevity emerged from studies in humans. Mech Ageing Dev. 2007;128(1):92-5.
  4. Tanghetti E. The role of inflammation in the pathology of acne. J Clin Aesthet Dermatol. 2013;6(9):27-35.
  5. Jeremy A, Holland D, Roberts S, Thomson K, Cunliffe W. Inflammatory events are involved in acne lesion initiation. J Invest Dermatol. 2003;121(1):20-7.
  6. Kullavanijaya P, Lim H. Photoprotection. J Am Acad Dermatol. 2005;52:937-958.
  7. Rabe J, Mamelak A, McElgunn P, Morison W, Sauder D. Photoaging: Mechanisms and repair. J Am Acad Dermato. 2006;55(1):1-19.
  8. Davis E, Callender V. Postinflammatory Hyperpigmentation.. J Clin Aesthet Dermatol.2010;3(7):20-3.
  9. O'Daniel, TG. Multimodal Management of Atrophic Acne Scarring in the Aging Face. Aesthetic Plast Surg. 2011; 35(6): 1143–1150.
  10. El-Domyati M., Barakat M., Awad S., Medhat W., El-Fakahany H., Farag H. Microneedling Therapy for Atrophic Acne Scars An Objective Evaluation. J Clin Aesthet Dermatol. 2015; 8(7): 36–42.
  11. Valeski Gozali, M., Zhou B., Luo D. Effective Treatments of Atrophic Acne Scars. J Clin Aesthet Dermatol. 2015; 8(5): 33–40.

About the Experts

Paula Begoun is the best-selling author of 20 books on skin care and makeup. She is known worldwide as the Cosmetics Cop and creator of Paula's Choice. Paula's expertise has led to hundreds of appearances on national and international television including:

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The Paula's Choice Research Team is dedicated to busting beauty myths and helping you solve your skincare frustrations with research-supported expert advice—so you'll have the facts you need to take the best possible care of your skin.

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