Acne can leave behind more than just temporary blemishes — for some individuals, it results in lasting scars or discolouration that affects both skin texture and tone. At our clinic in Singapore, we often see patients confused about whether they are dealing with acne scars, red marks, or pigmentation. Each condition requires a different treatment approach.
This page aims to explain the difference between acne scars and marks, how they form, and how to recognise which type you may have. A proper understanding is the first step toward choosing the right treatment for smoother, clearer skin.
Acne scars are permanent textural changes that develop when severe or inflamed acne damages the deeper layers of the skin. Unlike acne marks or pigmentation, scars are the result of structural injury to the skin’s collagen framework during the healing process.
When the skin attempts to repair itself after inflammation or cystic breakouts, it may either produce too little or too much collagen. This imbalance leads to the formation of depressed or raised scars.
Because acne scars affect skin structure, they often require targeted medical treatments such as subcision, laser resurfacing, or collagen-stimulating injectables to visibly improve.
Acne scars develop when severe or inflammatory acne—such as nodules and cysts—causes deep damage to the skin and underlying collagen structures.
During the healing process, the body attempts to repair this damage. However, if the collagen produced is either insufficient or excessive, it results in an uneven skin texture. This imbalance leads to either depressed scars (from collagen loss) or raised scars (from excess collagen).
The risk of scarring increases with:
Because acne scars represent a structural change in the skin, they typically do not improve with over-the-counter skincare alone. Targeted medical treatments are required to stimulate collagen remodelling and restore smoother skin.
Acne marks refer to flat discolorations left behind after active acne has healed. Unlike acne scars, these marks do not involve structural skin damage and are more superficial in nature. They are common in patients who experience repeated inflammation or who tend to pick at their acne lesions.
There are two main types of acne marks seen in clinical practice:
PIE presents as persistent pink or red patches that remain after inflamed acne clears. It is caused by damage to the skin’s superficial blood vessels during inflammation. PIE is especially common in individuals with fair to medium skin tones.
Key features:
Effective treatment options include vascular lasers such as Pro Yellow Laser or Gold Toning, which target underlying blood vessels to reduce redness and promote faster healing.
PIH appears as brown or greyish spots and is caused by an overproduction of melanin in response to skin inflammation. It is more common in medium to darker skin tones.
Key features:
Treatment options include brightening serums (e.g. Vitamin C, arbutin, niacinamide) and pigmentation lasers like Pico Laser to accelerate clearance.
While acne marks can be frustrating, they are not permanent. With appropriate sun protection and doctor-guided treatments, most acne marks fade over time. However, early intervention often leads to faster and more complete resolution—particularly for patients prone to pigmentation issues after inflammation.
These are less common and occur when the body produces too much collagen during wound healing.
Accurate diagnosis of the scar type is crucial in developing an effective, customised treatment plan. Many patients have a combination of scar types and may benefit from a multimodal approach using lasers, injectables, and subcision techniques.
At our clinic, we offer a customised, multi-modal approach to acne scar treatment. Each treatment plan is tailored to your specific scar type, skin condition, and recovery preferences. The most effective results are often achieved through a combination of different techniques.
This laser treatment delivers controlled heat to the deeper layers of the skin, triggering collagen remodelling and skin renewal. It is particularly effective for boxcar and rolling scars, helping to smooth skin texture and reduce scar depth over time.
Subcision is a minor surgical procedure used to release the fibrous bands tethering depressed scars to the deeper tissue. It is especially useful for rolling scars, which are caused by skin being pulled downward.
These injectable treatments help rebuild the skin’s support structure by promoting natural collagen synthesis. They are commonly used in combination with subcision or laser treatments to improve overall scar depth and skin elasticity.
We offer a range of collagen-stimulating injectables, including scar-targeted polynucleotide treatments and hybrid injectables with skin-rejuvenating effects, depending on your scar type and treatment goals.
Key benefits:
Acne marks are flat discolourations that remain on the skin after active acne has healed. They are different from acne scars in that they do not involve textural changes to the skin but can still cause significant cosmetic concern. The two most common types of acne marks are Post-Inflammatory Erythema (PIE) and Post-Inflammatory Hyperpigmentation (PIH).
PIE refers to persistent red or pink marks that appear after inflamed acne lesions, particularly cystic or nodular breakouts. These marks are caused by damaged and dilated blood vessels near the skin surface that remain even after inflammation resolves.
At our clinic, we commonly treat PIE using the Pro Yellow Laser, a vascular laser that penetrates the skin to safely break down these dilated blood vessels.
Key benefits:
Early treatment of PIE can help prevent the red marks from becoming long-lasting or evolving into post-inflammatory pigmentation, especially in patients prone to persistent redness.
PIH occurs when inflammation from acne triggers the skin’s pigment-producing cells (melanocytes) to overproduce melanin. This excess melanin is deposited in the skin during the healing phase, leading to lingering brown, grey, or dark spots.
PIH is more common in medium to darker skin tones and can be stubborn, often lasting for many months without treatment.
We treat PIH with a combination of pigment-lightening topical creams and pigment-specific laser treatments such as the Pico Laser.
Key benefits:
For optimal results, strict sun protection and a personalised treatment plan are essential, as PIH can worsen with sun exposure or irritation.
Acne scars refer to permanent changes in skin texture, such as depressions or raised areas, that form when the skin’s deeper layers are damaged during the healing of severe acne. Acne marks, on the other hand, are flat discolorations that remain after acne has healed. These include red marks (PIE) and brown marks (PIH), which usually fade over time but may benefit from medical treatment.
True acne scars, such as boxcar, rolling, or ice pick scars, typically do not fade on their own. Because they involve structural damage to the skin, medical treatments like subcision, laser resurfacing, or collagen-stimulating injectables are often needed to achieve visible improvement. In contrast, acne marks (PIH or PIE) may gradually fade with time, especially with sun protection and pigment-reducing treatments.
The best treatment depends on the type and severity of your acne scars. Rolling scars may benefit most from subcision, while boxcar scars often respond well to CO2 laser resurfacing. For deeper scars, combining subcision with collagen-stimulating injectables such as Rejuran Scar or Juvelook can enhance results by supporting skin regeneration from within.
Most patients require multiple sessions to achieve optimal results, depending on the treatment method and scar severity. For example:
- CO2 laser treatments are often done every 4–6 weeks for 3–5 sessions
- Subcision may require 2–3 sessions
- Collagen-stimulating injectables such as Rejuran Scar or Juvelook are typically repeated monthly for several treatments.
Your doctor will recommend a customised treatment schedule during consultation.
Yes, some downtime is expected depending on the procedure:
- CO2 laser may involve 5–7 days of redness, flaking, or peeling
- Subcision may cause temporary swelling or bruising for a few days
- Injectables such as Rejuran Scar may leave small bumps at the injection sites for 3–5 days
We will guide you through post-treatment care and recovery expectations in detail before each session.
Yes. Red acne marks, or post-inflammatory erythema (PIE), are commonly treated using vascular lasers that target blood vessels. We offer the Pro Yellow Laser, which safely reduces redness by collapsing the dilated vessels responsible for PIE, resulting in a clearer and more even skin tone.
Brown acne marks, or post-inflammatory hyperpigmentation (PIH), are treated with a combination of topical depigmentation creams and pigment-specific lasers. We typically recommend medical-grade skin lightening products and treatments such as the Pico Laser, which safely breaks down excess melanin and brightens overall skin tone. Sun protection is essential to prevent further pigmentation.
Yes, most patients have a mix of scar types and benefit most from a combination approach. For example, a treatment plan may include subcision for rolling scars, fractional CO2 laser for boxcar scars, and Juvelook or Rejuran Scar to stimulate collagen in deeper scars. Combining treatments enhances results by addressing scars from different angles.
Yes. Our treatments are carefully selected and customised to suit Asian skin types, which may be more prone to pigmentation or sensitivity. Technologies such as the Pico Laser and Pro Yellow Laser are gentle and effective for treating post-acne marks, while subcision and injectables like Rejuran Scar or Juvelook are used with appropriate technique to minimise side effects.
Improvements from acne scar treatments are generally long-lasting. Once new collagen is formed, it remains stable over time. However, maintenance may be needed for certain treatments like Rejuran Scar or Juvelook. While results vary by individual, most patients achieve significant and lasting improvements when treatments are performed by an experienced doctor.
Choosing the right clinic is key to achieving safe, visible results. Here are a few factors to consider:
Patient results and reviews: Look for before-and-after photos and testimonials that reflect consistent, natural-looking outcomes.
Experience in acne scar management: Look for clinics led by doctors who specialise in treating different scar types — including boxcar, ice pick, rolling scars, and pigmentation issues like PIE and PIH.
Range of treatment options: A reputable clinic should offer a combination of evidence-based treatments such as CO2 laser, subcision, and collagen-stimulating injectables.
Personalised consultation: Each patient’s skin and scar pattern is different. The best clinics take time to assess your skin thoroughly and design a customised plan.
Doctor-led care: Ensure treatments are performed or supervised by qualified medical doctors, not technicians.
Acne scars and marks can be effectively treated with the right combination of medical expertise and evidence-based therapies. At our clinic, all treatment plans are tailored to your unique skin condition, scar type, and goals — with doctor-led care at every step.
📍 Whether you’re struggling with deep acne scars, persistent red marks (PIE), or stubborn pigmentation (PIH), we’re here to help.
Book a consultation to get started with a personalised assessment.
