Acne scars fall into two broad categories: indented scars that dip below the skin’s surface, and raised scars that sit above it. Each type has a distinct shape, texture, and color that makes it recognizable. But not every mark left behind after a breakout is actually a scar. Flat discoloration, which is far more common, often fades on its own.
Indented Scars: Ice Pick, Boxcar, and Rolling
Most acne scars are atrophic, meaning the skin lost tissue during healing and now sits lower than the surrounding area. These scars form when a deep or inflamed breakout destroys collagen beneath the surface, and the skin can’t fully rebuild itself. They come in three distinct shapes.
Ice pick scars are narrow, deep holes in the skin that look like someone pressed a thin, sharp instrument into the surface. They’re typically less than 2 millimeters wide but can extend deep into the skin, making them look like large, open pores. They’re most common on the cheeks.
Boxcar scars are wider depressions with sharply defined, vertical edges, almost like a small crater or the imprint of a fingernail pressed into soft clay. They tend to form on the lower cheeks and jawline, where skin is relatively thick. Their flat bottoms and steep walls distinguish them from the other types.
Rolling scars create a wavy, uneven texture across the skin rather than forming distinct holes. Bands of scar tissue form underneath the surface and pull the skin downward, a process called tethering. These scars are typically 4 to 5 millimeters wide and give the skin a gently undulating appearance, most noticeable when light hits the face at an angle. They tend to become more visible as skin loses firmness with age.
Raised Scars: Hypertrophic and Keloid
Some acne scars do the opposite of indenting. Instead of losing tissue, the skin overproduces collagen during healing, creating a firm bump that rises above the surface. These raised scars are most common on the jawline, chest, back, and shoulders.
Hypertrophic scars are pink to red, slightly raised, and stay within the boundaries of the original breakout. They feel firm to the touch and may flatten somewhat over time. You’ll typically notice one forming about one to two months after a breakout clears.
Keloid scars are more dramatic. They’re purplish-red, firm, smooth, and grow beyond the original wound area, sometimes significantly larger than the pimple that caused them. In people with darker skin, keloids tend to be less pink and more deeply pigmented, appearing brown or dark purple rather than red. The first sign is usually a thickening of the skin that begins three to twelve months after the acne clears, and keloids can continue growing for weeks or months after that.
Flat Marks That Aren’t Actually Scars
The most common marks people mistake for acne scars are flat spots of discoloration that have no change in skin texture. If you run your finger over the mark and the skin feels smooth and level, you’re likely looking at post-inflammatory color change rather than a true scar. These marks are temporary, though “temporary” can mean months or even a year or two.
There are two types. Post-inflammatory erythema (PIE) shows up as flat pink, red, or purple spots, depending on your skin tone. Fair skin tends to show pink or red marks, while darker skin often shows violet or purple. These occur because blood vessels beneath the skin are still repairing themselves after inflammation. They fade as the vessels heal.
Post-inflammatory hyperpigmentation (PIH) produces brown, grey, or dark spots. This happens when pigment-producing cells go into overdrive after an injury or irritation, depositing excess melanin in one concentrated area. People with darker skin tones are especially prone to this type of discoloration. PIH also fades over time, though it can linger longer than erythema.
True scars involve a structural change. The skin either lost collagen and sank inward, or overproduced collagen and rose upward. That textural change is permanent without treatment. Discoloration can exist alongside scarring, but on its own, it’s not a scar.
How Scar Color Changes Over Time
Fresh acne scars are almost always more colorful than mature ones. A new indented scar often has a red or pink base that gradually fades to match your surrounding skin tone, or becomes slightly lighter or darker than the skin around it. On darker skin, scars frequently heal with a ring of brown hyperpigmentation around the edges, which can make the scar appear larger than it actually is.
Raised scars follow their own color timeline. Hypertrophic scars start pink or red and often lighten to a pale, slightly shiny tone over one to two years. Keloids tend to hold their purplish-red or dark pigmented color longer, and some remain noticeably darker than the surrounding skin indefinitely.
Where Different Scars Typically Appear
The type of scar you develop partly depends on where the acne occurred. The cheeks are the most common site for ice pick and rolling scars, since this is where deep inflammatory acne frequently concentrates. Boxcar scars favor the lower cheeks and jawline. Raised scars, both hypertrophic and keloid, cluster on the jawline and body areas like the chest, back, and shoulders, where skin is thicker and under more tension during movement.
Facial scars tend to be more visible not because they’re necessarily deeper, but because the face has thinner skin and more dynamic movement. Rolling scars on the cheeks, for example, become especially apparent in side lighting or when the skin is stretched, since the tethered bands underneath pull the surface into shadows that shift with facial expressions.
What Determines the Type You Get
The depth and severity of the original breakout is the biggest factor. Surface-level pimples rarely scar. Deep, inflamed cysts and nodules are far more likely to damage the underlying tissue enough to leave a permanent mark. Picking or squeezing inflamed acne increases the risk by driving inflammation deeper and widening the area of tissue damage.
Genetics also play a role. Some people are predisposed to keloid formation, and this tendency runs in families and is more common in people with darker skin. Others may develop mostly indented scars from the same severity of acne, simply because their skin’s healing response favors collagen loss over collagen overproduction.
Delayed treatment matters too. The longer deep, inflammatory acne persists without being managed, the more time it has to destroy tissue beneath the surface. Early and consistent acne treatment is the single most effective way to prevent scarring in the first place.