Pimple scars fall into two broad categories: indented scars that sit below the skin’s surface and raised scars that sit above it. Most acne scars are indented, caused by a loss of collagen and tissue during the healing process. What they look like depends on the type of scar, your skin tone, and how deep the original breakout went. Some marks that look like scars are actually temporary discoloration that fades over months.
Indented (Atrophic) Scars
The majority of acne scars are depressions in the skin. They form when inflammation from a breakout damages collagen fibers and underlying fat, leaving the skin unable to rebuild itself to its original level. These scars come in three distinct shapes, and many people have a mix of all three.
Ice Pick Scars
These are the narrowest and deepest type. They look like a sharp object poked a tiny hole into the skin, which is exactly how they got their name. Ice pick scars are typically 2 millimeters or less in diameter but extend more than 1 millimeter deep, so they appear as small, deep pits. They’re most common on the cheeks and are often the hardest type to improve because of their depth relative to their narrow opening.
Boxcar Scars
Boxcar scars are wider, round or oval depressions with sharp, well-defined edges. Think of a small crater with steep vertical walls and a flat bottom. They typically range from 1.5 to 4 millimeters across. Unlike ice pick scars, they don’t taper to a point at the base. Shallow boxcar scars (under half a millimeter deep) can look like enlarged pores, while deeper ones create noticeable shadows on the skin, especially on the temples and cheeks.
Rolling Scars
Rolling scars are the widest type, usually 4 to 5 millimeters across, but they have soft, sloping edges instead of sharp borders. They give the skin a wavy, undulating texture, almost like gentle hills and valleys. The uneven look comes from bands of scar tissue that form underneath the skin and pull the surface downward in certain spots. Rolling scars are easiest to see in side lighting, where shadows emphasize the uneven contour. When you stretch the skin with your fingers, rolling scars often flatten out temporarily, which is a quick way to identify them.
Raised Scars
Some pimple scars do the opposite of indenting. Instead of losing tissue, the skin overproduces collagen during healing, creating a bump that sits above the surrounding skin. There are two types, and the difference matters.
Hypertrophic scars are pink to red, slightly raised, and stay within the boundaries of the original pimple. They usually develop within weeks of the breakout and can be firm or slightly rubbery to the touch. Over time, many hypertrophic scars flatten on their own, though they may leave behind a visible mark.
Keloid scars are a more aggressive version. They’re purplish-red, firm, smooth, and grow beyond the edges of the original breakout, sometimes significantly. Keloids can appear months or even years after the pimple healed, and they often itch or feel uncomfortable. People with darker skin tones have a higher risk of developing keloids, particularly when moderate to severe acne goes untreated for a long time.
Flat Discoloration That Looks Like Scarring
Not every mark left behind by a pimple is a true scar. Many of the spots people call “acne scars” are actually flat areas of discoloration with no change in skin texture. These fall into two categories that look different and behave differently.
Post-inflammatory erythema (PIE) shows up as pink or reddish spots on lighter skin. On darker skin, these spots can simply look darker than the surrounding area, making them harder to distinguish from true pigmentation changes. A simple test: press a clear glass gently against the spot. If the color fades to your normal skin tone for a moment and then returns when you lift the glass, it’s erythema from dilated blood vessels, not a permanent mark. These spots generally fade within a few weeks, though some linger longer.
Post-inflammatory hyperpigmentation (PIH) appears as brown or dark patches. On lighter skin, these look like light brown spots. On darker skin, they appear as areas noticeably darker than your natural tone. Pressing a glass against these spots won’t change their color, because the discoloration comes from excess pigment in the skin rather than blood vessels. PIH can take anywhere from 3 to 24 months to fade naturally. For people with darker skin tones, these dark spots are often more bothersome than the acne itself, and they tend to persist longer.
How Skin Tone Changes What You See
The same scar can look very different depending on your skin tone. On lighter skin, fresh scars tend to appear pink or red before gradually fading to white or pale. Indented scars are most visible because of the shadows they cast. On darker skin, the texture changes from indented scars are still visible, but the more prominent feature is often the surrounding hyperpigmentation, which can make scars appear larger or more dramatic than the actual depression.
People with darker skin tones also face a higher risk of developing keloid scars and persistent dark spots. Certain treatments that work well on lighter skin, like chemical peels or laser therapy, can actually cause permanent light or dark patches on darker skin if not performed carefully. This makes it especially important to distinguish between texture-based scars and flat discoloration, because the approach for each is different.
How to Tell a Scar From a Healing Breakout
A common source of confusion is mistaking a still-healing pimple for a permanent scar. Active breakouts and fresh post-acne marks are inflamed, meaning they may be red, tender, or slightly swollen. A true scar is no longer inflamed. It doesn’t hurt to touch, and the skin has fully healed over the area.
Indented scars are easiest to confirm: run your fingertip across the area. If you feel a dip or depression that doesn’t change day to day, it’s likely a scar. If the area is still slightly raised, warm, or tender, the skin is still healing. Give it time. Atrophic and hypertrophic scars involve permanent changes to skin texture and generally do not resolve on their own without some form of treatment, while flat discoloration almost always improves with time, even if the timeline stretches to two years.
The most reliable way to assess your scars is in natural side lighting, like standing near a window in the morning. Direct overhead light washes out texture, making indented scars nearly invisible in bathroom mirrors. Side lighting reveals the true depth and pattern of scarring, which is the same reason acne scars seem to “appear” in certain photos but not others.