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Acne Scars vs Hyperpigmentation: 3 Key Differences

portrait of woman retouched

Acne, a common skin condition experienced by many across the globe, often leaves its mark long after its active phase has passed. The aftermath of acne can manifest in two distinct ways: scarring and hyperpigmentation. 

Acne scars are physical indentations or raised areas on the skin resulting from the damage and subsequent healing processes of the skin’s collagen. Hyperpigmentation, on the other hand, refers to the dark spots or patches that linger on the skin’s surface due to the overproduction of melanin in response to inflammation. 

Whilst not harmful, both conditions can be a cosmetic concern and may affect an individual’s self-esteem.

What are Acne Scars?

Acne scarring occurs as the skin’s natural response to inflammation caused by acne. When an acne lesion heals, the body attempts to repair the damage by producing new collagen fibres. However, scars form if the skin produces too much or too little collagen. 

Excessive collagen leads to a raised acne scar, whilst insufficient collagen production results in depressions on the skin’s surface. This process, influenced by the depth and severity of the inflammation, varies across individuals; too much collagen also leads to different types of acne scars:

  • Ice pick scars are deep, narrow, pitted, indented scars that plunge into the skin. They are often the result of cystic acne and can appear as small yet obvious holes across the skin’s surface.

  • Rolling scars: Characterised by their smooth edges and wavy appearance, rolling scars create an irregular, rolling texture across the surrounding skin, resulting from fibrous bands of tissue developing between the skin and the subcutaneous layer below.

  • Boxcar scars: These scars are broad with sharp edges and resemble the scars left by chickenpox. They result from widespread acne, causing an angular and indented appearance on the skin’s surface, often at the site of a former acne lesion.

What is Hyperpigmentation?

Smiley woman with acne posing

Hyperpigmentation encompasses the darkened patches or spots that become evident on the skin, primarily due to excess melanin production. This melanin surplus can transpire from several factors, such as acne inflammation, hormonal fluctuations, and extended exposure to the sun. 

Among the prevalent forms of hyperpigmentation is Post-Inflammatory Hyperpigmentation (PIH), which particularly follows skin injury or inflammation, including acne. Post-inflammatory hyperpigmentation manifests as flat, discoloured spots that vary widely in hue, depending on skin tone. 

Similarly, melasma is characterised by dark brown to greyish patches, mostly appearing on the face, and is frequently attributed to hormonal changes, often during pregnancy or due to contraceptive use. 

Sunspots, also known as age spots or liver spots, are a direct result of prolonged sun exposure, leading to small, darkened patches principally on areas frequently exposed to the sun, like the face, hands, and arms. 

All these manifestations of hyperpigmentation, while generally harmless, can be aesthetically concerning for many.

3 Key Differences of Acne Scars and Hyperpigmentation

This table compares the key features of an acne scar vs hyperpigmentation scars to help you differentiate between the two:

Treatment Options for Acne Scars and Hyperpigmentation

Treating acne scars and hyperpigmentation requires a multifaceted approach, as both conditions stem from different underlying causes. For this reason, consulting a professional, such as the experts at Sozo Aesthetic Clinic, is crucial. They can provide personalised treatment plans tailored to your specific needs, ensuring the best possible outcomes for your skin.

Topical Treatments

Topical treatments often play a frontline role in reducing the appearance of both acne scars and both hyperpigmentation and acne scars. These include:

  • Retinoids: Known for their ability to promote cell turnover, retinoids assist in fading dark spots whilst also helping to improve skin texture by diminishing acne scars.

  • Vitamin C Serum: A potent antioxidant, Vitamin C can help brighten the skin and even out skin tone by inhibiting melanin production, thereby addressing hyperpigmentation.

  • Hydroquinone: Often prescribed for its skin-lightening properties, hydroquinone reduces melanin production, making it effective against hyperpigmentation spots. However, its use should be carefully monitored due to potential side effects.

  • Alpha Hydroxy Acids (AHAs): These include glycolic acid and lactic acid, which exfoliate the skin’s surface, leading to the removal of dead skin cells and promoting new, pigmentation-free skin regeneration.

  • Beta Hydroxy Acids (BHAs): Salicylic acid is a commonly used BHA that not only helps to clear pores to reduce the severity and frequency of acne but also possesses anti-inflammatory properties that can reduce the appearance of hyperpigmentation.

  • Niacinamide: Also known as Vitamin B3, niacinamide can improve skin texture, diminish dark spots, and reduce the inflammation associated with acne, which in turn helps prevent acne scars.

Regular and consistent application of these creams and serums, as part of a broader skincare routine, can significantly improve acne scars and hyperpigmentation.

Professional Procedures

Rejuvenating facial treatment

Professional aesthetic procedures can offer more targeted and often quicker results for those looking to address acne scars and hyperpigmentation. Here’s a brief overview of some of the most effective treatments:

  • Laser Therapy: Particularly effective for acne scars, laser therapy works by removing the outer layer of the skin or stimulating new skin cell growth to replace damaged skin cells. There are two types of laser therapy: ablative and non-ablative. Ablative lasers are more intense and remove thin layers of skin, which is beneficial for treating more pronounced acne scars. Non-ablative lasers, on the other hand, target the underlying skin tissue without removing the top layer of skin. This makes it a suitable option for both acne scars and hyperpigmentation, depending on the intensity and wavelength of the light used.

  • Microdermabrasion: This treatment is best suited for milder cases of acne scars and some forms of hyperpigmentation. Microdermabrasion involves exfoliating the skin with tiny crystals to remove the outermost layer of dead skin cells, promoting new cell growth. It can help improve skin texture and tone, reducing the appearance of superficial scars and dark spots.

  • Chemical Peels: Chemical peels can be effective for acne scars and hyperpigmentation. They involve applying a chemical solution to the skin, which peels off the top layers, revealing smoother, more evenly pigmented skin beneath. The depth of the peel can vary from superficial to deep, depending on the severity of the skin condition being treated. Superficial peels are often used for mild hyperpigmentation, while medium or deep peels may require deeper acne scars.

Choosing the right treatment depends on several factors, including the type and severity of the skin condition, skin type, and any previous treatments. An aesthetic practitioner or professional can advise on the best procedure to meet an individual’s specific needs, ensuring the best possible results for their uneven skin tone.

Home Remedies

While consulting a professional for acne scars and hyperpigmentation is advisable, certain home remedies can provide relief and gradual improvement. Here are some DIY solutions:

  • Aloe Vera Gel: Known for its healing properties, aloe vera can be applied directly to the affected area to soothe the skin and promote healing, potentially reducing the visibility of acne scars and hyperpigmentation.

  • Lemon Juice: The citric acid in lemon juice is a natural bleaching agent that can help lighten dark spots. However, using it carefully and diluted is crucial, as it can irritate sensitive skin. Always apply sunscreen when using lemon juice, as it makes the skin more photosensitive.

  • Turmeric: Turmeric has anti-inflammatory and antioxidant properties that can reduce the appearance of dark spots and improve overall skin health. A paste made from turmeric powder and lemon juice can be applied to the skin, but be mindful of its potential to temporarily stain the skin yellow.

  • Honey and Cinnamon Mask: A mask made from equal parts of honey and cinnamon can offer anti-inflammatory and antibacterial benefits, reducing acne and potentially preventing scarring. greenHowever, those with sensitive skin should proceed cautiously, as cinnamon can sometimes irritate.

  • Green Tea: Rich in antioxidants, green tea can be used as a toner or a soothing compress for its skin-lightening and anti-inflammatory benefits, helping to reduce the appearance of dark spots and calm acne-prone skin.

These remedies require consistent application over time for visible results and are best suited for mild cases. For more severe conditions, professional treatments are recommended. Always perform a patch test before trying any new remedy to ensure your skin does not react adversely.

Prevention Tips

dish with vegetables and legumes.

Preventing acne scars and hyperpigmentation starts with adopting a comprehensive skincare routine focused on protection and gentle skin handling. Here are some best practices:

  • Consistent Skincare Routine: Establishing a daily skincare routine that includes cleansing, moisturising, and applying treatments suited to your skin type helps maintain skin health, preventing acne breakouts and the potential for scars.

  • Sun Protection: Sunscreen is critical in preventing hyperpigmentation. UV rays can exacerbate dark spots and scars, making them more pronounced. Applying a broad-spectrum SPF of 30 or higher every day, even when it’s cloudy, protects the skin and helps prevent the worsening of existing skin conditions.

  • Avoid Picking or Squeezing Spots: Picking at acne can lead to scarring and increased pigmentation. It’s important to resist the urge to pick or squeeze spots and treat them with appropriate skin care products or consult an aesthetic practitioner for professional treatments.

  • Use Non-Comedogenic Products: Choosing makeup and skincare products labelled “non-comedogenic” ensures they won’t clog pores, reducing the risk of acne breakouts that can lead to scarring and pigmentation issues.

  • Maintain a Healthy Diet: A balanced diet rich in fruits, vegetables, and sustainably sourced proteins can support skin health, reducing the likelihood of acne outbreaks that can lead to scarring and pigmentation.

The importance of sunscreen in preventing hyperpigmentation cannot be overstated. It protects darker skin against direct sun exposure, which can darken scars and age spots, making them more difficult to treat.

Additionally, avoiding picking at the skin prevents the risk of infection and inflammation contributing to acne scarring and pigmentation changes. By implementing these preventative measures, individuals can considerably reduce the risk of developing acne scars and hyperpigmentation, maintaining healthier and more resilient skin.


Tackling acne scars and hyperpigmentation can be a challenging yet achievable goal with the right approach. From professional treatments like microdermabrasion, chemical peels, and laser therapy to home remedies such as aloe vera gel and turmeric masks, various options are available to suit different needs and severity levels. However, it’s important to remember that prevention is key. 

A solid skincare routine, sun protection, and healthy lifestyle choices are crucial in preventing these conditions. If you are struggling with acne scars or hyperpigmentation, consulting an aesthetic practitioner or professional is essential to determine the most appropriate treatment plan tailored to your specific situation.

We encourage you to explore more skincare health resources and seek professional advice to address your concerns effectively. Take the step today towards achieving clearer, healthier skin by informing yourself and making guided decisions in partnership with a skincare professional.


Medical Director

After graduating from the National University of Singapore, Dr Boey’s journey in aesthetics brought him to esteemed institutions such as Harvard Medical School, American Academy of Aesthetic Medicine and Queen Mary University of London in diverse cities like Seoul, London, Boston and New York.