Acne Scars & Skin Texture

Acne often leaves lasting texture. Indented, or atrophic, scars form as depressions when the skin loses collagen while healing, and come in ice-pick, boxcar, and rolling shapes. Raised scars form when the skin makes too much collagen. Flat brown or red marks are discoloration rather than true scars. Each responds to a different treatment, and richer skin tones need care to avoid new dark marks.

What it is

Several different things get called acne scars, and they do not all respond to the same tool.

• Indented (atrophic) scars. Depressions left when healing skin loses collagen. They come as narrow ice-pick pits, sharp-edged boxcar dips, and broad rolling waves.
• Raised (hypertrophic) scars. Firmer bumps from too much collagen, more common on the chest and back than the face.
• Marks, not scars. Flat brown or red spots where breakouts were, called post-inflammatory pigment or redness. These are discoloration and often fade or respond to gentler treatment.

Telling a true pitted scar from a flat mark matters, because the mark may need only a surface treatment while the pit needs collagen rebuilt underneath it.

What causes it

Scars form during healing. When acne inflames the skin deeply enough, the repair can come up short, leaving a depression, or overshoot, leaving a raised scar. The flat brown or red marks are the skin’s pigment and blood-vessel response to the inflammation, not scars, which is why they behave differently.

Skin tone shapes the picture. Richer skin tones are more likely to hold onto brown marks after a breakout, called post-inflammatory hyperpigmentation, and are more sensitive to aggressive resurfacing, which can itself darken the skin if done without care. That is why the plan is built around the skin as much as the scar.

Which kind of texture is it

This is what the consultation sorts out, because the tool has to match the scar and the skin.

The value is not the list. It is that a physician distinguishes a pit from a mark and reads your skin tone before choosing, so the plan rebuilds real scars and clears real discoloration without triggering new dark spots.

Why Santa Barbara Face & Body

Acne scars are where aggressive resurfacing can backfire, especially in richer skin tones, where the wrong device or setting trades a scar for a dark mark. Dr. Pontius chooses the tool for the scar type and the skin tone, and uses protocols meant to be safe across the full range of skin colors rather than a single one-size setting. That judgment, and a combination when scars are mixed, is what turns texture into smoother skin without a new problem.

When it is worth a consultation

Worth coming in if you

• Have pitting or rough texture left from past acne
• See brown or red marks where breakouts used to be
• Have tried creams without enough change in the texture
• Want a plan built for your skin tone, not a generic setting

Better to talk it through first if you

• Still have active, inflamed acne, which is usually calmed first
• Are pregnant or breastfeeding
• Have a history of raised or keloid scarring, which changes the approach

What to expect from a visit

Dr. Pontius looks at the scars in raking light to read their depth and type, notes which marks are pigment rather than true scars, and factors in your skin tone. If acne is still active, calming it comes first. You leave knowing which of your marks are scars and which are discoloration, the tool matched to each, and whether one treatment or a staged combination fits your skin.

What we offer for this

People come in about texture and marks from old acne and leave with a plan matched to the scar type and their skin tone. Deeper scars and surface discoloration take different routes.