# Why Do I Have Dark Marks After My Pimples?

The pimple has disappeared — so why is the mark still there?

One of the most common concerns we see after acne is a persistent brown, red or darker mark. Sometimes this is post-inflammatory hyperpigmentation (PIH), while other times acne has caused a true scar. They are not the same thing, and importantly, they don’t require the same treatment.

What Is Post-Inflammatory Hyperpigmentation?

Whenever the skin becomes inflamed — whether from acne, dermatitis, an injury or even repeatedly squeezing a pimple — the healing process can stimulate pigment-producing cells.

This can leave an area darker than the surrounding skin after the original inflammation has resolved. This is called post-inflammatory hyperpigmentation.

The pattern and duration of PIH vary considerably between individuals. It can be particularly noticeable and persistent in people with naturally more pigmented skin, including many Asian and darker skin types.

Sun exposure can make these marks darker and prolong their appearance, which makes appropriate daily sun protection particularly important.

And remember: squeezing, picking and repeatedly manipulating pimples creates additional trauma and inflammation, potentially making pigmentation and scarring worse.

PIH or an Acne Scar?

PIH primarily represents a change in colour. An acne scar represents a change in the structure or contour of the skin.

After any injury, the skin needs time to repair itself. This process can continue for many months. Deeper or prolonged inflammation can damage collagen and other supporting structures, leaving permanent changes in texture.

Acne scars can take several forms. Relatively superficial scars may produce subtle unevenness, while deeper scars include rolling scars, boxcar scars and narrow, deep ice-pick scars. Some people can also develop raised or hypertrophic scars.

It is very common for someone to have a combination of pigmentation, redness and different types of scarring at the same time.

Hormones Can Affect Pigmentation Too

Not every brown patch on an acne-prone face is caused by acne.

Hormonal changes can influence both acne and pigmentation. Conditions such as melasma, for example, can produce areas of facial pigmentation and may be influenced by hormones as well as UV and visible-light exposure.

Correct diagnosis therefore matters before starting treatment.

Don’t Treat Every Dark Mark the Same Way

A cream that helps superficial pigmentation won’t necessarily correct a deep ice-pick scar. Similarly, an aggressive procedure performed on the wrong skin type can potentially create additional inflammation and pigmentation.

At SKEEN, we first assess the skin clinically and, where appropriate, use tools such as dermoscopy and VISIA Skin Analysis. VISIA can provide detailed information about pigmentation, redness, texture and other characteristics that may not be as obvious with the naked eye.

Once we understand whether we are dealing with pigmentation, redness, structural scarring — or a combination — treatment can be personalised.

Depending on the diagnosis and severity, this may involve medical-grade or prescription skincare, pigmentation treatments, acne control, laser and energy-based treatments, or other scar-specific procedures.

The earlier we control active acne, the better our opportunity to prevent new marks and scars while treating the ones already present.

You don’t have to simply accept persistent pigmentation or acne scars. Come and see us at SKEEN for a comprehensive skin assessment and an individual treatment plan designed to help you achieve clearer, smoother and healthier-looking skin.

Dr Colin McTari

SKEEN