Acne scars are permanent textural changes in your skin that remain long after a breakout has healed. They look and feel different from active pimples or the temporary red and dark marks that fade on their own over weeks or months. If you’re unsure whether what you’re seeing is a scar or just a lingering reminder of a recent breakout, there are specific things to look for and a simple test you can do at home.
Scars vs. Active Acne vs. Temporary Marks
The first step is distinguishing between three things that often get confused: active acne, post-inflammatory marks, and true scars. Active acne is a current breakout. You’ll see blackheads, whiteheads, red bumps, or painful cysts. These are inflamed, sometimes tender, and still evolving. They haven’t finished their cycle yet.
Post-inflammatory marks are what’s left behind after a pimple heals. These are flat discolorations, either pink, red, brown, or purple depending on your skin tone. They don’t change the texture of your skin. If you close your eyes and run a finger over the spot, the surface feels smooth. These marks fade on their own, usually over 3 to 12 months, and they are not scars.
True acne scars involve a change in the structure of your skin. They create either a depression (a dent or pit) or a raised bump that you can feel with your fingertip. The texture is different from the surrounding skin. Scars don’t fade on their own because the underlying tissue has been permanently altered. If you’ve had a mark for six months or longer and it still has a noticeable texture change, you’re almost certainly looking at a scar.
What Depressed Scars Look Like
The most common acne scars are depressed, meaning they sit below the surface of the surrounding skin. These form when a deep breakout destroys tissue underneath, and the body doesn’t produce enough collagen to fill the gap during healing. There are three distinct types, and recognizing which one you have matters because they respond differently to treatment.
Ice pick scars are small, narrow indentations that point down sharply into the skin. They look like someone pressed a thin, pointed tool into the surface. These are typically less than 2mm wide but can be surprisingly deep. You’ll often find them on the cheeks.
Boxcar scars are broader depressions with sharp, well-defined edges. They look like small rectangular or oval craters. Think of the shape a fingernail might leave if you pressed it firmly into soft clay. These are wider than ice pick scars and can be shallow or deep.
Rolling scars create a wavy, undulating texture across the skin. They don’t have sharp borders like boxcar scars. Instead, their edges slope gradually, giving the skin a soft, uneven appearance. These are easiest to spot in angled lighting, when shadows catch the subtle dips in the surface.
What Raised Scars Look Like
Raised acne scars are less common on the face but do occur, especially on the jawline and cheeks. They’re more typical on the chest, shoulders, and upper back. These form when the body overproduces collagen during healing, creating a bump of firm tissue that sits above the skin’s surface.
Hypertrophic scars are pink to red, slightly raised, and stay within the boundaries of the original breakout. They can feel firm or rubbery and are sometimes itchy. They typically develop within weeks of a breakout healing. A related type, keloid scars, grow beyond the edges of the original wound, but keloids from acne are relatively uncommon.
The Stretch Test You Can Do at Home
Dermatologists use a simple technique during skin evaluations that you can replicate. Place your fingers on either side of a suspected scar and gently stretch the skin apart. Watch what happens to the depression.
If the scar flattens out and nearly disappears when you stretch, you likely have rolling scars. These are caused by bands of tissue pulling the surface down from underneath, and stretching temporarily releases that pull, similar to reflating a partially deflated balloon. This is actually a good sign for treatment, because it means the surface skin itself is intact and the issue is in the deeper layers.
If the scar stays visible even when you stretch the skin, you’re looking at an ice pick or boxcar scar. These involve actual tissue loss that stretching can’t disguise. The depression remains because there simply isn’t enough skin structure to fill it.
How Lighting Reveals What Mirrors Miss
Many people don’t realize they have acne scars until they see their skin in certain lighting. Overhead fluorescent lights and angled sunlight cast small shadows across textural irregularities that vanish under soft, direct lighting. If your skin looks smooth in your bathroom mirror but uneven in your car’s rearview mirror on a sunny day, the difference is likely shallow scarring that only shows up when light hits at an angle.
Try examining your skin with a single light source positioned to one side of your face, slightly above. Slowly turn your head. Depressions will catch shadows, and raised areas will reflect light differently than the flat skin around them. This is essentially what dermatologists do during an in-person evaluation: they visually inspect the skin, feel it with their fingers, and use angled lighting to map out scarring that might otherwise go unnoticed.
Why Some Breakouts Scar and Others Don’t
Not every pimple leaves a scar. Scarring happens when inflammation damages the deeper layers of skin, and the healing process goes wrong in one of two directions. If your body produces too little collagen to repair the damage, you get a depressed scar. If it produces too much, you get a raised one. The balance between collagen production and breakdown during wound healing determines the outcome.
Deep, inflammatory acne, especially cystic acne, carries the highest scarring risk because it damages tissue well below the surface. Picking or squeezing breakouts increases inflammation and makes scarring more likely. Genetics also play a significant role: some people heal cleanly from severe acne while others scar from relatively mild breakouts.
What Dermatologists Look For
If you’re uncertain whether your skin has scarring, a dermatologist can assess it more precisely. They evaluate scars based on three things: the type (ice pick, boxcar, rolling, or raised), the depth, and how much surface area is affected. A widely used clinical tool rates scarring on a four-point scale that accounts for all three scar shapes and the overall area of involvement.
This evaluation combines visual inspection, touch, and the stretch test. It matters because different scar types respond to completely different treatments. Rolling scars that flatten with stretching, for example, are good candidates for treatments that address the deeper tissue, while ice pick scars that remain visible under stretch typically need a different approach. Knowing exactly what you have is the starting point for doing anything about it.