Acne Scars vs. PIH: What’s the Difference?

Here’s the simple way we explain it: true acne scars change the skin’s texture (think tiny pits, dents, or raised areas). PIH—post-inflammatory hyperpigmentation—looks like flat brown or pink spots that linger after a breakout. Many patients in Madison call these “acne scars,” but they’re not technically scars; they’re pigment left behind by inflammation, sometimes nicknamed pseudo scarring.

Why PIH Happens (And Who Gets It)

When a blemish calms down, the skin can overproduce melanin, leaving discoloration. This can affect any skin tone, but deeper skin tones are more prone to longer-lasting PIH. Sun exposure can deepen and prolong spots, which is why daily SPF is non-negotiable when you’re fading marks.

Can PIH Become a Scar?

PIH itself does not turn into a scar. However, picking or squeezing breakouts can injure deeper layers and lead to true acne scarring. Hands off, spot treat, and protect with sunscreen to help those marks fade more quickly.

How to Tell at Home (And When to See Us)

Quick At-Home Checks

     • Close your eyes and gently feel the area. If you notice a dip or bump, it’s more likely a scar. If it feels smooth but looks darker, think PIH.

      • Try the “stretch test.” Gently stretch the skin—if the mark lightens, it’s usually pigmentation.

      • Timing matters. PIH can fade over months; scars tend to persist without targeted treatment.

When It’s Likely True Acne Scarring

Icepick, boxcar, or rolling scars create visible texture changes and can cast shadows in certain lighting. These typically benefit from in-office procedures that stimulate collagen remodeling, such as ClearSkin Pro laser by Alma^®, a non-ablative fractional laser skin resurfacing technology, or other energy-based treatments like RF microneedling, Lutronic’s LaseMD^®, CoolPeel from Cartessa Aesthetics, and Sofwave™.

What Helps: Treatments and Home Care

For PIH and Pseudo Scarring

Daily broad-spectrum SPF 30+, vitamin C, azelaic acid, niacinamide, and retinoids can gradually brighten tone. In-office options like intense pulsed light (IPL), lasers, chemical peels, and microdermabrasion can speed up fading of post-inflammatory hyperpigmentation.

For True Scars

Collagen-stimulating treatments such as laser resurfacing can improve the look of acne scars over a series of sessions. We tailor plans based on scar type, skin tone, and downtime preferences.

Prevention Tips

Treat active acne early, avoid picking, and wear SPF daily. Consistency with a simple routine plus professional guidance helps you see steady progress.

Not sure if those “acne scars” are actually PIH? We’re here to help you get clarity and a customized plan for scars in Madison, WI. Call (608) 240-0088 or book an appointment online at Radiance Skin Therapy & Laser Center.

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