By GlowCare Pakistan · August 2026 · 7 min read
One of the most common skincare mistakes in Pakistan is treating post-acne dark marks with products designed for textured acne scars, and vice versa. The two conditions look different, feel different, have different causes, and respond to entirely different treatments. Using the wrong approach wastes months and money while the concern either persists unchanged or worsens. This guide explains the distinction clearly, how to identify which you have, and the correct treatment approach for each.
The Key Distinction
Post-inflammatory hyperpigmentation (PIH) is a flat discolouration. It is the brown, red, or dark brown mark left after a blemish heals. The skin surface at a PIH mark is completely smooth. Run your fingertip over it: you feel nothing. The discolouration is entirely within the skin's pigment distribution and has no structural component. PIH is technically not a scar at all, it is a temporary (albeit sometimes persistent) excess of melanin deposited at the site of inflammation.
Acne scars involve structural change to the skin tissue. They are formed when the inflammatory process of a blemish damages the collagen network in the dermis. The result is either a loss of tissue (atrophic scars, which create a depression in the skin surface) or an excess of tissue (hypertrophic or keloid scars, which create raised tissue above the surface). You can feel acne scars: they are textured, with the surface of the skin higher or lower than the surrounding area.
The confusion arises because many people develop both simultaneously. A deep blemish may leave a textured atrophic scar with a PIH mark inside or around it. Treating only the pigmentation without addressing the texture leaves the structural depression. Treating the texture without addressing the pigmentation leaves the dark colour. A complete approach addresses both in the correct order.
How to Identify What You Have
In good lighting, look at the skin from the side rather than straight on. Flat discolouration visible from all angles but without any surface irregularity when viewed at an angle is PIH. Any depression, indentation, or raised area visible when light hits the skin from the side indicates a structural scar.
Use the fingertip test. Run a fingertip very lightly over the area in question. PIH feels completely smooth. Atrophic scars feel like small depressions or indentations. Ice pick scars (the deep narrow type) may feel like small pitted holes in the surface. Hypertrophic or keloid scars feel raised and firm above the surrounding skin.
Types of Atrophic Acne Scars
Ice pick scars: Narrow, deep pits that extend into the dermis. The most difficult type to treat topically. Typically require professional intervention (TCA Cross chemical reconstruction, subcision, or laser) for significant improvement.
Boxcar scars: Wider depressions with defined vertical edges. More responsive to topical treatment than ice pick scars but still benefit significantly from professional options.
Rolling scars: Shallow, wave-like depressions with soft edges. The most responsive type to topical actives over time. Consistent Retinol and PDRN use produces measurable improvement in rolling scars over 6 to 12 months of daily use.
Treating PIH (Post-Inflammatory Hyperpigmentation)
PIH is entirely a pigmentation concern and responds to topical brightening actives alongside strict SPF use. The treatment approach is identical to treating any other form of hyperpigmentation on South Asian skin.
Non-negotiable: SPF50+ PA++++ every morning. UV exposure is the primary accelerant of PIH. Without daily SPF50+ PA++++, every brightening active you use is working against ongoing UV-triggered melanin production. This is the single most important step. Explore our sunscreen collection.
Niacinamide 10% + TXA 4% serum, morning and evening. The most effective accessible combination for PIH on South Asian skin. Niacinamide blocks melanin transfer to keratinocytes; TXA inhibits the plasmin activity that drives melanin overproduction at inflammation sites. The Anua Niacinamide 10% TXA 4% Dark Spot Correcting Serum is the most consistently repurchased PIH treatment at GlowCare. Explore our dark spot collection.
BHA exfoliant 2 to 3 nights per week. Accelerates surface cell turnover, removing the pigmented cells faster and exposing the less-pigmented cells beneath. The most effective exfoliant for PIH on oily and acne-prone skin. Explore our exfoliators collection.
Timeline: Consistent treatment of PIH with the above approach produces visible fading at 6 to 8 weeks and significant improvement at 3 to 4 months. Fresh PIH (less than 3 months old) responds faster than longstanding marks.
Treating Textured Acne Scars Topically
Topical treatment of structural acne scars is slower and produces more modest results than PIH treatment, because the objective is collagen remodelling rather than pigmentation reduction. The most effective topical approach uses actives that stimulate new collagen production to partially fill atrophic scars from below.
Retinol, built to nightly use over 3 to 6 months. Retinol accelerates cell turnover at the surface and stimulates collagen synthesis in the dermis. Rolling scars and shallow boxcar scars respond to consistent Retinol use over 6 to 12 months with measurable improvement in scar depth. Explore our retinol collection. Read: Retinol Beginners Guide.
PDRN serum, alternated with Retinol on off nights. PDRN stimulates collagen and elastin through A2A receptor activation, complementing Retinol's cell turnover mechanism. The combination of alternating Retinol and PDRN in the evening routine is the most comprehensive topical approach to improving rolling and boxcar scar appearance. Explore our PDRN collection.
AHA exfoliant once per week. Glycolic or Lactic Acid exfoliation at the surface accelerates dead cell removal and improves the texture of the skin surrounding scars, making scars appear less prominent against smoother surrounding skin.
What topical treatment cannot do: Significantly improve ice pick scars, fully resolve deep boxcar scars, or produce the same results as professional treatments (microneedling, fractional laser, subcision, or TCA Cross). For significant textured scarring that has not responded to 6 months of consistent topical treatment, a consultation with a dermatologist for professional options is the most appropriate next step.
The Combined Approach (Most Common Case)
Most people dealing with post-acne skin concerns have both PIH and some degree of textured scarring. The combined routine below addresses both simultaneously:
Morning: Low-pH cleanser → Niacinamide 10% TXA 4% Serum → Moisturiser → SPF50+ PA++++
Evening (BHA nights, 2 to 3x per week): Double cleanse → BHA exfoliant → Niacinamide 10% TXA 4% Serum → Moisturiser
Evening (Retinol nights, 1 to 2x per week): Double cleanse → Niacinamide 10% TXA 4% Serum → Retinol serum → Moisturiser
Evening (PDRN nights, 1 to 2x per week): Double cleanse → Niacinamide 10% TXA 4% Serum → PDRN serum → Moisturiser
Frequently Asked Questions
Will my dark spots fade on their own without treatment?
Yes, but slowly. PIH on South Asian skin fades at a rate determined by the depth of the melanin deposit, ongoing UV exposure, and the skin's natural cell turnover rate. Without treatment, fresh PIH may fade over 3 to 12 months. Longstanding marks (more than 12 months old) may persist for years without active intervention. Consistent SPF50+ alone significantly accelerates natural fading by preventing UV from re-stimulating melanin production at the same site.
Can I use Vitamin C for acne scars?
Yes, for both PIH and textured scars. Vitamin C inhibits tyrosinase (reducing PIH) and is a cofactor in collagen synthesis (supporting structural repair of textured scars). It is most effective applied in the morning before SPF50+. Read: Vitamin C in Skincare: Which Form Is Best.
Is microneedling effective for acne scars?
Yes, particularly for rolling and boxcar scars. Professional microneedling creates controlled micro-injuries that stimulate the skin's collagen repair response, improving scar depth and texture over a series of sessions. It is the most widely recommended professional treatment for atrophic acne scars and is most effective when combined with consistent home use of Retinol and PDRN in the weeks between sessions. This is a clinical decision to be made with a qualified dermatologist.
Read More
How to Fade Post-Acne Marks on Pakistani Skin
Niacinamide: Everything You Need to Know
Retinol Beginners Guide: How to Start Without Irritating Your Skin
PDRN in Skincare: The Clinic Ingredient Now Available at Home
Salicylic Acid in Skincare: The Complete Guide
Browse the GlowCare dark spot collection and active ingredients collection with nationwide delivery.
