The acne itself has settled. What it left behind hasn’t.

Dark patches across the cheeks. Small pits along the jawline. A raised, uncomfortable lump on the chest where one bad spot used to be. For a lot of people this part is harder than the acne was — because acne feels temporary, and this doesn’t.

Here’s the good news, and it applies to most people reading this: what you’re looking at is probably not a scar. And that changes everything about how it’s treated.

First: is it a mark or a scar?

This is the most important distinction on this page.

Post-inflammatory hyperpigmentation — a mark — is a colour change. The spot has healed, the skin surface is intact, but extra pigment was deposited during the inflammation. The skin is flat. It just isn’t the right colour.

A scar is a texture change. The healing process itself altered the structure of the skin, leaving a dent, a pit, or a raised lump. The surface is no longer smooth.

The ten-second mirror test

Stand at a mirror in good light and look at the affected area from the side, at an angle, rather than straight on.

  • If it’s flat and only visible because of colour → mark
  • If you can see it catch shadow — a dip or a raise — → scar
  • Run a clean fingertip lightly over it. Feel nothing? Mark. Feel texture? Scar
Marks (PIH) Scars
Nature of the problem Colour Texture
Feel to the touch Smooth, flat Pitted or raised
Will it fade alone? Yes — months to a couple of years No
Main treatments Pigment-directed, sun protection Resurfacing, needling, procedures
Realistic outcome Can clear substantially Improvement, not erasure

Most people have both, in different areas. That’s normal, and it means a plan with two tracks rather than one product.

Why this matters so much on brown and black skin

Two things are true of deeper skin tones, and both get glossed over.

First, PIH dominates. The same spot that leaves a barely-visible pink mark on fair skin often leaves a distinct dark brown patch on deeper skin, and it persists longer. So the majority of what people here call “acne scarring” is pigment, not structure — which is genuinely encouraging, because pigment is more treatable than structure.

Second, aggressive resurfacing carries real risk. The strong lasers and deep peels marketed for acne scars work by injuring the skin so it rebuilds. On deeper skin tones, that injury can itself trigger a fresh round of hyperpigmentation — you treat the scar and gain a dark patch. In some people it can also provoke raised scarring.

This is why the approach matters more than the equipment. Gentler, staged treatment with the right preparation beats one aggressive session, and anyone offering the latter without discussing your skin tone is not thinking about your skin.

Working with skin of colour is the default here, not a specialism bolted on.

The types of true acne scar

Where there is genuine texture change, the type determines what can be done.

Type What it looks like General approach
Ice pick Narrow, deep, steep-sided — like a pinprick puncture Hardest to treat; targeted techniques rather than general resurfacing
Boxcar Wider depression with sharp defined edges, like a small crater Responds reasonably to resurfacing and needling
Rolling Broad, shallow, wavy undulation across the skin Often the most improvable; responds well to collagen stimulation
Hypertrophic / keloid Raised, firm, sometimes itchy or tender Injections and specific scar treatment — never resurfacing

Ice pick scars are narrow and deep, which is exactly why generalised treatment struggles with them — you’d have to resurface a lot of healthy skin to reach the base of a tiny deep hole.

Raised scars are the opposite problem and are more common on deeper skin tones, particularly on the chest, shoulders, jawline and back. They need a completely different approach. Treating a keloid with a resurfacing procedure makes it worse.

Why some people scar and others don’t

Two people can have similar-looking acne and end up in completely different places. What drives the difference:

How deep the lesion went. Surface whiteheads and blackheads rarely scar. Deep, firm, painful nodules and cysts — the ones that sit under the skin for weeks — are the ones that damage the structure beneath. If your acne was mostly nodular, scarring is much more likely.

How long inflammation lasted. A spot that resolves in a week does far less damage than one that stays angry for a month. This is the strongest argument for treating acne early and properly rather than waiting it out.

Whether it was squeezed. Squeezing forces inflammatory contents deeper into the skin rather than out of it. It reliably worsens both the mark and the scar. Almost everyone knows this and almost everyone does it anyway — but it genuinely is the difference between a mark that fades in three months and one that lasts two years.

Genetics. Some people simply heal with more collagen and some with less. A family tendency toward keloids is a meaningful warning sign, particularly for chest and shoulder acne.

Delay in treatment. The single biggest preventable factor. Years of untreated inflammatory acne produces scarring that months of treated acne would not have.

None of this helps if you already have scars. It matters for two reasons: it explains why your friend with similar acne has clear skin, and it tells you what to protect against if any acne is still active.

The rule nobody wants to hear: control the acne first

If you still get new spots regularly, scar treatment is premature.

There’s no way to soften that. Every new inflamed lesion has the potential to leave a new mark or a new scar, so treating what’s already there while fresh ones keep arriving is spending money to stand still. Some scar treatments also can’t be safely combined with certain acne medications.

So the sequence is:

  1. Get the acne genuinely under control — see acne treatment in Nairobi
  2. Let things settle for a few months
  3. Then assess what’s actually left — often less than you feared, because a lot of it was pigment and has faded
  4. Then treat, in stages

That waiting period frustrates people. It also produces far better results and costs less overall.

How each kind is treated

For dark marks

Pigment responds to pigment-directed treatment, and to sun protection above all else — UV exposure actively darkens existing PIH and is the single most common reason marks refuse to fade.

Topical treatment plus superficial chemical peels works well for this, staged gently. Our hyperpigmentation and melasma treatment page goes into the pigment side in depth.

For pitted scars

Boxcar and rolling scars respond to controlled stimulation of collagen production, so the skin rebuilds from underneath. Microneedling is the mainstay, usually as a course rather than a single session — that page covers exactly how it works and what to expect.

Ice pick scars typically need targeted work rather than surface treatment, and are honestly the type where expectations need managing most carefully.

For raised scars

Hypertrophic and keloid scars are treated by reducing the excess tissue, not resurfacing it. Intralesional steroid injections flatten and soften raised scars over a series of treatments. For established keloids, particularly on the chest and shoulders, see keloid treatment and removal.

What realistic improvement looks like

Straight answer: marks can clear substantially. Scars improve — they don’t disappear.

Anyone promising to erase pitted acne scarring completely is overselling. What good treatment achieves is meaningful softening — shallower, less shadow-catching, less noticeable in normal light. Most people describe the result as no longer being the thing they see first in the mirror.

For pigmentation, the ceiling is higher. With consistent treatment and genuine sun protection, dark marks can fade to the point of being hard to find.

Both take months, not weeks. Skin remodels slowly, and the treatments that work with your biology rather than against it are the ones that work at biology’s pace.

A rough sense of the timeline, so you can plan rather than wonder:

  • Weeks 1–4. Little visible change. With pigment treatment you may notice marks stop getting darker before they start getting lighter — that in itself is progress.
  • Months 2–3. Pigmentation usually begins to lift noticeably. Texture work is under way but collagen remodelling has barely started.
  • Months 4–6. The point at which most people first say the scarring looks different, not just the colour. This is when photographs earn their keep.
  • Months 6–12. Continued gradual improvement in texture. Collagen laid down during treatment keeps maturing long after the last session.

Plan around events accordingly. If there is a wedding in six weeks, this is not the moment to start — and any clinic willing to promise you a result on that timescale is telling you what you want to hear.

Protecting what you’ve achieved

  • Daily sun protection — the single highest-impact habit for pigmentation, and non-negotiable during treatment
  • Don’t pick or squeeze. Every squeezed spot deepens the mark and raises the scar risk
  • Keep the acne controlled — relapse undoes progress
  • Be patient between sessions. Doubling up doesn’t double results, it raises risk
  • Be sceptical of fast fixes. Anything promising to erase scars in one session, or any unlabelled lightening cream, is a risk to your skin
  • Photograph your progress monthly, in the same light. Change this slow is invisible day to day — photos are the only honest record

What your first appointment looks like

  1. We assess in proper light, including from an angle — because that’s how texture reveals itself.
  2. We separate marks from scars, and identify which scar types you have.
  3. We check whether the acne is genuinely controlled. If not, that’s the first conversation.
  4. We build a staged plan with realistic expectations for each component.
  5. We take baseline photographs so improvement can be measured rather than guessed at.

Appointments run from 8:30am to 5:00pm on weekdays, and 9:00am to 4:00pm on Saturdays.

Getting to the clinic

We are on the 2nd floor of Landmark Plaza, Argwings Kodhek Road, on the Hurlingham edge of Upper Hill.

Frequently asked questions

Are my acne scars permanent? True scars are permanent in the sense that the tissue changed — but they can be meaningfully improved. Dark marks aren’t scars at all and will fade, faster with treatment.

How long do dark marks take to fade on their own? Anywhere from a few months to a couple of years, depending on how deep the pigment sits and how much sun exposure the skin gets. Treatment shortens that considerably; sun protection is what stops it dragging on.

Can you completely remove acne scars? No, and be wary of anyone who says otherwise. Substantial improvement is realistic. Complete erasure is not.

Why do I need to treat my acne first? Because new spots create new marks and new scars. Treating scarring while acne is active is spending money to stand still.

Is microneedling safe on dark skin? Yes, when done appropriately — it’s generally better suited to deeper skin tones than aggressive laser resurfacing, because it causes less thermal injury. Technique and staging still matter. The microneedling page covers it properly.

What about the creams sold for scar removal? Products can genuinely help pigmentation. No cream fills a pitted scar — that requires a procedure. Be especially careful with unlabelled lightening products, which cause a separate set of problems.

I have raised scars on my chest. Same treatment? No — the opposite. Raised and keloid scars need injections and specific scar treatment, not resurfacing, which would worsen them.

How many sessions will I need? It depends on which types you have and how deep. Most scar treatments are a course of three to six sessions spaced weeks apart, with pigment treatment running alongside. We’ll give you a realistic number after assessing you, not before.

Does treatment hurt? Most procedures are done with numbing cream and are uncomfortable rather than painful. Recovery is usually a few days of looking like mild sunburn.

Book an appointment

If you’re not sure whether you’re dealing with marks or scars, that’s the most useful thing an appointment can settle — and it’s frequently better news than people expect.

We open at 8:30am Monday to Friday and 9:00am to 4:00pm on Saturdays.

Landmark Plaza, 2nd Floor, Argwings Kodhek Rd, Nairobi
Call or WhatsApp 0728 566990
info@skinbydrnancy.com

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