How to Fade Acne Marks: Red Marks, Brown Marks and Real Scars

The fastest way to fade acne marks is to work out which kind you have. Flat red or pink marks (post-inflammatory erythema, or PIE) and flat brown or grey marks (post-inflammatory hyperpigmentation, or PIH) are colour changes, not scars, and most fade on their own over months. Daily sunscreen, hands off, and a well-chosen topical like azelaic acid can speed things up. Dents and raised bumps are true scars, and no cream will erase them. Here’s how to tell them apart and what the evidence actually supports for each.

Is it a red mark, a brown mark, or a scar?

Start with texture. Look at the spot with light coming from the side or run a fingertip over it. The American Academy of Dermatology (AAD) says flat spots left behind after acne are usually not scars, and that they usually fade over time. If the skin is flat and only the colour differs, you’re dealing with a mark. If there’s a pit, dip or raised bump, it’s a scar.

Red, pink or purple: post-inflammatory erythema (PIE)

PIE is leftover redness after a spot heals. A 2013 report in the Journal of Clinical and Aesthetic Dermatology describes it as mainly affecting lighter skin types (Fitzpatrick I to III), while in darker skin, marks after acne tend to show up as extra pigment rather than redness.

Brown, grey or dark: post-inflammatory hyperpigmentation (PIH)

PIH is extra melanin laid down after inflammation. According to StatPearls (NCBI Bookshelf), it is more common and more pronounced in darker skin, and in people with darker skin tones who have acne its incidence can be as high as 65%. How deep the pigment sits matters a lot, as the timeline section below explains.

Dents or bumps: true acne scars

Scars form when healing skin makes too little collagen (leaving depressed scars such as ice pick, boxcar and rolling scars) or too much (leaving raised hypertrophic or keloid scars), per the AAD. The AAD notes the deeper a breakout goes, the more likely it is to scar, and that picking, popping and squeezing raise the risk.

How long do acne marks take to fade?

Honest answer: it depends on the type and depth, and the evidence on timelines is thinner than most skincare marketing suggests.

For brown marks, the AAD says a spot a few shades darker than your natural skin colour usually fades within 6 to 12 months, while deeper discoloration can take years. StatPearls explains why: pigment in the top layer of skin (epidermal PIH) typically resolves or improves significantly within 6 to 12 months, but pigment that ends up in the deeper dermis improves slowly and may be permanent.

For red marks, a 2022 systematic review of post-acne erythema treatments notes that some lesions improve over time but others persist. I couldn’t find a reliable figure for how long PIE typically lasts, so be wary of anyone quoting a precise number.

What fades brown marks (PIH)?

Daily sunscreen comes first

UV exposure keeps pigment going, so sun protection is the foundation. The AAD recommends a broad-spectrum, water-resistant sunscreen with SPF 30 or higher, and for darker skin a tinted formula containing iron oxide, which blends in and avoids a white cast. Reapply every two hours outdoors and after sweating or swimming. StatPearls also lists daily broad-spectrum sunscreen as a primary intervention for PIH.

Azelaic acid

Azelaic acid is one of the more appealing options because it treats acne and targets pigment. In a 2024 randomised, double-blind, placebo-controlled trial of 60 people with skin types III to IV, 15% azelaic acid gel used twice daily for 12 weeks significantly reduced melanin in PIH lesions compared with placebo. An earlier small open-label pilot study of 20 adults with darker skin (types IV to VI) also reported benefit over 16 weeks, though without a control group that evidence is weaker. The AAD says azelaic acid is thought to be safe during pregnancy.

Retinoids

StatPearls lists topical retinoids (tretinoin, adapalene, tazarotene) among the main PIH treatments, and the AAD includes retinoids in its list of dark-spot ingredients alongside azelaic acid, glycolic acid, kojic acid and vitamin C. There’s a catch: retinoids can irritate, and a clinical review in the American Journal of Clinical Dermatology points out that irritation itself can contribute to unwanted pigment changes in darker skin. Start slowly and moisturise. The AAD notes tazarotene can cause birth defects and that most experts advise stopping tretinoin and adapalene during pregnancy.

A word on hydroquinone

Hydroquinone is a long-standing prescription lightening agent, but in the US the FDA says over-the-counter skin-lightening products containing it are not legally marketed since the 2020 CARES Act, and it has received reports of rashes, facial swelling and ochronosis (a bluish-black discoloration that may be permanent). That’s a clinician conversation, not a DIY purchase. The AAD also warns against imported lightening products that may contain unlabelled steroids or mercury.

What fades red marks (PIE)?

This is where most people get frustrated, because the brown-spot playbook doesn’t target redness well. The red colour comes from dilated blood vessels rather than melanin.

• Calm the acne and stop picking. New inflammation means new marks. The AAD warns that picking and squeezing risk both scars and dark spots.
• Azelaic acid. In the same 2024 placebo-controlled trial, 15% azelaic acid gel significantly improved PIE scores from weeks 8 to 12 and lowered haemoglobin (a measure of redness) in PIE lesions versus placebo. About two-thirds of users had mild, temporary stinging, dryness or peeling. It’s one trial of 60 people, so promising rather than proven.
• Vascular lasers and light. The 2022 systematic review (18 eligible studies) found pulsed-dye lasers were the most commonly used devices, followed by Nd:YAG lasers, and that topical tranexamic acid, oxymetazoline and brimonidine look promising. The authors concluded there is no gold-standard treatment and more randomised trials are needed. The 2013 JCAD report described two patients treated with a 595 nm pulsed-dye laser; that’s case-level evidence, not a trial.

Can you fade true acne scars at home?

Not in any meaningful way. The AAD’s scar treatment page says treatment usually starts by getting breakouts under control, then moves to procedures such as chemical peels, fillers, laser resurfacing, microneedling or minor surgery, and it frames results as making scars less noticeable rather than gone. A Cochrane review of 24 randomised trials (789 participants) found a lack of high-quality evidence for acne scar treatments, with only injectable fillers showing moderate-quality evidence versus placebo. If you’re weighing options, see our guides to acne scar treatments and laser treatment for acne scars.

A simple routine for fading marks

1. Treat active acne consistently. Fewer new spots means fewer new marks. Our simple acne routine covers the basics.
2. Sunscreen every morning, SPF 30+ and broad-spectrum; tinted with iron oxides if you have deeper skin or brown marks.
3. Add one targeted active, such as azelaic acid, or a retinoid if you’re not pregnant or trying to conceive. Introduce it slowly.
4. Keep your hands off. Picking deepens inflammation and prolongs marks.
5. Be patient and take photos. Compare monthly in the same light. For more on PIH specifically, see post-inflammatory hyperpigmentation and acne scars vs dark spots.

Frequently asked questions