Acne, Acne Scars, Dark Spots & Wrinkles: Causes and Everyday Skin Care

Acne, acne marks, dark spots and wrinkles.

These are all common skin concerns, but they do not develop through the same mechanisms.

Acne, for example, involves several factors, including sebum production, blocked follicles, normal skin bacteria and inflammation.

What people commonly call “acne scars” can also include several different conditions, such as lingering redness, brown pigmentation and changes in the texture of the skin.

Dark spots involve various types of pigmentation associated with melanin, while wrinkles may be influenced by ageing, long-term UV exposure and other changes in the skin.

For this reason, it is more useful to understand why a particular skin change is occurring and to consider skincare, sun protection, sleep and diet together rather than expecting one product or method to address every concern.

This article explains how acne develops, the different types of marks that may remain afterwards, and the basic mechanisms behind pigmentation and wrinkles, along with everyday skincare and lifestyle factors worth considering.

Acne, Dark Spots and Wrinkles Are Not the Same Skin Concern

Acne, post-acne marks, dark spots and wrinkles may all be noticeable changes in the appearance of the skin, but they develop in different ways.

In simple terms:

• Acne: a skin condition centred around hair follicles and sebaceous glands
• Redness or pigmentation after acne: changes in skin colour that may remain after inflammation settles
• Indented or raised acne scars: structural changes in the skin following inflammation and tissue damage
• Dark spots: pigmentation changes involving melanin
• Wrinkles: visible changes in the skin associated with ageing, UV exposure and other factors

Because the underlying mechanisms differ, one approach cannot address every skin concern in the same way.

Understanding what may be causing a particular change is an important first step when considering appropriate everyday care.

Why Does Acne Develop?

Acne is medically known as acne vulgaris.

It is sometimes assumed that acne simply develops because the skin is oily or unclean, but the process is more complex.

Several factors are involved, including:

• Increased sebum production
• Blockage of the follicular opening
• The involvement of Cutibacterium acnes
• Inflammation

1. Increased Sebum Production

Sebum is not an unwanted substance.

It forms part of the skin's natural surface and helps protect against excessive dryness.

During periods of significant hormonal change, including puberty, sebaceous glands can become more active and produce more sebum.

However, having more sebum does not automatically mean that acne will develop.

2. Blockage of the Follicular Opening

Changes around the opening of the follicle are also important in acne formation.

When cells accumulate around the follicular opening, sebum may not move as easily onto the skin surface and can build up inside the follicle.

This blocked stage is known as a comedone.

A closed comedone is commonly called a whitehead, while an open comedone may appear darker and is commonly called a blackhead.

3. Cutibacterium acnes

Cutibacterium acnes is not found only on people who have acne.

It is one of the microorganisms normally present on healthy skin.

When a follicle becomes blocked and sebum accumulates, C. acnes and other factors can contribute to inflammation.

For this reason, acne is not simply a matter of trying to eliminate all bacteria from the skin.

4. Inflammatory Acne

When inflammation develops inside a follicle, red or swollen acne lesions may appear, sometimes with visible pus.

If inflammation extends deeper into the skin, firmer nodules or deeper lesions can also develop.

This is why acne care is not simply about removing as much oil as possible. Avoiding unnecessary irritation, maintaining appropriate skincare and preventing inflammation from becoming more severe are also important.

Teenage Acne and Adult Acne

Acne is not limited to teenagers.

It can continue into adulthood or return after a period when the skin has been relatively clear.

Teenage Acne

During puberty, hormonal changes can increase sebaceous gland activity and sebum production.

Acne may therefore be particularly noticeable in oilier areas such as the forehead and nose.

Adult Acne

The basic mechanisms of adult acne are similar, but a number of everyday and biological factors may also be involved.

These may include:

• Hormonal changes
• The menstrual cycle
• Insufficient sleep
• Stress
• Friction against the skin
• Skincare that does not suit the individual
• Cosmetics or haircare products that may affect the follicles

It is therefore too simplistic to say that adult acne is always caused by dryness or that teenage acne is caused only by excess oil.

Skin condition and contributing factors vary from person to person.

Why Can Acne Become More Noticeable Before a Period?

Some women notice that acne tends to appear in similar areas around the same time before each menstrual period.

Hormone levels naturally change throughout the menstrual cycle.

These hormonal changes can influence sebaceous gland activity and may contribute to changes in acne at different stages of the cycle.

However, acne also involves follicular blockage, inflammation and other factors, so it should not automatically be explained simply as a “hormonal imbalance.”

If acne seems to follow a regular monthly pattern, keeping a simple record of skin changes may help identify whether there is a relationship with the menstrual cycle.

If inflamed acne repeatedly develops, particularly around the jawline or lower face, or lesions are persistent and difficult to manage, consulting a dermatologist may be appropriate.

Why Do Acne Marks Remain? Redness, Pigmentation and Scarring

The term “acne scars” is often used for almost anything that remains after an acne lesion settles.

In reality, changes in skin colour and structural scars are different conditions.

Common examples include:

• Lingering redness
• Brown or darker pigmentation
• Indented or raised scars

Lingering Redness

After inflamed acne has settled, a flat area of redness may remain.

Changes in blood vessels and inflammation within the affected area may contribute to this appearance, even though the original acne lesion is no longer active.

The redness may gradually become less noticeable, although it can persist for some time.

Brown or Darker Pigmentation

Inflammation from acne can stimulate increased melanin production, leaving a brown or darker area after the acne lesion itself has resolved.

This is known as post-inflammatory hyperpigmentation (PIH).

It can resemble other types of dark spots, but the pigmentation develops following inflammation such as acne.

UV exposure may make pigmentation more noticeable, so everyday sun protection is also worth considering.

Indented or Raised Scars

If the skin surface remains indented or raised, this is different from pigmentation alone.

When deeper inflammation damages skin tissue, changes that occur during the healing process can leave a structural scar.

Indented acne scars are known as atrophic scars and may be classified as ice-pick, boxcar or rolling scars depending on their appearance.

Raised scars can also occur.

Structural acne scars can be difficult to address with ordinary skincare alone.

For this reason, it is useful to distinguish whether a post-acne concern is primarily redness, pigmentation or a change in skin texture.

Why It Is Better Not to Squeeze Acne

When an acne lesion is noticeable, it can be tempting to touch or squeeze it.

However, squeezing acne yourself can increase irritation and may damage the surrounding skin.

In particular, pressing or picking inflamed lesions can contribute to deeper inflammation or tissue damage and may increase the likelihood of pigmentation or scarring.

Repeatedly touching acne with fingers or nails can also irritate the skin.

It is generally better to:

• Avoid repeatedly touching acne
• Avoid squeezing lesions with fingers or nails
• Avoid aggressive rubbing
• Seek medical advice when inflammation is significant

Dermatologists may perform appropriate procedures for certain acne lesions when clinically indicated. This is different from squeezing or extracting acne at home.

Medical advice is especially worth considering if acne is painful, deep or nodular, repeatedly occurs in the same areas, or is beginning to leave noticeable scars.

Why Do Dark Spots Develop? Understanding Melanin

There are several types of skin pigmentation commonly described as “dark spots.”

An important factor in many forms of pigmentation is melanin.

Melanin is sometimes thought of simply as the substance that causes unwanted pigmentation, but it is a natural pigment produced by the skin and plays a protective role in response to UV exposure.

When the skin is exposed to UV radiation and other stimuli, melanocytes in the epidermis produce melanin.

The melanin is transferred to surrounding skin cells and is gradually carried towards the skin surface as the outer layers of the epidermis renew.

However, repeated or long-term exposure to factors that stimulate melanin production can contribute to areas of pigmentation becoming more noticeable.

Not every mark that looks like a dark spot has the same cause.

Solar lentigines, post-inflammatory hyperpigmentation and freckles are examples of different forms of pigmentation with different characteristics.

If a pigmented area suddenly grows, changes colour or shape, bleeds, or otherwise changes noticeably, it should be assessed by an appropriate healthcare professional rather than assumed to be an ordinary dark spot.

Post-Acne Pigmentation and Other Dark Spots

When a brown or darker area remains after acne has healed, it may simply be described as a “dark spot.”

One possible explanation is post-inflammatory hyperpigmentation (PIH).

Inflammation can stimulate melanin production, and pigmentation may remain after the inflammation has settled.

This means that:

• Pigmentation associated with long-term UV exposure
• Pigmentation that develops following inflammation such as acne or dermatitis

may look similar even though they have different underlying causes.

Post-inflammatory hyperpigmentation is a flat change in skin colour and is different from an indented acne scar.

When looking at a post-acne mark, it can therefore be useful to distinguish between a colour change and an actual change in skin texture.

UV exposure can make post-inflammatory pigmentation more noticeable, so everyday sun protection is also important.

Why Do Wrinkles Develop? Ageing Is Not the Only Factor

Wrinkles tend to become more noticeable as we age.

However, ageing alone does not explain every visible change in the skin.

With age, the skin undergoes changes involving:

• Collagen structure
• Elastic fibres
• Skin thickness and elasticity
• Functions involved in maintaining oil and moisture levels

Together, these changes can make the skin less firm and elastic and make wrinkles more noticeable.

UV Exposure and Photoageing

Long-term exposure to UV radiation is another important factor.

Changes that accumulate in the skin because of repeated UV exposure are known as photoageing and can be associated with wrinkles, pigmentation and changes in skin texture.

Age-related skin changes and changes caused by long-term UV exposure can occur together, which is why sun protection is worth considering throughout life.

Dryness Can Make Fine Surface Lines More Noticeable

When skin is dry, fine surface lines may appear more noticeable.

However, temporary surface changes caused by dryness are not the same as deeper wrinkles involving structural changes within the skin.

Maintaining moisture at the skin surface is a basic part of skincare for helping prevent dryness and tightness.

How UV Exposure Affects the Skin

UV exposure is a common factor worth considering when discussing post-acne pigmentation, dark spots and wrinkles.

Long-term UV exposure can contribute to photoageing, which may include:

• Wrinkles
• Pigmented spots
• Changes in skin texture
• Changes in elasticity

UV exposure is also associated with skin cancer risk, so sun protection is not simply a cosmetic consideration.

Everyday Sun Protection

Useful measures can include:

• Using shade when possible
• Covering exposed skin with clothing or a hat
• Wearing sunglasses
• Using sunscreen appropriately
• Reapplying sunscreen when needed during prolonged outdoor exposure

Combining several forms of protection can be more practical than relying on one measure alone.

For acne-prone skin, labels such as “non-comedogenic tested” may also be one consideration when choosing facial sunscreen.

Why Gentle Cleansing Matters

When acne or visible pores are a concern, it can be tempting to try to remove as much oil and dirt as possible.

However, aggressive rubbing or washing the face more often than necessary can irritate the skin.

It is generally better to avoid:

• Scrubbing the skin vigorously
• Using hard brushes or rough towels
• Frequent use of harsh scrubs
• Layering several strong cleansing products

A basic approach is to use a cleanser that suits your skin and wash gently without excessive friction.

Rinse thoroughly and pat the skin dry rather than rubbing it with a towel.

Do Not Increase Cleansing Simply Because You Have Acne

Sebum also has a normal protective role in the skin.

Trying to remove it too aggressively through frequent cleansing can contribute to dryness and irritation.

For acne-prone skin, the goal should be to keep the skin clean without unnecessary irritation, rather than to remove every trace of oil.

Moisturising and the Skin Barrier

Some people with acne-prone skin worry that moisturising will automatically block pores.

However, appropriate moisturising can still be useful when the skin is dry.

The outermost layer of the skin helps reduce excessive water loss and protects against external irritants. This is commonly referred to as the skin barrier.

Dry skin may feel tight or become more sensitive to irritation.

After cleansing or whenever the skin feels dry, use a moisturiser that suits your individual skin type.

For acne-prone skin, wording such as “non-comedogenic tested” may be one factor to consider when comparing skincare products.

However, a non-comedogenic test does not guarantee that acne will never develop in every person.

Moisturising should also not be understood as a treatment for acne.

It is simply one part of basic skincare for helping prevent dryness and maintaining everyday skin comfort.

Sleep and Skin Condition

Many people have heard that going to bed early is “good for the skin.”

Research has explored relationships between sleep and skin condition, and chronic sleep restriction or poor sleep quality has been associated with changes in skin barrier function and other aspects of skin condition.

However, the commonly repeated idea that everyone must be asleep specifically between 10 p.m. and 2 a.m. for healthy skin is overly simplistic.

Rather than focusing only on a fixed time window, it is more practical to consider:

• Getting enough sleep for your individual needs
• Maintaining a reasonably regular sleep schedule
• Avoiding chronic sleep deprivation
• Creating an environment that supports restful sleep

Sleep Alone Does Not Resolve Skin Concerns

Some people may feel that their skin looks or feels better after a good night's sleep.

However, sleep alone does not resolve acne, pigmentation or wrinkles.

It is better viewed as one part of an overall lifestyle that also includes skincare, sun protection, diet and stress management.

Diet and Skin: How Should We Think About the Connection?

When skin concerns appear, it is natural to wonder, “What should I eat?” or “What foods should I avoid?”

However, skin condition cannot usually be explained by one food alone.

Statements such as “chocolate always causes acne” or “one particular vegetable will clear acne” are overly simplistic.

As a general foundation, aim to obtain a variety of:

• Protein
• Carbohydrates
• Fats
• Vitamins
• Minerals
• Dietary fibre

from a balanced range of foods.

Extreme dietary restriction or consuming very large amounts of one nutrient is generally not a balanced approach.

Dietary supplements should not be regarded as treatments for acne, dark spots or wrinkles. If supplements are used, they should be considered as foods intended to complement the normal diet, with serving directions and product information followed appropriately.

Skincare Habits to Avoid Overdoing

When skin is bothering you, it is understandable to want to try several things at once.

However, doing too much can sometimes add unnecessary irritation.

• Squeezing acne or repeatedly touching it with fingers or nails
• Rubbing aggressively during cleansing or makeup removal
• Washing the face more often than necessary
• Overusing exfoliating or peeling products
• Introducing several new skincare products at the same time
• Spending extended periods in strong UV exposure without appropriate protection

If the skin is inflamed or particularly sensitive, keeping skincare simple and avoiding additional irritation may be more appropriate.

When to See a Dermatologist

Some skin concerns can be managed with ordinary skincare, but there are situations in which professional medical advice is appropriate.

Consider seeing a doctor or dermatologist if:

• Acne is significantly inflamed
• There are multiple painful nodules or pus-filled lesions
• Acne repeatedly returns over several months
• Indented or raised acne scars are increasing
• Pigmentation remains for a long time and is concerning
• Your skin continues to concern you despite ordinary over-the-counter care
• Skin symptoms are having a significant effect on daily life or emotional wellbeing

Deeper inflammatory acne is more likely to leave scars, so persistent or severe acne should not necessarily be left untreated in the hope that it will simply disappear.

A mark that appears to be an ordinary dark spot should also be professionally assessed if it changes in size, colour or shape, or if it repeatedly bleeds or forms a crust.

Summary | Understand the Cause and Build Consistent Everyday Care

Acne, post-acne marks, pigmentation and wrinkles do not all develop through the same mechanisms.

Acne involves several factors, including sebum production, follicular blockage, Cutibacterium acnes and inflammation.

Changes that remain after acne should also be distinguished between redness, post-inflammatory hyperpigmentation and structural scarring.

Dark spots involve melanin, but pigmentation related to long-term UV exposure and pigmentation that appears after inflammation can have different underlying causes.

Wrinkles may reflect age-related structural changes in the skin as well as the cumulative effects of long-term UV exposure and photoageing.

Useful everyday foundations include:

• Gentle cleansing
• Moisturising according to your skin's needs
• Regular sun protection
• Avoiding squeezing or repeatedly touching acne
• Getting sufficient and reasonably regular sleep
• Eating a balanced diet
• Avoiding excessive exfoliation and friction

If significant inflammation continues, acne scarring is increasing, or a pigmented area is changing in a way that concerns you, seek advice from an appropriate healthcare professional rather than relying only on self-care.

Skin does not change dramatically overnight.

Rather than looking for one thing that will make every concern disappear, understanding how the skin works and maintaining skincare and lifestyle habits suited to your individual needs provides a more practical foundation for healthy-looking skin.