Treatment Order
New Acne, Red Marks, Pigmentation, and Pitted Scars: What Should Be Treated First?
We first reduce the acne that creates new scars, then divide the direct treatment of marks and scars into stages.
Click on unfamiliar terms to see their meanings immediately.
Attempting to treat active deep inflammation, flat marks, and structural scars all at once can lead to skin irritation and mismatched expectations.
| Stage | Primary Change | Priority Question |
|---|---|---|
| Active | New comedones, papules, pustules, nodules | Has the rate of new acne formation decreased? |
| Discoloration | Flat red or brown marks | Have new inflammation and irritation stopped? |
| Structural Scarring | Indentations or protrusions | Have the type and depth been evaluated? |
First, count the new acne that is deep and painful.
Check whether inflammation that creates new scars is continuing.
Marks are divided into red and brown.
Check if the color change is flat without any elevation or depression.
Since comedones, papules, and pustules can appear together on one face, we examine the deepest acne and the rate at which new ones form together.
Treatment for structural scars is planned after the skin has stabilized.
of procedures and herbal medicine by type Recurrence We distinguish the regulatory role.
Try organizing your information this way before your appointment
In photos taken over 7 days under the same lighting, new comedones, papules, pustules, andnodulesand if you count the remaining redness, brown discoloration, and indentations separately, it becomes easier to determine the order of treatment. inflammatory acneThis record is also used when comparing with guidance on post-acne red marks and post-acne hyperpigmentation.
Redness that remains flat at the site of acne, without being raised or painful, must be distinguished from new inflammation, rosacea, and pitted scars.
Check current priorities in the following order: active acne → flat marks → structural scars.
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The next steps will vary depending on your current appearance
Rather than picking just one similar part from a photo, look at the depth of the acne, remaining marks, and accompanying discomforts such as itching or stinging.
When it is closer to inflammatory acne
Inflammatory acne occurs when inflammation develops inside a clogged pore, appearing as red papulepustules; if it deepens, hard and painful nodules or cysts may form. Rather than just counting the number of acne lesions, comedoneswe look at the ratio of inflammation, the number of deep and painful acne lesions, and the risk of inflammation and scarring that developed within a week.
Reduce the number and depth of new inflammation occurring each week, and shorten the time it takes for pain to subside and for red or brown marks to remain.When it is closer to post-acne erythema (red marks)
Post-acne red marks are flat, vascular redness that remains where inflammation has subsided, Post-inflammatory erythemait may be. You must check that it is not raised or painful to the touch, and that pink or red tones are more central than brown. However, new papules orpustules, persistent flushing of the entire face, and pitted surface changes must be distinguished from active acne, rosacea, and scars, respectively.
reduce the speed at which new inflammation occurs and the number of days facial heat persists, allowing for separate management of existing marks and newly formed acne.When it is closer to post-inflammatory hyperpigmentation (brown marks)
Post-acne hyperpigmentation is a change where melanin increases at the site where inflammation has passed, leaving flat brown or grayish-brown spots. It differs from structural scars in that the skin surface is not pitted or raised, and it is distinguished from post-inflammatory erythema, which is primarily pink or red. UV exposure, friction,Extractionand if new inflammation recurs, marks may become darker and last longer.
reduce the speed at which new inflammation and marks appear, and create a skin condition where existing pigment management can continue without irritation.When it is closer to atrophic acne scars (indentations)
Pitted acne scars are narrow and deep Icepick-type, where relatively angular borders are visible boxcar type, and wide, gently undulating rolling types, which may be mixed in one area. Even if red or brown, if the surface is flat, it may be post-inflammatory hyperpigmentation. We cannot promise that Korean herbal medicine will fill an already pitted dermal structure; we distinguish between the role of reducing recurrent inflammation and recovery conditions that create new scars, and the actual scar procedures.
reduce active inflammation to lower the speed at which new indentations increase, and help ensure that structural scar treatment is performed on stabilized skin.Please record only this much before your appointment
- Number of new papules, pustules, and nodules over 7 days
- Number of days with pain and recurrence in the same location
- Sebum and heat sensations, and conditions before and after meals, sleep, and menstruation
- Those who have red, painful papules and pustules appearing every week
- Those who are concerned about marks or pitting due to deep inflammation on the chin and cheeks
- For those whose acne recurs along with heat sensations, sebum, digestive issues, and sleep disturbances, even when using topical medications
Frequently Asked Questions
Common questions after reading this guide
What is the primary cause of acne?
It is a process where sebum and skin cells block the pores, and bacteria and inflammation are added. Risk contexts such as hormones, family history, medications, and products overlap differently for each person.
Will acne disappear if I stop eating chocolate or drinking milk?
While the link between certain diets and worsening symptoms is being researched, a single specific food is not the cause for everyone. Record reactions that recur for you, but it is difficult to view one single food as the sole cause.
Does stress cause new acne?
Stress can worsen acne for some people, but it is not established as the sole cause. Hormones, sleep, and changes in products are also considered.
If I think it was caused by medication, can I stop taking it immediately?
Do not stop taking medication arbitrarily. Show the prescriber the name of the medication, the start or change date, and photos of the acne to discuss the correlation and safe alternatives.
Evidence and Update Information
This content was organized by Korean medicine doctor Choi Yeon-seung based on the materials below and was updated on 2026-08-26.
- American Academy of Dermatology: Acne diagnosis and treatment
- UCLA Health: Acne Clinic
- NIAMS: AcneEvidence regarding the process of pore clogging by sebum and skin cells, bacterial and inflammatory action, and the influence of hormones, family history, certain medications, and aggravating factors