Macules or “pseudo-scars”: are flat, red or reddish spots that are the final stage of most inflamed acne lesions. After an inflamed acne lesion flattens, a macule may remain to “mark the spot” for up to 6 months. When the macule eventually disappears, no trace of it will remain -unlike a scar.

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Acne Scars Causes:
Acne scarring is caused by a variety of factors. When acne is produced on the skin as a response to sebum, the body may attempt to target the
inflammation with white blood cells. Once the inflammation has subsided, however, the tissue may have yet to be fully repaired, and as such,
scar tissue will show. [...]

Acne Scars: Acne scarring occurs when the visible remnants of acne are permanently left on the skin after the acne itself
has subsided.

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Treatment of keloids: Surgical removal is seldom if ever used to treat keloids. A person whose skin has a tendency to form keloids from acne damage may also form keloids in response to skin surgery. Sometimes keloids are treated by injecting steroid drugs into the skin around the keloid. Topical retinoic acid may be applied [...]

Skin grafting: may be necessary under certain conditions

Skin Surgery: Some ice-pick scars may be removed by “punch” excision of each individual scar. In this procedure each scar is excised down to the layer of subcutaneous fat; the resulting hole in the skin may be repaired with sutures or with a small skin graft. Subcision is a technique in which a surgical probe [...]

Laser Treatment: Lasers of various wavelength and intensity may be used to recontour scar tissue and reduce the redness of
skin around healed acne lesions. The type of laser used is determined by the results that the laser treatment aims to accomplish. Tissue may actually be removed with more powerful instruments such as the carbon dioxide [...]

Microdermabrasion: This new technique is a surface form of dermabrasion. Rather than a high-speed brush, microdermabrasion
uses aluminum oxide crystals passing through a vacuum tube to remove surface skin. Only the very surface cells of the skin are removed, so no additional wound is created. Multiple procedures are often required but scars may not be significantly [...]

Dermabrasion: This is thought to be the most effective treatment for acne scars. Under local anesthetic, a high-speed brush or fraise used to remove surface skin and alter the contour of scars. Superficial scars may be removed altogether, and deeper scars may be reduced in depth. Dermabrasion does not work for all kinds of scars; [...]

Autologous fat transfer: Fat is taken from another site on your own body and prepared for injection into your skin. The fat is injected beneath the surface of the skin to elevate depressed scars. This method of autologous (from your own body) fat transfer is usually used to correct deep contour defects caused by scarring [...]