Advice for scar on chest from acne - will it fade or need to be treated? (Photo)

Question

In January of this year, I had two acne lesions on my chest that i picked at, it has since turned into a raised textured scar on my chest that is very dark and bigger than the original lesion. I am just wondering how likely it is to fade in time? The bottom scar also used to be slightly raised but has flattened down and pigment is just left.

Anna Chacon, MD, FAAD · Answer

What you’re describing is very typical of how chest skin can respond after inflammation, especially when acne lesions are picked or irritated during healing. The chest is one of the areas most prone to both post-inflammatory hyperpigmentation (dark marks) and hypertrophic scarring (raised texture) because the skin there is thicker, more reactive, and under more tension compared to the face.

From your description, it sounds like you may be dealing with a combination of two processes:

The raised, textured area  likely a mild hypertrophic scar
The dark coloration  post-inflammatory hyperpigmentation left behind after healing

The fact that one area has already flattened and only pigment remains is actually a good sign—it suggests your skin is still actively remodeling and improving over time.

Will it fade on its own?

There is a good chance of partial improvement over time, especially since this is relatively recent (months rather than years). In many cases:

Raised chest scars gradually soften and flatten over 6–18 months
Dark pigmentation slowly fades, but can take several months to over a year
The speed depends on inflammation level, sun exposure, and how the skin heals individually

However, it’s also important to be realistic: once a scar becomes raised, it doesn’t always return completely to baseline without assistance. Pigment is more likely to improve naturally than texture.

Why chest scars behave this way

Chest skin has:

Higher collagen tension (so it tends to “over-heal” slightly, becoming raised)
Slower and more uneven pigment recovery in some cases
More friction from clothing, which can prolong inflammation
What can help it improve faster

If the goal is to soften both texture and color, there are a few effective approaches:

1) Topical treatments (early stage support)

Silicone gel or silicone sheets (help flatten raised scars over time)
Gentle retinoids (support skin turnover and remodeling)
Brightening agents for pigment (to gradually fade discoloration)
Daily sunscreen on the chest (very important—sun exposure can darken scars further)

2) In-office treatments (if it persists)

Steroid injections for raised scars to help flatten them
Laser treatments targeting redness or pigmentation (chosen carefully for skin type)
Microneedling or combination therapies for texture remodeling
Bottom line

Based on how recent this is and the fact that one lesion is already flattening, there is a strong chance of continued improvement over time—especially in the pigmentation. The raised portion may soften significantly, but if it stays elevated after several months, targeted treatment can help it settle more completely.

Most importantly, this is still in an active remodeling phase, so changes over the next several months are expected and often gradual rather than immediate.

Advice for scar on chest from acne - will it fade or need to be treated? (Photo)

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