SITA Medical Clinic · Lat Lum Kaeo, Pathum Thani

Daily 08:00–19:30

Dark Spots · DARK SPOTS & POST-INFLAMMATORY MARKS

The dark marks that remain
may not tell the whole story
of what your skin has been through

Dark marks may appear after acne, an inflamed rash, chickenpox, scratching or other skin injuries. What remains today may not tell the whole story of what happened to the skin before.

Before deciding how to care for a mark, it helps to distinguish changes in colour from changes in texture, and to consider whether inflammation is still present.

A change in colour ≠ A change in texture

Assessment first, then an individual care plan

This page provides general information for understanding. It does not offer a diagnosis or individual treatment advice.
Dark marks may appear after acne, an inflamed rash, chickenpox, scratching or other skin injuries. What remains today may not tell the whole story of what happened to the skin before. Before deciding how to care for a mark, it helps to distinguish changes in colour from changes in texture, and to consider whether inflammation is still present.

This page provides general information for understanding. It does not offer a diagnosis or individual treatment advice.

Sometimes, what you see today
is a trace of what happened before

BEFORE · PAST EVENT

Inflammation or injury to the skin

An episode of skin inflammation or injury, such as acne, a rash, chickenpox or a scratch.

NOW · CURRENT MARK

The marks that remain after the event

A change in colour or a mark that is still visible after the earlier event has passed.

The inflammation or wound may have healed while a change in colour or a mark remains visible. Sometimes, the original problem and the marks are present at the same time.

Distinguishing the two helps clarify whether care is addressing what remains, what is still happening, or both.

What can leave dark marks?

Each event may leave changes in colour, texture or both. Not every episode leaves a mark.

  1. After acne

    Some inflamed spots may leave dark or red marks. Some people also develop changes in skin texture.

  2. After chickenpox

    Chickenpox spots may leave changes in colour, texture or both. Not every spot leaves a mark.

  3. After scratching or abrasions

    Scratching, picking or a healed superficial wound may leave a dark mark or skin that looks different from the surrounding area. This varies with the person and the wound.

  4. After a laser or heat injury

    Skin injured during a procedure may develop dark marks, redness, lighter areas or changes in texture. These changes are not all the same.

  5. After insect bites or stings

    Marks may remain when inflammation or scratching is involved. Not every bite leaves a mark.

  6. After a rash or skin irritation

    Dermatitis or significant irritation from products or contact with other substances may leave dark marks in some people.

Similar-looking marks may represent different changes. A doctor needs to assess whether they involve colour, texture or both.

Before looking at the colour, first ask what happened to the skin beforehand

A doctor listens to a patient’s skin history and circumstances

Questions that help explain the mark’s history

  1. Before this mark appeared, was there acne, a rash, a blister or a wound in that area?
  2. Was the area scratched, picked, burned or treated with a procedure before the mark appeared?
  3. Has the earlier problem resolved, or is inflammation or another symptom still present?
  4. How have the colour and texture changed since then?

What you can share

  • Approximate timing
  • Previous skin conditions
  • Past treatments or procedures
  • Products you use
  • Changes you have noticed

This information supports the conversation. It is not a scale for grading the marks.

04 — Colour and texture COLOUR ≠ TEXTURE

A change in colour
is different from
a change in skin texture

Changes in colour

COLOUR · THIS PAGE
Colour

The main visible change is in the colour of that area of skin.

  • Dark marks
  • Red marks
  • Colour changes after inflammation or injury

Changes in texture

TEXTURE · /acne/
Texture

The change is in the surface texture of that area of skin.

  • Pitted skin
  • Uneven texture
  • Raised or indented scars

Marks after acne, chickenpox or a wound should not automatically be called “dark marks” or “scars” simply because they look similar.

Chickenpox spots or skin injuries may leave changes in colour, texture or both. Not every spot leaves a mark, and not every mark is a scar.

After an injury or certain procedures, skin may become darker, redder or lighter, or change in texture. These changes can differ and may need different considerations. This distinction is for understanding, not self-classification.

A patient touches her cheek and looks in a mirror while exploring differences in skin colour and texture
05 — When acne came first WHEN ACNE CAME FIRST

When marks follow acne,
check whether acne is still active

What is still happening

New acne spots appearing now

May coexist with

What remains

Dark marks from spots that have settled

Some people are concerned about dark marks from acne while new spots are still appearing. Having marks does not mean the acne has ended. If new spots continue, new marks may also develop.

Where to begin depends on an assessment of your skin at that time. There is no single sequence that suits everyone.

06 — Dark marks and melasma DARK MARK ≠ MELASMA

Similar-looking dark areas
may have different histories

Post-inflammatory dark marks

This page
Afterwards

Appear after inflammation or injury in that area of skin.

Melasma

MELASMA · /melasma/
Patches

Often appear as broader patches and have their own context.

The terms “dark marks” and “melasma” should not automatically be used interchangeably.

  1. At a glance, both may look similar. Size, shape or location alone is not enough to identify them.
  2. Marks after inflammation or injury and melasma may coexist on the same face.
  3. This distinction is a reason for assessment, not a rule for diagnosing yourself at home.
07 — Dark marks and freckles DARK MARK ≠ EVERY BROWN SPOT

A brown spot
is not always a mark
left after inflammation

Some brown spots, such as freckles, have a different context from marks left after inflammation, even when they look similar at first glance.

08 — Change over time CHANGE OVER TIME

Similar marks may change differently in each person

Dark marks after skin inflammation or injury may gradually fade over time, but the time needed varies greatly between individuals.

Unsuitable skin care, scratching, picking or repeated irritation may make the marks more noticeable.

  • None number of days
  • None number of sessions
  • None timeline for all

This page does not specify how many days, weeks or sessions it will take for marks to fade. There is no single timeline that applies to everyone.

09 — Before the plan BEFORE THE PLAN

Assessment considers more than
how dark or light a mark looks

These are factors that may be considered during assessment. They are not a self-checklist or diagnostic criteria.

What an assessment may consider

  1. What happened before the mark appeared
  2. Whether the earlier problem has resolved
  3. Whether any symptoms are still present
  4. Whether the concern involves colour, redness, texture or a combination
  5. Whether previous procedures or laser treatments may be relevant
  6. Past products and skin care
  7. Whether other skin conditions need assessment
  8. Whether other pigmentation concerns coexist

With a fuller understanding of the context, care can be planned around the individual.

UNDERSTAND

Understand

What happened before the marks appeared

ASSESS

Assessment

Colour, texture and any coexisting concerns

PLAN

Plan

According to individual needs

REVIEW

Follow up

Observe changes over time

Explore the SITA Care System
A doctor explains a skin care plan to a patient after an assessment at SITA Clinic
10 — Frequently asked questions QUESTIONS PEOPLE OFTEN HAVE

Common questions
about dark marks

How do dark acne marks differ from pitted acne scars?

Dark acne marks involve colour that remains after a spot has settled. Pitted acne scars involve a change in skin texture. Both can follow acne, and some people have both in the same area.

Because these are different concerns, the considerations may differ. For acne scars and texture, visit the  acne page

How do dark marks differ from melasma?

Post-inflammatory dark marks are usually related to something that previously happened in that area. Melasma often appears as broader patches and has its own context.

Some people have both at the same time, so an in-person skin assessment is helpful. Read more on the  melasma page

How do dark marks differ from freckles?

Freckles are often small, separate brown spots. Post-inflammatory dark marks follow inflammation or injury in the affected area.

Explaining when the marks first appeared and what happened beforehand can help clarify the distinction. Read more on the  freckles page

Can dark marks fade on their own?

Dark marks after skin inflammation or injury may gradually fade over time. However, the time needed varies greatly, and no single timeline applies to everyone.

If inflammation persists or skin care is unsuitable, marks may become more noticeable or new marks may develop. An assessment helps determine whether to allow more time, monitor changes or plan care.

If I still have acne, should I address the acne or the dark marks first?

No single sequence suits everyone. If new acne spots are still appearing, new marks may develop at the same time.

Where to begin depends on your skin’s condition at the time of assessment. For more about the order of acne care, visit the  acne page

Can a photograph alone identify the type of dark mark?

Photographs can make it easier to show what you see, but lighting, camera angles and editing may change the apparent colour. A photograph also cannot explain what happened to the skin beforehand.

Care options and outcomes depend on the skin’s condition, the nature of the concern and each person’s circumstances. They should therefore be considered after an in-person skin assessment.

Care approaches and outcomes depend on each person’s skin, health, concerns and circumstances. This content provides general information for understanding. It is not a diagnosis or a treatment prescription. Consult a doctor for an individual assessment.

11 — Start with the context START WITH THE CONTEXT

If you are unsure
whether you see dark marks, melasma, freckles
or acne-related marks

You do not need to name the concern correctly or choose a care approach before coming in.

Start by sharing what your skin went through before the marks appeared, such as acne, chickenpox, scratching or previous procedures. A doctor can then assess your skin as it is on the day.