Acne
Expert care for acne and acne scarring in all skin tones — with particular expertise in melanin-rich skin. Serving Vinings, Buckhead, Cumberland, and greater Atlanta.
Acne is the most common skin condition in the United States and in patients with darker skin tones, it carries a second burden that is often overlooked: post-inflammatory hyperpigmentation, or PIH. The dark spots left behind after acne heals can be as distressing as the acne itself, and treating them requires a very different approach than treating lighter skin. Dr. Christina Marcelus is a board-certified dermatologist in Atlanta, Georgia, specializing in acne and acne scarring in patients of all skin tones, with particular expertise in melanin-rich skin. Cutis MD Dermatology serves patients throughout Vinings, Buckhead, Cumberland, and greater Atlanta.
What is Acne?
Acne is an inflammatory condition that develops when hair follicles become clogged with oil and dead skin cells, creating an environment where bacteria can thrive. This produces a range of lesions — from non-inflammatory blackheads and whiteheads to inflamed papules, pustules, and cysts. Acne is not caused by poor hygiene or diet alone. It is driven by sebum production, follicular occlusion, bacterial overgrowth, and inflammation — and in many patients, hormonal fluctuations play a significant role.
Acne in Skin of Color: Why the stakes are higher…
Every pimple, cyst, or inflamed lesion is a potential dark mark. In patients with Fitzpatrick skin types IV through VI, the inflammatory response of acne almost always triggers melanin overproduction in the surrounding skin — leaving behind post-inflammatory hyperpigmentation (PIH) that can persist for months to years after the acne itself has resolved. For many patients with darker skin tones, the dark spots become the primary complaint.
This is why treating acne in patients with melanin-rich skin requires a strategy from the start that accounts for PIH prevention — not just acne control. Aggressive treatments that cause significant irritation may clear acne while leaving behind more hyperpigmentation. Dr. Marcelus approaches acne treatment with this reality in mind from day one.
Acne scarring
Beyond PIH, some patients develop true acne scars — depressions or raised areas where the skin architecture has been physically altered. Ice pick scars, boxcar scars, rolling scars, and keloid or hypertrophic scars can all develop, and some types of scarring are more common in patients with darker skin. Treating acne scars in melanin-rich skin requires careful selection of procedures — not all scar treatments are appropriate or safe across all skin tones.
How is acne treated at Cutis MD?
Dr. Marcelus develops individualized treatment plans based on your acne type, severity, skin tone, and history. Options may include:
• Topical retinoids and retinol formulations
• Azelaic acid and tranexamic acid for simultaneous acne and PIH control
• Topical antibiotics and benzoyl peroxide, selected to minimize dryness and irritation in darker skin
• Oral antibiotics including doxycycline and minocycline
• Hormonal therapies including spironolactone and oral contraceptives
• Isotretinoin for severe or treatment-resistant acne
• Chemical peels selected for skin-of-color safety
• Microneedling for acne scarring and PIH
• Comprehensive skincare guidance
Cutis MD accepts new patients for acne and acne scarring evaluation and treatment. In-person appointments in Vinings, Atlanta — virtual consultations available throughout Georgia.
Frequently Asked Questions
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Post-inflammatory hyperpigmentation (PIH) is the dark discoloration that can remain after acne inflammation heals. It is especially common in melanin-rich skin, so treatment should address active acne while minimizing irritation and preventing new dark marks.
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The goal is the opposite. Dr. Marcelus selects acne treatments with skin-of-color safety in mind and adjusts strength, frequency, and supportive skincare to control breakouts without unnecessary irritation that can worsen hyperpigmentation.
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Many patients begin seeing fewer breakouts within six to eight weeks, but acne plans often need several months for their full effect. Dark marks and acne scars usually improve more gradually, and your timeline depends on acne severity, treatment consistency, and skin response.
Acne Scarring
Ice pick scars
Narrow, deep scars that extend deep into the skin.
Boxcar scars
Wide, shallow scars with defined edges.
Rolling scars
Wave-like depressions that give the skin an uneven texture.
Raised scars
Thick, elevated scars that can appear red or darker.
Ready to Start Your Acne Treatment Plan?
Our team at Cutis MD is here to help you achieve clearer, healthier skin with personalized, pigment-conscious care. In-person appointments are available in Vinings/Atlanta, with virtual consultations throughout Georgia.
