Non-inflammatory acne—whiteheads and blackheads—are superficial and typically do not cause scarring. Inflammatory acne, on the other hand, affects the deeper layers of skin and can cause scarring, especially when picked at. Inflammatory acne includes papules, pustules, nodules, and cysts.
When you pick at a blemish, especially with your fingers, there’s a good chance that you’ll accidentally rupture the follicle (pore) wall. If the damage is minimal, it will heal quickly.
However, bacteria can leak into the wound if the damage is severe, further irritating the skin and damage. As the skin heals, it creates new collagen. Unfortunately, sometimes the new collagen doesn’t lay smoothly, which creates unevenness and scarring.