Last updated date: 10-Jun-2023
Originally Written in English
Acne is every teenager’s nightmare and can make one embarrassed or self-conscious about his or her skin. Sometimes, people suffer from extreme acne cases that tend to leave behind hideous scars on the affected areas. Although some acne types can heal and disappear over time without leaving any mark, others cause noticeable scars.
In case you are in such a situation, then you are not alone. Many individuals out there are struggling to get rid of or trying to hide the stubborn scars. Read on to understand the nature of acne scars, types, and the available forms of treatment.
Understanding Acne Scars
Acne scars develop whenever the breakout penetrates deep in the skin, causing damage to the inner tissues. It begins when the skin pores or hair follicles on the skin become clogged due to excess oil or dead skin. This results in the formation of comedones. The bacterial will gradually start growing, causing red bumps and inflammation.
Acne scars tend to be mild, moderate, and severe. A person with severe acne cases can experience pain. This can be associated with pus-filled bumps known as cysts or nodules under the skin surface.
Moderate canes result in pus-filled pimples and red bumps. On the other hand, mild acne results in less irritable blackheads or whiteheads. This can be associated with a few pustules or red bumps.
In most cases, brown or light red marks that remain behind once the acne heals will clear up on their own with time. However, severe issues like cystic acne often leave behind permanent scars as the condition diminishes.
Types of Acne Scars
Before trying out any treatment, it's first essential to understand the type of acne scar you have. This helps determine a suitable treatment since every kind of scar responds and reacts differently to a treatment. Furthermore, certain forms of treatment are effective for some types of acne scars as compared to others.
Overall, these are the common types of acne scars;
Depressed or atrophic scars:
Depressed or atrophic acne scars are the most prominent ones on the face. They usually sit deep underneath the surrounding skin and are caused by inflammatory or papulopustular acne. Papulopustular acne refers to the lesion consisting of pimples, red blemishes, papules and pustules, pimples, and large swollen lesions (nodules). Depressed scars that occur due to inflammatory acne usually rest on collagen-rich scar tissue. This hinders the skin from restoring the indentation, and acne scar laser therapy might be necessary.
Depressed or atrophic scars comprise three major types, including;
- Ice pick scars
Ice-pick scars are sited deep in the skin and appear narrow, about less than 2mm across. These scars also resemble a big, empty pore on the skin and usually catch the most light. This makes them more visible and, unfortunately, the most difficult to hide.
- Rolling scars
Rolling scars are wide depressions in the skin characterized by round, sloppy edges. They also have an irregular texture and a rippling or wavy appearance caused by underneath skin damage.
- Boxcar scars
Boxcar scars nearly resemble rolling scars. However, boxcar scars are characterized by steep and defined points and are similar to chickenpox scars. Unlike rolling scars, they are relatively deep. In various ways, they tend to look like the print left on the skin whenever a fingernail is pushed into it.
Raised acne scars:
Unlike depressed scars, raised acne scars are not usually common, yet they too occur due to inflammatory acne. Mostly, they are more visible as compared to depressed acnes. The treatment approach for raised acne scars also tends to be complex. This is because there is too much scar tissue on the skin surface rather than healthy skin. This tissue scar appears like a bumpy and uneven surface that seizes the light.
The major types of raised acne scar include;
- Keloid scars
These types of scars are more common among individuals with dark skin. They usually occur when the scar tissue excessively develops on the skin due to too much production of collagen. The condition usually starts when the acne doesn’t undergo the normal recovery cycle, making the skin break. This causes the collagen to accumulate around the broken skin to enable the wound to seal and heal.
- Hypertrophic scars
Unlike keloid scars, hypertrophic scars are more common can appear as red or dark marks. They occur when the body switches off the production of collagen. With time, hypertrophic scars become pale and flatten but leave behind evidence or spots of the initial wound. If these spots accumulate in one area, it causes uneven, bumpy skin.
When the acne heals, it usually leaves behind discolored or dark patches on the skin. However, this is not considered a scar and tends to diminish with time after using sun protection treatment.
Hyperpigmentation can thus arise if severe acne causes damages to the skin. As the skin health, it releases excess melanin on the affected parts. This makes the area red, brown, purple, black, or pink based on the skin type.
Acne Scars Treatment Approaches
Sometimes, acne scars tend to be stubborn, and finding a treatment that clears them completely might be difficult. Nonetheless, medical providers recommend using one or a combination of these treatment techniques to enhance skin appearance. However, this usually depends on the type of scar, scarring severity, and skin type.
You can thus consider one or more of the following acne scars treatment options;
Home skincare remedy: Use of approved medicated sunscreen is essential in limiting the contrast between a scar and unscarred skin. Other types of medicated acne scars creams, including those that contain hydroxyl acid or azelaic acid, can also be helpful.
Injection of steroid: Administering injectable steroids on certain types of raised scars helps enhance the general appearance of the skin.
Soft tissue fillers: This treatment involves an injection of fat, collagen, or other components beneath the skin. This helps plump the skin on the depressed scars and make the scars less visible or noticeable. While the results of this approach are temporary, repetition of the treatment is necessary to maintain the effect. Moreover, it carries a few risks, including skin color changes.
Dermabrasion: This approach is mostly reserved for chronic scarring. It involves the removal of the top skin layer using a fast-rotating brush or any specially designed device. The medical provider can remove the surface scars completely, making the deep scars look less visible and noticeable. Dermabrasion can, however, result in a few side effects, including skin color changes and scarring.
Laser resurfacing: This treatment method is more common and is mostly recommended on scars that have been initially addressed with dermabrasion. Laser resurfacing generally has a higher risk, especially on individuals with a history of keloids or dark skin.
Chemical peeling: This involves the application of a certain chemical solution on the tissue scars. The purpose of this is to eliminate the top layer of the skin and reduce deep scar appearance. To retain the results, you can have repeated medium and mild peels. On the contrary, one can only undergo a single deep peel. Besides, the possible side effects of chemical peeling involve skin color changes, particularly with deeper peels on the dark skin.
Energy-based procedures: Depending on the type of acne scars, the medical provider can recommend radiofrequency and pulse light source devices. This makes the acne scars less visible without causing any damage to the outer or top skin layer. The overall results of energy-based procedures are subtle, and one might be required to repeat the treatment process.
Surgery: Sometimes, a minor surgical procedure known as punch excision is necessary. This enables the medical provider to cut out severe acne scars and repair the wound using skin grafts or stitches. Alternatively, they can conduct a surgical technique referred to as subcision. This involves the insertion of tiny needles beneath the skin to help loosen fibers under the acne scar.
Skin needling: This treatment method involves rolling a needle studded tool over the affected skin area. This helps stimulate the formation of collagen in the underlying skin tissue. Skin needling is generally a simple and safe procedure that is more effective in addressing acne scarring. It’s associated with a minor risk, including skin discoloration. However, the outcome is subtle, and the doctor can recommend repeating treatment to retain the result.
OnabotulinumtoxinA (Botox): In certain cases, the skin surrounding the acne scars tends to pucker. In such situations, the doctor can recommend an injection of Botox to help relax the skin. This also helps enhance the overall look of the acne scar. While the outcome is temporary, repeating the treatment might be necessary to maintain the effect.
While acne is usually common among teenagers, not everyone is susceptible. These acnes also vary from one person to another and can sometimes result in severe scarring, making the skin unattractive. However, the type of scarring one develops typically depends on the acne type you develop and the treatment.
For the bestacne scars treatment, you can always consider the CloudHospital medical platform. Here, you will receive treatment from professional dermatologists and other medical specialists from various fields. They also provide diagnostic services to determine the underlying causes of scars to develop a suitable treatment plan.