What are Acne Scars?
Acne scars are the result of collagen damage from inflamed blemishes. When an acne breakout penetrates the skin deeply, it causes a break in the follicle wall following the swelling of the pore, and if the pore incurs deep breakage, it affects the surrounding tissue and therefore creates deeper wounds. The body then tries to repair this damage by producing collagen. However, during the healing process, the body may produce lesser or more collagen than the original skin, and therefore the new skin could still look damaged. This is the acne scar.
Everyone can get acne scars. Some people are just more prone to scarring than the others.
Acne Scars Signs and Symptoms
Acne scars have two main types: atrophic and hypertrophic.
Atrophic Acne Scars
More commonly known as depressed acne scars, atrophic scars develop after a loss of tissue. If the body produces too little collagen during the acne’s healing process, the affected area is left with a dent.
There are specific types of atrophic scars, namely box car, ice pick, and rolling scars.
Box Car Acne Scars
These depressed scars are oval or round in shape and have shallow to medium in depth with well-defined edges. They normally occur on the cheeks and temples.
Ice Pick Acne Scars
Ice pick scars are narrow, about 2 mm, but deep, extending into the lower layer of the skin.
Rolling Acne Scars
This type of depressed acne scar is wider at 4 to 5 mm. Rolling acne scars are broad indents that have a “rolling” or undulating appearance due to its rounded and sloping edges.
Hypertrophic Acne Scars
On the other hand, there are instances when the body produces too much collagen during the healing. This results to hypertrophic acne scars, or raised scars. This type of acne scar is typically pink and firm with raised bundle that remains within the borders of the original acne area.
Although it also has an appearance of raised skin, hypertrophic scars are different from keloidal scars, which are more reddish-purple in color and develop beyond the borders of the original wound area. Both hypertrophic and keloidal scars are more common in people with darker skin and occur mostly on the back and chest.
Acne Scars Causes and Risk Factors
Acne Scars Causes
Scars are formed after pus-filled acnes are healed. These acnes penetrate the skin deeply, thus, damaging the skin and the tissue beneath it. The body produces collagen, which gives the skin support, in an attempt to replace the damaged skin tissue. Although acnes heal, the damaged tissues are often not replaced with skin as good as the original during the healing process. The amount of collagen developed by the body for the damage determines what type of scar the acne will heal into.
Not all acne heals into scars. Some heal into acne marks, which look darker than the rest of the skin. These marks may fade away in time. However, there are acnes that end up becoming scars.
Acne Scars Risk Factors
Although there is no telling if a person is more prone to developing acne scars, there are factors that increase the risk of developing it. Those who have inflammatory acne like acne cysts and nodules, which penetrate deep into the skin, are more at risk of developing acne scars. The genes of a person also play a role. If a person has a blood relative who developed acne scars, the person is at risk of developing them as well.
Treatment Options for Acne Scars
Treatments for acne scars depend on the type. Acne marks, or acnes that healed into darker color than a person’s skin tone, may be improved by lightening agents such as bleach. Acne scars, however, require more complex treatments.
Depressed Acne Scar Treatment Options:
This is best suited for treating few depressed acne scars. Dermatologists can either lift the scar closer to the surface of the skin to make them less noticeable or break up scar tissue.
- Skin Resurfacing
Skin resurfacing treatment works best for treating shallow depressed scars. This acne scar treatment allows the removal of the top layers of the skin, and even the middle layers in some cases, to even out acne scars with shallow indents.
This procedure includes laser skin resurfacing, chemical peeling, dermabrasion, and microdermabrasion.
Needling or rolling is a collagen-induction therapy that encourages the body to produce more collagen in the depressed scar area. This involves rolling a needle-studded rolling device across the depressed scar to puncture the skin and stimulate underlying tissue.
It may take as long as nine months before a result is observed, however. Also, this procedure takes several repeated treatments in duration of weeks.
- Soft Tissue Fillers
To fill out the indent on a depressed scar, some people go for collagen or fat injection. This plumps up the depressed area either permanently or temporarily (lasting from six to eight months), depending on the type of filler used.
This procedure is mostly used for box car acne depressed scars. It is not a full treatment, though, just part of a treatment plan. It works by using electric probes to heat the tissue, causing the tissue to die and therefore reshape the edges of a box car scar.
Raised Acne Scar Treatment Options
Unlike collagen injection for atrophic scars, injection treatments for hypertrophic scars soften raised scars to flatten them. For this treatment, corticosteroids, a type of anti-inflammatory medicine, are usually injected into the area to reduce the raised skin. It may take several treatments in a span of weeks before a result can be noticed.
Surgeries to treat raised acne scars are often followed by an injection treatment to prevent the raised scar from returning. Patients may receive corticosteroids injections once a month in a span of a few months.
- Laser therapy
Laser treatment, pulsed light sources therapy, or other energy-based procedures help reduce and flatten a raised acne scar without damaging the outer layer of the skin. Repeated procedure is necessary before a noticeable effect appears.
- Topical creams and gels
Topical products for acne scars are mostly over-the-counter medications. They help shrink and fade the raised skin. This type of treatment is best used for newly acquired scars and needs continual application.
Acne Scars Prevention
There is no guarantee that acne would not result in a scar when it healed. However, there are ways on lowering the risks of developing acne scars.
- Don’t pick or squeeze acne. Bacteria from fingers touching the acne can worsen a minor breakout. Squeezing or popping acne can also cause trauma to the skin, and therefore aggravating the condition.
- Don’t over-scrub the skin. People tend to scrub their skin when they have acne breakout. However, over-scrubbing or even over-washing the affected skin can reduce the skin’s elasticity further, increasing the chance of the acne healing into scars.
- Avoid the sun. The ultraviolet from the sun can cause scars to darken and slow the healing process. If it’s unavoidable, apply a sunscreen with 30 or higher sun protection factor and which can protect against UVA and UVB.
- Finally, the first step in acne scars prevention is the prevention of acne. Severe acne is more likely to result in scars. Dermatologists can prescribe oral and topical medicines to prevent the occurrence of acne.
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