What Is Acne Scar?

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An acne scar is a result of inflammation caused by acne within dermis of your skin. Acne affects almost 85% of people at some point in their life. It may last for a few months or a few years and go off by itself. Once an acne lesion heals, it leaves behind a red or hyper-pigmented mark on the skin. This mark is not a scar but only a post-inflammatory change.  Usually our skin takes 6-12 months to heal and remodel itself. But if the mark does not go away for more than a year, it is definitely a permanent scar. Thus an early and appropriate treatment is all you need to prevent acne from leaving acne scars and dis-pigmentation behind.

How scars are formed?
Every acne lesion works to heal itself naturally. But sometimes, it results in too much of collagen collection at one spot and a scar is formed.

Thus, every acne or pimple results in either loss of tissue or formation of new tissues over the skin. This is what forms a scar after your acne is healed. The loss of tissue results in milder scars such as ice pick, indented boxcar, rolling and depressed fibrotic scars, while formation of new, thick layer of tissue results in severe forms of scars such as  fibrotic, hypertrophic or keloid acne scars.

In many cases acne heals without leaving any scars, but in cases of severe, cystic and inflamed acne permanent scars are often left out. Such scarring gives a very old look to your skin and the skin may also lose its elasticity over the time.

Causes
Generally there are two causes of acne scars.
* The first is the increase in tissue formation due to collagen build-up in the skin. Scars caused by increased tissue formation are also known as keloids scars. It is believed that keloid scars are generally genetical.
"* The second cause is loss in tissue formation. Such scars are more common.

Prevention
One of the main steps to prevent acne scarring is simply not to pick, pinch, and squeeze your pimples. Besides, you can use glycolic peels and some special creams to soften the scar tissue and enhance the texture of the skin. You can also use cryotherapy, collagen injections and some other vitamins and minerals that help reduce acne scarring such as the vitamins A and E, as well as zinc.

Types of scars
Ice Pick Scars- A scar that makes your skin appear as if it has been pierced by a pin or needle is known as ice pick scar. Such scars are deep and narrow and they usually extend up to the dermis. The scar usually looks like a small hole in the skin or a large one may resemble an open skin pore. It is usually a result of cystic acne or a deep blemish.

Ice pick scars are best treated with punch excision or punch grafting.

Boxcar Scars- Boxcar Scars are wider than ice pick scars. They are round or oval depressions in the skin with steep vertical sides. They form small pits in to the skin as those appear after one has had chicken pox. They are a result of tissue lost caused due to a severe inflammatory breakout.

Boxcar scars are best treated with the help of punch excision, punch elevation, dermal fillers or laser resurfacing.

Rolling Scars- If you get a wave-like appearance of scars over your skin, it could essentially be a wave of rolling scars. These scars are formed when fibrous bands of tissues develop between the layers of skin. These bands pull the epidermis and bind it to the deeper structures of the skin to form an impression of rolling waves on your skin.

Rolling scars are best treated with the help of subcutaneous incision, also known as subcision.

Hypertrophic or Keloid Scars- Keloid Scars resemble a raised, firm mass of tissue. These scars are usually larger than the original wound caused by acne. They are common to men folks, who mostly get them on their torso. The hypertrophic scars are not caused by the loss of tissue but by the overproduction of collagen.

Keloid scars are best treated with the help of steroid injections, tapes, or creams. Herein, a scar treatment aims to contract and flatten the scar.

You can also classify acne scars into 1. pitted scars and 2. pigmented scars. These scars can remain on the affected area even after an acne treatment. Pigmented scars are those red or brown spots which remain even after diminishing of acne blemishes and are the most common but pitted scars are a very difficult skin condition to treat. Pitted scars symbolize permanent damaged skin tissue. It will require multiple methods of scar treatments to clear off the skin.

Treatments

Cosmetic Procedures
Acne Creams and Acne Lotions- There are numerous acne scar removal creams and lotions that can be purchased over the counter. Go in for the one that carries authentic approval from AAD or FDA.

These creams and lotions are generally meant to reduce small scars that are not very deep, flatten raised scars such as keloid scars, and treat discolored patches of skin resulted from acne treatment. Silicone bandages or simple taping can also help to flatten raised scars.

Most of the acne creams contain glycolic acid, retinol, and vitamin C. These active ingredients help to produce new collagen and fight the loss of tissue caused by acne. The new collagen build-up helps to pump up the skin afresh.

Chemical peels- Chemical peels also help rejuvenate the damaged skin. The damaged skin is peeled off which creates room for new cell growth. Chemical peels are aimed at improving the texture of the skin. They are meant to lend a smooth and even surface to the skin. These peels contain chemicals that cause the skin to blister and then peel off, thereby taking away with it the acne scars. The skin that exposes thereafter is much smoother and clearer. These peels are helpful for treating only the minor and small type of scars. They are neither helpful in treating icepick scars nor the deep rooted ones.

Surgical procedures
Surgery is one of the finest treatments for removing scars caused by acne. It provides a complete solution for acne scars.

Dermal fillers- Also known as soft tissue augmentation, dermal fillers involve the process of injecting collagen under the scars. This causes the scars to elevate to the level of the surrounding skin.

Subcutaneous incision- Subcutaneous incision or subcision refers to the process of cutting the deep scar tissue from the normal skin tissue. As cut is made, blood clots below the scarred tissue and the scar elevates.

Punch excision- This scar removal method involves cutting out individual scars. In punch excision, a tool is used to cut out the scars and wound is covered with teri-strips, skin glue or sutures.

Dermabrasion- Dermabrasion makes use of an abrasive tool to peel off the scarred layer of the skin. This process can be quite painful.

Microdermabrasion- Microdermabrasion is a painless version of dermabrasion. In this process small granules attack your skin at high speed to exfoliate the skin gently. This method is very beneficial as it uses a fine stream of tiny aluminum oxide crystals that gently abrades and exfoliates the skin thus removing the superficial layers.

Punch elevation- Like punch excision here too individual scars are cut out. However, the difference in case of punch elevation is that the base and walls of the scar are left intact for the scar to grow to the normal skin level and disappear.

Injectibles
Cortisone injection- It is used for keloid scars or scars that are above the skin surface. Collagen injections reduce the appearance of such scars.

Steroid injections- Herein, steroid injections are injected directly into the scar. Steroids cause the skin tissue to flatten out. There are certain risks involved with this acne scar treatment.

Collagen injections- Collagen injections are used for scars that are not at the surface of the skin but are rather sunk in. injecting collagen causes these scars to rise and finally disappear.

Laser Procedures
Laser resurfacing- This process involves burning of damaged and scarred skin layers. As the burned skin heals, fresh and un-scarred skin is revealed after laser resurfacing is over.

Blue light therapy- An absolutely painless acne scar treatment; blue light therapy makes use of blue light to destroy acne causing bacteria.

Pulsed light and heat energy- Pulse light and heat energy are used together to destroy the oil producing glands present under the skin surface.

Diode laser treatment- In Diode laser treatment, a laser beam directly penetrates into the middle layers of the skin without affecting the outermost layers.

Consider pros and cons of each of these scar treatments before you go in for any of these methods. As suitable to your skin and scar type, the method will help cure your acne scarring.

Comments (4)
  • jane  - acne scarring
    Don´t waste your money on laser resurfacing fractional resurfacing does not help and fraxel wont help either!! I had done exoderm twice my scars are not so deep anymore but are stil there. i want to let them fill with hyaluron acid like restylane or perlane but I do not want to waste my money on that to. Has anyone good experiences with fillers on moderate acne scarring?
  • Mr.x  - Dear Arnold
    You can treat acne marks using Ayurveda,
    My choice is gingelly oil. Simply apply oil on clean skin. It is better to use it after bath. u can wash the face after one hour with soap. You may feel oily, but it works. later wash your face again with cold water to rid stickiness of oil.
    Do not use chemicals in cosmetics. Hope this will help you!
  • Arnold  - Laser Resurfacing
    Hi. I have very deep and old acne scars.(From 4 years) I tried injectible fillers to fix my lesions 8 months back. But I can notice small bumps appearing all over again. My skin looked fine for 3-4 months but now :( new zits make me feel I wasted my money.

    I think I will try laser resurfacing now. My doc said it works on most types of the scars. I want to read people's comments on this. Has anyone tried it? Kindly share your experience. I want to be double sure this time!
  • Tracy
    Hi there, I had laser surgery many years ago as I had bad acne scaring. I had to have it done twice. At first my skin looked good, but after a while it went back to how it was, and now you wouldnt even know I had had it done, A lot pain and discomfort for what I feel was a waste of time.
    Sorry if this isnt what you wanted to hear, but that was my experience. Good luck!!
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