Acne scars are the result of inflammatory acne. Inflammatory acne can be red blemishes, pimples, papules, pustules, or nodules. Acne scars are a product of the normal healing process of the skin. The body repairs itself from inflammatory acne.
Acne is a result of clogged pores, with oil, dirt, and debris. These clogged pores also get infected with bacteria. This may lead to inflammation and formation of the acne comedone. The sebaceous glands secrete sebum which spreads in the dermal layer of the skin after pimples rupture. These secretions include sebum, fatty acids, skin cells, dead debris, and pus.
When these lesions rupture, the body recognises this as an injury. It immediately tries to control the damage by starting the healing process. To repair this affected area of your skin, fibroblast cells help new collagen fibres form. When excess collagen fibres form, it causes bumpy lesions on the which are called raised or hypertrophic scars. Raised scars can form on the chest, back, nose and chin.
If there is a deficiency, there is a pitted or small dent on your skin. These scars are depressed or atrophic scars. This generally happens if there are big pimples on the forehead or cheek which become rolling/boxcar/ice pick scars. This leaves your skin with an uneven texture and hyperpigmented or darkened. There are many different reasons for scarring, the most important of which is the neglecting of acne when it first appears and not treating it in the initial stages.
Do & Don't for Getting Acne Scars
DO: Visit your dermatologist in the initial stages.
DO: Follow a healthy skincare regime to prevent acne.
DO: Use products that reduce inflammation and redness.
DO: Moisturise your skin.
DON’T: Pop and poke your pimples.
DON’T: Try home remedies as they don’t work.
DON’T: Delay the treatment of your acne.
Types of Acne Scars
1. Atrophic or Depressed scars
Depressed or atrophic scars are pits or shallow dents on the skin due to the loss of tissue. The loss of collagen prevents the skin from repairing the indentation.
There are three main types of depressed scars such as rolling scars, icepick scars and boxcar scars.
- Rolling scars: These are broad and shallow depressions in the skin. They have rounded or sloping edges. Rolling scars may be rough in texture and appear wavy. They are a result of damage under the skin.
- Boxcar scars: These have steep, defined edges. They are similar to chickenpox scars. In addition, they are quite deep.
- Ice pick scars: These are deep and narrow. They appear as a large sunken pore on the skin. Moreover, these are very difficult to cover up with makeup.
2. Raised scars
Raised scars are a result of inflammatory acne. They appear as uneven bumps on the skin surface. Moreover, raised scars are a result of excess scar tissue formation on the skin.
There are two types, keloid scars and hypertrophic scars.
- Hypertrophic scars: These occur when the skin creates excess collagen during the healing process. They appear as a thick, wide and raised scar. They may be itchy and painful.
- Keloid scars: These occur when the scar tissue grows over the boundaries of the original wound. They appear as a puffy, round protrusion. They mostly appear on the chest and back.
Causes of acne scars
Acne is caused when the follicles or pores get clogged with excess oil, dead skin cells, and bacteria. This gets inflamed and eventually the follicle wall ruptures. The higher the inflammation, the higher the chances of scarring.
Deep acne breakouts:
If the follicle ruptures close to the surface of the skin, the wound heals quickly and may not scar. However, if the inflammation has damaged the deeper layers, the skin forms new collagen fibres to repair this damage. This causes scarring.
Long healing period:
The chances of scarring are higher if the inflammatory acne takes a long time to heal. This happens because the infected material spills out into the dermis and destroys healthy skin tissue.
Treatments are available for all types of acne scars and are based on the type and severity of the scars.
Treatments of acne scars
Dermatologists treat acne scars according to their type and grade. Moreover, the dermatologist assesses the scars under indirect lighting and from different angles. In fact, dermatologists use different treatment modalities for various types of scars.
Treatment for Mild Scars
The treatment modalities are procedural. Basically, they are not laser treatments.
- Chemical peels
- Dermaroller or Dermapen
- TCA cross
Moreover, dermatologists may do Platelet Rich Plasma Therapy in combination with some of these treatments.
These treatment modalities are laser therapies.
- Q switch ND YAG MILD SCARS
- Long pulsed ND YAG laser 1064
- Endymed RF Skin tightening
Treatment for Moderate Scars
These treatment modalities are Laser therapies.
- CO2 laser
- Erbium glass (non-ablative)
- Microneedling RF
Surgical Treatments for Moderate and Severe Scars.
Dermatologists carry out these procedures for all atrophic and hypertrophic scars. In fact, these treatments show very effective results for deep acne scars.
- Subcision with Dermal Fillers or Fat Transfer
- Excision with PRP
- Punch elevation with PRP
Therefore, how do these treatment modalities work?
- Laser treatments: There are various types of Lasers all in different frequencies. In fact, the are two main types of lasers are: Ablative and Non-ablative. In fact, both these types of lasers work in different frequencies. Moreover, these frequencies alter or change as per the dermatologist’s discretion.
- Chemical peels: Chemical peels come in different concentrations and different acids. Dermatologists apply these peels to the affected area. They dissolve the scarred and dead skin cells and expose fresh and new skin. They also stimulate natural collagen production.
- Dermarolling: Dermarolling is a minimally invasive procedure. The microneedles pierce the skin so as to stimulate the production of collagen.
- Microdermabrasion: Microdermabrasion is an effective method of exfoliating skin cells. In fact, this procedure exfoliates dead and dry skin cells. Moreover, it also stimulates collagen production.
- Silicone patches: Silicone patches can help to reduce the inflammation of raised scars.
- Punch excision: In this technique, dermatologists cut out the skin around the area. However, this must heal naturally. Therefore, the new skin is smooth and level.
- Dermal fillers: These are injections containing substances like hyaluronic acid, collagen, gelatin matrix and fat implants that add volume and fullness when injected under the skin. They help level the indentations and pits as a result of the acne
Acne scars are permanent, however, their appearance can be reduced with the help of various medical treatments. The treatments take time to show results…READ MORE
After 3 Months
After 5 Months
After 7 Months
After 9 Months
Acne scars are permanent, however, their appearance can be reduced with the help of various medical treatments.
Acne Scars – Q&A
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