Some people are more likely than others to experience scarring after their acne has cleared, but it is never a pleasant thing to deal with. There are many different types of acne scars, some of which are severe while others are barely visible.
What are acne scars?
Acne scars, similar to all other types of scars, appear as the result of an injury to the skin. These scars appear when acne penetrates the skin on a deep level, damaging the tissue beneath. As the acne begins to clear up, the body does its best to heal the damage. When this healing process occurs, collagen is produced. If there is too little or too much collagen, a scar will form. The type of scar that forms depends entirely on how much collagen is produced.
Types of acne scars
You will find that there are a variety of acne scars that can form, depending on the amount of collagen a person’s body produces when it begins healing itself after acne has cleared. Some of the different types of acne scars include rolling scars, boxcar scars, ice pick scars, hypertrophic scars, and keloid scars. Some of these types of scars go deeper than others, and each kind has a unique shape or appearance.
Ice pick scars
Ice pick scars are typically very difficult to treat without a surgical procedure. These scars are usually very deep, which is what makes them difficult to treat with traditional resurfacing techniques. Acne scar treatments such as chemical peels and micro-dermabrasion are typically not successful in removing these scars because they do not remove an adequate amount of tissue. There are certain forms of laser therapy that have proven somehwat effective in treating ice pick scars, but the results are usually not very noticeable.
Boxcar acne scars usually present as oval depressions on the skin, and they are significantly wider than ice pick scars. These scars form as the result of an inflammatory breakout which destroys collagen along with tissue. The total amount of tissue that is lost will determine the severity of these scars. Some of the most common treatments used to remove or minimize boxcar scars include elevation, punch excision, laser resurfacing, and dermal fillers.
Rolling scars appear most commonly on those who have had long inflammatory term acne that has affected isolated patches of skin. These scars usually become more noticeable as the person gets older and their skin ages, losing more and more of its elasticity. The rounded, sloping borders of these scars make it relatively easy for those who have them to get excellent results from a number of treatments. Laser resurfacing typically works well for people with rolling scars, though there is also chemical peels, intense pulsed light or IPL, and micro-dermabrasion. While cosmetic fillers are sometimes used to treat rolling scars, they can be ineffective with larger areas of scarring. It may be necessary for someone with this type of scarring to look into certain mild surgical procedures to get noticeable results.
Hypertrophic acne scars are areas of tissue that are raised and typically do not grow to a larger size than the original wound itself. When these scars are caused by acne, they are usually found on the torso. Unlike boxcar or ice pick scars, this kind does not appear because of tissue loss, but rather because of an overproduction of collagen. There are numerous treatment options available for those with hypertrophic scars, including steroid creams and interferon injections, which are used to soften scar tissue.
Keloid scars almost always grow to be larger than the original wound, contrasting with hypertrophic scars, which do not expand outside the boundaries of the injury to the tissue. These scars are more common with those who have darker skins, specifically African Americans. Both men and women have an equal chance of developing keloid scars, though they tend to affect people between the ages of 20-30. While keloid scars are usually difficult to treat, there are a number of options available. Steroid injections are sometimes effective in treating keloid scars, and they are given every 2-6 weeks until signs of improvement appear. Radiotherapy as well as cryotherapy are two other treatment options for people with this type of scarring, though they are not always effective.
Hyperpigmentation occurs when high levels of the pigment known as melanin collect in the skin. This presents as spots or blotches that can resemble freckles. This skin condition occurs when melanocytes, which are the cells responsible for producing melanin, start to accumulate in the area that was injured. Hyperpigmentation can usually be treated with various types of laser treatments that target the melanin itself, including pulsed dye lasers, intense pulsed light or IPL, and KTP. Prescription medications, including hydroquinolone, are sometimes given to those with this condition as well. While topical retinoids can be effective at treating this condition, laser treatments tend to be far more effective.
Hypopigmentation forms when melanocytes deplete from the area of the skin where the injury occurred. When melanocytes lose their ability to produce melanin, a person can develop this condition. Many people who have areas of skin that formed into scar tissue develop hypopigmentation, and it usually presents as a pinkish discoloration. This condition is much more noticeable in those who have darker skin tones. Unfortunately, there are not many treatments for this condition that are very effective.
Erythema is a condition that develops when small capillaries near the surface of the skin get damaged or permanently dilated. An area of redness typically appears on the skin, and sometimes the capillaries are actually visible. This condition is fairly common among those with acne, and it tends to be much more visible in people with lighter skin tones. Erythema is often treated with various prescription medications to keep vasodilation at a minimum, but the results tend to be only temporary. People with this condition have been known to see noticeable and long lasting results with laser light treatments that specifically target hemoglobin.
Preventing acne scarring
While severe acne usually leaves some amount of scarring, especially if breakouts are frequent, there are certain steps that can be taken to minimize it as much as possible. Fire and foremost, it is important to get treatment for one’s acne before it becomes severe. When acne becomes severe, the chances of preventing scarring decrease significantly. It is also important to continue treatment even after the acne clears. If you want to ensure that you have minimal scarring after your acne is gone, you will want to continue treatment and refer to your dermatologist before deciding when to stop it.
You will also want to avoid picking or popping any pimples that appear on your skin, as this is one of the most common causes of scarring. Gentle skin care is crucial when it comes to preventing acne scars. It is important that you avoid scrubbing your face when using topical acne treatment products, because this will only cause more irritation, which in turn could lead to scarring later on.
Acne scar treatment options
There are lots of different options for those with acne scars, but there is no single treatment that works for everyone who has them. The effectiveness of the treatment depends on the severity and type of the scars. Some people benefit more from certain treatments than others, so it is largely a matter of trial and error.
Dermabrasion and microdermabrasion can be extremely effective methods of removing acne scars, though these treatments are not effective for everyone with acne scarring. Dermabrasion was first developed to improve the look of acne scars as well as scars resulting from disease or serious accidents, and it is considered safe for most people with fair skin. Those who have a darker skin tone will most likely experience discoloration after undergoing dermabrasion. A high-speed instrument with an abrasive wheel or brush is used to remove the outermost layers of the skin to improve the surface appearance of areas with scarring.
Microdermabrasion is safe for people with all different types of skin, and the results are usually subtle with no change in skin color or scarring. This particular treatment is not recommended for those with deep scarring, such as ice pick acne scars. One of the benefits associated with microdermabrasion is that there is less overall downtime than dermabrasion. The areas that are treated with this method temporarily take on a pink coloration, but it generally disappears within 24 hours after the procedure. Microdermabrasion does not require the use of any anesthetics and is not invasive, which are two other major benefits for those with light to moderate acne scarring. This procedure begins with tiny crystals sprayed onto the affected areas of the skin to remove the outer layer. It is essentially an exfoliating/rejuvenation procedure that will cause the skin to look brighter and become softer.
A chemical peel is a solution that is applied to the skin to strategically destroy certain parts in such a way as to where new skin will grow in its place. This particular treatment can be very effective for certain people with acne scarring, and there are different types.; Superficial chemical peels are fairly mild and can be used on all types of skin. These peels usually involve the use of a liquid that consists of a mild acid, typically glycolic acid.
Medium chemical peels are able to penetrate the skin on a deeper level, causing a second-degree burn. Trichloroacetic acid, also known as TCA, is the primary agent used in this type of peel. A medium peel may be done in several different steps with another chemical solution after the TCA is applied. This type of peel can be effective for those with moderately deep acne scars.
Deep chemical peels are able to penetrate through several layers of skin and also cause a second-degree burn on the affected areas. This deep peel cannot be used on those with a darker skin tone, as it tends to bleach the skin. Even those with a lighter skin tone may find that this treatment will bleach the skin, though it is less common. People with very deep acne scars, such as those that come from long-term cystic acne, may find this procedure to be one of the most effective at removing them or reducing their visibility on the skin.
Retinoic acid, or Retin-A, can be an excellent treatment option for those with moderate to severe acne scars. This type of acid is extremely abrasive and is applied directly to the affected area, though not everyone will want to use this method of acne scar removal. Certain types of scarring requires retinoic acid cream, which is applied directly to the scar to minimize its visibility, especially with keloid scars.
Laser treatments are another option for those with acne scars, and they too have proven to be highly effective. Laser resurfacing can produce some great results for those with light acne scars. If you have scarring that goes deeper into the tissue, laser treatments are probably not the way to go. These treatments work by removing the outermost layers of skin of the affected areas with a powerful laser tool.
CO2 laser resurfacing is one option that those with acne scars have, and it can work well with wrinkles, warts, and lighter scars. This type of laser treatment uses a short pulsed light energy, known as ultrapulse, to produce beans that remove thin layers of skin without significant heat damage.
Erbium laser resurfacing can remove scars that are on the surface as well as those which are moderately deep. There is minimal burning of the surrounding tissue with this procedure, and recovery time is generally faster than with CO2 resurfacing. While this particular laser treatment is not right for everyone with acne scarring, it has been known to be effective with certain people with this problem.
Excision treatment for acne scars comes with a number of benefits, but like many of these treatment options, it is not for everyone. Those who have deep ice pick acne scars are particularly good candidates for excision treatment, though laser resurfacing may also be required as a follow up measure. With this procedure, a doctor will cut into your skin to remove all traces of acne scarring and then close the wound with stitches.
A skin graft can also be a highly effective option for acne scarring. With punch replacement grafting, a doctor uses a round sharp tool that is the same size as the scar to remove it completely. Skin is taken from the ear or another area of the body and is used to fill in the wound. These skin grafts have been known to produce outstanding results for those with even deep acne scars, and there are few serious risks involved.