What are Acne Scars?
Acne scars are the dark and sometimes swollen pits left in the skin long after the pimple has healed and are divided into four categories according to appearance and cause: ice pick (small pits), boxcar (scars that have sharp edges), rolling (caused by damage underneath the epidermis) and hypertrophic (raised and bumpy because of excess scar tissue under the skin).
How Do People Get Acne Scars?
Surprisingly, all acne scars are NOT caused by picking at the outbreak. The skin on your face is extremely sensitive and if you suffer from extreme period of intense inflammation, such as what often occurs when you have cystic acne, hypertrophic acne scars will be the result.
What causes acne?
Many factors contribute to acne but the main ones are hormonal, bacterial and inflammatory disturbances that take place at the level of the oil pore (pilosebaceous unit which is made up of a hair follicle, sebaceous gland, and a hair). In summary, there are four major causes of acne and they are: Overactive oil glands, blockage of the skin pores, activity of normal skin bacteria, and inflammation.
What Acne Scar Treatment Options are Available?
There are multiple over-the-counter creams that succeed in getting rid of acne scars by “bleaching” the discolored parts, but they don’t take out the pits or take out the scars altogether. Laser acne scar removal uses lasers to clear the skin by smoothing the surface while increasing the production of collagen. Injections involve injecting fillers into the indented areas, while chemical peels take out layers of skin, leaving behind fresh, new-looking skin.
How does laser scar treatment work?
Unlike surgery, laser acne scar treatment uses ultra-short pulses of laser light to reach deeply into the skin’s sub-layers, treating the support structure. Then the body’s natural healing process sweeps away older, damaged tissue and rebuilds it with fresh, new collagen and elastin, which is the most vital part of the building blocks of normal-looking skin. It’s a fast and simple procedure that’s easy to tolerate and requires little-to-no downtime.
How is laser good for my acne?
Unlike topical acne treatment, laser stimulation can reach deeper into your skin’s layers to kill harmful bacteria, effectively resolving your current acne problems. You might additionally find that your skin produces less excess oil after cosmetic laser treatment, also helping to prevent future acne outbreaks.
After a cosmetic laser treatment session, you might notice some mild redness and irritation for a few days. Protect your skin from sunlight and harsh chemicals until your reactions subside. Depending on your skin condition, you may benefit from multiple treatment sessions, spaced out to let your skin completely recover.
Cosmetic laser treatment stimulates your skin to produce greater amounts of the protein collagen. With your collagen levels on the rise for several weeks following each treatment session, your skin will noticeably gain fullness and firmness. You can watch as the depressions and pits left behind by acne scars start to fill in and smooth out. You might need a few treatment sessions to completely restore the surface of your skin.
How long does it take?
The treatment can be performed in as little as 15 minutes or less, depending on the size of the targeted area.
What does the treatment feel like?
Most people feel minimal discomfort during laser acne scar treatment. We will work with you on the best option for optimal comfort based on your individual situation.
How many treatments will I need?
Acne scars will begin to show improvement in 2 treatments but a series of 3 to 5 treatments is recommended for optimum aesthetic results.
How quickly will I recover?
Most people resume regular activities immediately following the treatment session.
Are there any side effects?
Typical side effects include temporary redness and swelling at the treatment site. Unwanted pigmentation associated with the acne scarring should slightly frost (whiten) or have a slight greying color during treatment, then darken over the following 24 hours and then shed over time.
Acne scars on the face, chest and back are very common. Some 80% of people between ages 11 and 30 will get acne, and one out of five of those people will develop scars. Reducing the scars requires treatment either over-the-counter medications or one or more procedures performed by a dermatologist.
What causes acne?
An acne lesion (pimple) grows when bacteria, oils and dead skin fill up and inflame pores, the tiny openings in your skin through which oil and sweat rise to the surface. Some 40,000 cells fall off your skin every hour but, sometimes, those dead cells clog up a pore. Sometimes clogged pores are small and result in “whiteheads or blackheads.” Sometimes these pores become inflamed and lead to other types of acne.
If you have acne, you’re not alone! Acne is the most common skin condition in the world. About 80% of people between the ages of 11 and 30 will have it. Teenagers get acne thanks to their changing hormones. Adults have stress, the environment, menstrual cycles, oil-based products and birth control pills to blame, although hormones can still play a role.
What are the types of acne and what do they look like?
Acne presents as many different forms. Whiteheads and blackheads are typical and tend to heal smoothly more often than not. Then there are the types that can lead to scarring:
- Papules: Pink to red bumps that hurt when you touch them.
- Pustules: Pus-filled lesions. They’re red at the base and white or yellow at the top.
- Nodules: Solid lesions. They’re larger than papules and pustules and can hurt more because they extend deeper into the skin.
- Cysts: Cysts lie deep within the skin. They’re painful, full of pus and are most likely to scar.
How does acne cause scars?
Your skin is your largest organ. It has three main layers. They are, starting with the outermost, the epidermis, the dermis and the hypodermis. The layers protect your fragile insides from the elements, from UV rays and bacteria, and they also help produce vitamin D thanks to sunlight. Any area with sebaceous glands is prone to acne — especially the face, back and chest.
Acne scars are the result of inflammation of acne blemishes. The acne pore swells and a breakdown occurs in the wall of the pore. Some acne blemishes are small and the scars created are shallow and heal quickly. Sometimes the contents of blemishes spill into the surrounding tissue and cause deeper scars. The skin’s response is to repair the scar by forming new collagen fibers.
Acne scars take on two main forms: either a scar develops when there is a loss of tissue, resulting in an indentation in the surface of the skin; or, a scar develops that is raised on the surface of the skin. This type of acne scar, in fact, is a sign that your skin is doing its job — but, perhaps, too well. Your skin creates collagen (“repair tissue”) to help heal the wound — the acne — but, if it makes too much collagen, raised scars form.
Keep in mind that just because you have acne, that doesn’t mean you’ll get scars. And if you do (one in five people with acne will also have scarring), the good news is that not all acne scars are permanent! Treatments are available. Some treatments nearly remove the scars while others help the skin heal itself with its own collagen.
What are the types of acne scars and what do they look like?
If you have acne scarring, you’re likely to have more than one of the following types. Rarely does someone have just boxcar scars, or just keloid scars, etc. Each of these can be treated with varying degrees of success.
Atrophic or Depressed Scarring:
- Ice pick: An ice pick tool has a wide shaft that narrows down to the tip. This type of acne scar resembles the tool in that it’s a hole that’s wide at the top and narrows to a point as it goes deeper into the skin. Such an indentation is common and also one of the most challenging scars to heal. You’ll find them on your forehead and upper cheeks, where your skin is thinner.
- Rolling: These scars are typically found on the lower cheeks and jaw, where your skin is thicker. The indents have sloping edges that makes the skin look uneven and wavy.
- Boxcar: Boxcar scars are indents that have sharper edges. Those edges go down deep into the skin. These scars are common on the lower checks and jaw.
Hypertrophic or keloid scars: These lesions of scar tissue rise off the skin. They’re caused when fibrous tissues, the collagen, in the region of the skin overgrow. These scars are usually found on the chest, back and shoulders and jaw line and can be itchy, tender or painful.
How common is acne scarring?
Very common. About 80% of people between the ages of 11 and 30 will have acne, and one out of five of that population will have scarring. Teenagers are the hardest hit. Nearly 90% of them will get acne.
SYMPTOMS AND CAUSES
What causes acne?
Clogged pores. Dead skin, oils and bacteria build up in your pores and inflame them. You might also have a genetic predisposition to acne.
What causes acne scars?
Scars happen because your body is trying to repair the acne. How your unique body responds to a wound determines if and how much scarring you’ll have. The process of repair includes the creation of collagen. If there’s too much collagen then the raised scars appear. Other scarring is caused by the loss of tissue, which creates pits or indentations in the skin.
DIAGNOSIS AND TESTS
How is acne diagnosed?
A dermatologist will examine your skin and determine if the lesions are consistent with acne or another dermatologic process
How are acne scars diagnosed?
A dermatologist will examine your skin and determine if you have acne scarring and what type it is.
Are there any tests performed to diagnose the type of acne scar?
A visual examination by a dermatologist is enough to determine a diagnosis. Your dermatologist may also determine how severe your acne scarring is. One measurement system has four grades of acne scarring: macular, mild, moderate and severe. Grade one, macular, is a scar that’s red but flat. Grade two, mild, is a scar that can easily be covered by makeup or facial hair. Grade three, moderate, is “obvious at a social distance.” It is not as easily covered by makeup or facial hair. Finally, grade four, severe, is scarring that is very evident at a social distance greater than 50 centimeters (1.64 feet). It is unlikely that facial hair or makeup will completely cover up these scars.
MANAGEMENT AND TREATMENT
Consult with a dermatologist about treatment options and management techniques. They will determine what type of acne scar(s) you have and recommend the best treatments based on your wants and the location of the scarring.
Get in touch as soon as possible. Delays in treatment increase the severity of acne scarring.
Will my current acne breakouts interfere with the treatment for my acne scars?
Yes! Your skin needs to be blemish-free before you start treatment for your acne scars. Medications and treatments used on acne can interfere with medications and treatments used on scars.
What at-home treatments are most effective for removing acne scars?
Over-the-counter creams are best. Check with your dermatologist regarding which is best for your skin type and your type of scar. There are a variety of effective creams out there. They include the following chemicals, or a combination of:
- Alpha hydroxy acids.
- Lactic acid.
- Salicylic acid.
You can also choose to cover-up scars with facial hair or makeup. There are many over-the-counter makeup products available.
What in-office treatments are most effective for improving acne scars?
There are many cosmetic procedures to choose from. You and your dermatologist will discuss the best options for your acne scars. It is not unusual for a patient to have repeat procedures, or need two or more types of procedures to restore their skin.
- Chemical peels: This treatment uses special chemicals to remove the top layer of old skin. Typically whenever the top layer is removed, the new skin that grows in is smoother and has fewer scars.
- Dermabrasion: This treatment uses a special tool that produces friction to remove the top layers of skin, much like a sander removes the top layers from a plank of wood.
- Microdermabrasion: Microdermabrasion, similar to dermabrasion, uses a special machine to remove the upper layer of skin.
- Laser resurfacing: A laser delivers heat to the scarred collagen under the skin. This relies on the body’s wound-healing response to create new, healthy collagen. This encourages the growth of new skin to replace it. There are two different types of laser resurfacing: ablative and non-ablative. Your dermatologist will determine which type is best for your skin type and nature of your acne scars.