Types of Acne Scars and Their Treatment

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Are you aware of the fact that a whopping 45 to 55 percent of today’s adult population experience persistent breakouts? Among these, acne scars are the most common. So if you experience acne or its scars, you are definitely not alone. 

The good news is that there are numerous topicals, face wash options, and medications available today than back in your high school days. The downside? You may have some leftover stubborn scars.

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You might be noticing some skin issues or pimples from time to time, but are you ok with it? But if not, there are several ways to minimize the look of those scars.

Here we discuss the various types of acne scars and what treatments are available so that you do not have to live with these unfriendly scars lifelong.

Why Do You Have Acne Scars?

A scar is a mark left on your skin after an injury or wound that has healed. In fact, a scar is a natural part of the healing process. 

Most will fade away, although they never completely disappear. There could be a combination of factors that causes acne. But you should get rid of acne scars at the earliest because they are tough to remove the longer they stay.

Scarring is a normal part of your body’s healing process after any tissue damage in your skin or other parts of the body. When your skin is wounded, the surrounding tissues in the area break. Resulting in the release of the protein called collagen. 

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Collagen is a protein that builds up anywhere in your body where the tissue is damaged. It helps to heal and strengthen your wound slowly.

In simple terms, you would notice scars as they result from the biological process of wound repair in your skin.  Most wounds, except for minor ones, often result in some degree of scarring. Scars can also result from accidents, diseases, skin conditions such as acne, or surgeries.

New collagen formation continues for several weeks around your wound. Over time the blood supply increases in the area causing your scar to become lumpy, red, and raised.

But the worst part is that scarring has an emotional effect. Scars can affect you both psychologically and physically. A scar prominently visible on your face can be very distressing. The situation can be even worse if you feel you are being stared at.

As a result, you automatically avoid meeting people because of your appearance. Leading to a scenario where you quickly become socially isolated.

All this could lead to depression as well. Consult your doctor if you feel your scars are making you depressed or if they are affecting your daily activities.

How is Acne Scars Formed?

The peaks and valleys can have variety. Older acne scars are very challenging to treat. Acne often appears when your hair follicles or pores get clogged by oil and dead skin cells. Bacteria can start to grow around the hair follicles, causing inflammation, irritation, and red bumps. 

Scarring can result from damage to your skin following repeated inflammation from acne cysts. If your pimples constantly keep popping, it might make the process worse. 

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But acne can cause scarring even without your pimples popping. How big your scar will be left after a blemish will solely depend on the depth of the breakout. As your pores become clogged and form a blemish, the pores may swell, thus collapsing your follicle wall.

The depth of your lesion determines the severity of your scar. If you have a shallow lesion, it often heals quickly, leaving little or no scarring at all. On the other hand, deeper lesions spread and affect nearby tissues, causing a more pronounced scar. If your scars have aged, then it is even more challenging to treat. 

Types of Acne Scars

There are primarily two categories of acne scars, raised acne scars and depressed acne scars. You are likely to have depressed acne scars when there is a loss of tissue. 

On the contrary, raised acne scars result when there is an overproduction of tissue. Depressed acne scars are often the most common type. 

The following are a few examples of depressed acne scars or atrophic acne scars: 

1 Ice-pick scar. These are deep, narrow, and pitted scars. Deep indentations are common on your cheeks. They resemble a scar made from a tiny ice pick. In fact, they are one of the more challenging scars to treat. 

2 Boxcar scars. These are wide scars with sharply defined edges. These are not as narrow as ice pick scars. They are often a wider depression in your skin that has more defined edges. They generally resemble a chickenpox scar. Wider scars are comparatively harder to treat than narrow scars.

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3 Rolling scars. These resemble boxcar scars but have sloping edges. Rolling scars are the most common of the lot and do not have distinct edges. Instead, they often have curved edges, varying depths, and a more irregular look.

4 Atrophic scars. These are generally flat, thin, or depressed scars.

In the case of raised acne, hypertrophic acne is the only example. These are lumpy, thick scars that occur when you have an overproduction of skin repair tissue. It is common in adults who have more than one type of acne scar.

Treatment Options for Atrophic Acne Scars

To address this type of atrophic acne scar, your dermatologist will first try reducing the depth of your scar and then treat any discoloration. 

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There are numerous treatments available that range from mild to clinical-level procedures to address these tough scars. Discuss with your dermatologist to see what treatment option is suitable for you and your skin tone.

A Skin Resurfacing procedures for Acne Scar Treatment 

The treatments include:

Laser therapy. Your doctor can use lasers to treat layers of your skin and encourage new skin growth. High-energy light beams remove the outer layers of your skin to stimulate collagen production. This method is called ablative laser therapy. Non-ablative therapy uses heat to spark the production of collagen in the skin.

Chemical peels. If you have mild scarring, this treatment removes the top and middle layers of the skin and encourages new skin growth. Glycolic acid or Salicylic acid is an essential ingredient in the chemical peel treatment that helps clear the outer layers of your skin. Do not use this therapy for very deep scarring.

Dermabrasion. This procedure removes the top-most layer of the skin to encourage a smoother layer to grow in its place.

B Other Acne Scar Treatments

The treatments include:

Dermal fillers. A popular treatment method uses substances such as hyaluronic acid or calcium hydroxylapatite as injectables to temporarily fill scars. This process helps to improve the appearance of your skin. 

Microneedling. During the microneedling procedure your dermatologist will use tiny needles to stimulate collagen production and reduce the depth of scars. 

Punch excision. Another method wherein your dermatologist will cut out and then stitch together the area to create a less noticeable scar.

Punch grafting. The scar is cut out in this treatment, and the area is replaced with skin from elsewhere. The skin is usually taken from behind the ear.

Subcision. During the procedure, the scar tissue is broken away from your skin. As a result, it raises up and looks less noticeable.

TCA CROSS peels. Your doctor will use trichloroacetic acid or TCA on a scar to encourage collagen growth during the procedure.

Treatment Options for Hypertrophic Acne Scars

Unlike atrophic acne scars, hypertrophic scars are raised from the skin instead of indentations. This scenario occurs due to too much collagen produced while healing. These kinds of scars are less common than the other kinds and are mostly associated with body acne. 

Keloid scars are also hypertrophic scars. Keloid scars are firm, smooth, and hard growth due to spontaneous scar formation. These scars arise soon after an injury or could even develop months later. 

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Keloids may be uncomfortable and itchy and extend well beyond the original wound. Keloid scars become much larger than the original spot. But hypertrophic scars are of the same size as the acne that caused it. 

The purpose and the goal of treating raised scars are all about reducing the height of the scar. Treatments include:

  • Laser resurfacing.
  • Surgical removal.
  • Steroid injections soften the scar tissue and reduce its size.
  • Over-the-counter (OTC) scar treatments like silicone sheets or oils.

There are several OTC treatments available that often claim to reduce the appearance of your scars. But you should check with your doctor before wasting any money on products that might not work.

When to See a Dermatologist

For most, acne scars will fade with proper acne treatment and sun protection. However, consult your dermatologist if you have scarring or discoloration that lasts more than a year and are interested in treatment.

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Your dermatologist will help develop a treatment plan best suited to your skin type. Home treatments might also help reduce the appearance of your acne scars. But home remedies are not as effective as treatments offered at the clinic.

Managing Acne Scars

Managing your acne scars can be a daunting task, but there are various options available for treatment. By understanding the types of acne scars, you can control your scars, appearance, and health.

Once you have identified the kind of acne, you do not have to undergo treatment for the different types of acne scars. You can discuss this with your dermatologist and decide on the proper skin treatment. 

Even with the most careful treatment, you might develop acne scars. If you have acne, you should first attempt to control the breakouts as much as possible. It is very difficult to effectively treat acne scars if they are still actively breaking out.

Your dermatologist can only help you find an acne treatment that will help bring the breakouts under control. Once your facial skin is reasonably clear, the next step is treating acne scars. Your dermatologist can help with that too.

Your results depend primarily on the knowledge and skill of your doctor performing the treatment. Dermatologists perform these procedures frequently. So they have the experience and skills needed to perform these procedures safely and effectively. You and your doctors can work together to make decisions best suited for you.

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