One of the most important aspects of treating acne effectively is to prevent the formation of acne scars. Similar to battle scars, scars left behind by acne breakouts are permanent reminders of an acne sufferer’s physical and often emotional struggle with acne.
Because acne scars are often very noticeable, they can cause an acne sufferer to feel very self-conscious which can lead to low self esteem and a loss of self-confidence. This is why it is imperative to start an effective treatment program without delay in an attempt to prevent the development of permanent acne scarring.
Even in acne sufferers who exhibit fairly mild breakouts, the presence of scarring can justify the use of more aggressive treatments in order to prevent further scarring from taking place.
What causes acne scars to form?
Not all acne suffers develop scars. The tendency to develop acne scarring can be traced at least in part to an individual’s genetic make up and the way in which their skin responds to injury. Acne breakouts can cause intense inflammation within the skin, which injures the skin structures around the pore.
In response, the skin attempts to heal itself once the breakout resolves. However, in some people, the normal steps required for healing can malfunction causing the skin to heal with a noticeable scar.
Types of Acne Scars
Hypertrophic and Keloid Scars
In some acne sufferers, healing of acne breakouts can involve an overproduction of collagen which can cause a scar to appear thick and raised. These types of scars are called hypertrophic or keloid scars.
When healing of acne breakouts alters the normal structure of the skin well below the surface, the area of healing may pull down on the surface causing the skin to become indented and not as thick as the surrounding normal skin.
These types of scars can take different shapes. Some are rectangular and can resemble “boxcars” while others are not as well formed and have less defined borders, often referred to as “rolling” scars.
Others appear as small, deep holes in the skin surface resembling enlarged pores and are commonly referred to as “ice pick” scars.
Treatment for Acne Scars
The treatment for each type of acne scar can be different. Scars that are thicker can often be treated by injecting them with a steroid medication that tends to cause them to flatten down. Sometimes repeated injections are needed until the scars completely flatten.
Treatment for Atrophic Scars
Atrophic scars which appear indented on the surface of the skin, can be treated with a variety of techniques. One such method is called subcision. This technique involves using a needle to probe and undermine the collagen layers beneath the scar to break up the fibers that are pulling the scar downward.
This can help the scar to become more elevated and appear in line with the normal skin surface. Sometimes multiple sessions are necessary to achieve the best result.
Another treatment that can be useful for improving the appearance of atrophic scars is called the TCA Cross technique. This is a method in which a very strong acid called trichloroacetic acid, is applied directly over the indented scar and the resultant effects of the treatment can cause the scar to break down and become very inflamed.
This can prompt the skin to heal itself again, this time more effectively than it did after the initial acne breakout. This can lead to an improved appearance of the depressed scar. Also as with other methods, this method can require multiple sessions.
Treatment for Ice Pick Scars
For ice pics scars, a procedure called punch excision is sometimes used. This technique involves the use of a cookie-cutter-like instrument to remove or punch-out the deep hole in the skin.
Once the scar is removed, the remaining skin can be sutured back together. While this can lead to improvement, care must be taken not to cause a bigger scar from the surgical technique.
Laser Treatment for Acne Scarring
Laser treatments for acne scars are sometimes helpful. There are many different types of lasers so it is important to seek treatment with an experienced practitioner who is knowledgeable in the most effective lasers for treating different types of acne scars.
Some lasers for example only penetrate the very superficial layers of the skin. This is often not sufficient to work on scars which are present in the lower parts of the skin. Therefore, it is important to use a laser that can penetrate deeply enough to reach the level where scars are found.
Caution must be used however when using the more deeply penetrating lasers because they have the potential to cause additional scarring and discoloration of the skin. Acne sufferers with darker skin complexions are more prone to treatment-related discoloration and are often not candidates for these more aggressive laser treatments.
Healing can also be more challenging with the more aggressive lasers and should always be considered prior to undergoing a laser procedure.
For acne sufferers who have numerous scars involving large areas of the face, a resurfacing procedure called dermabrasion can be used. This technique employs a rotary machine that scrapes away the skin surface down to a level deep enough to reach the areas where the scars have formed.
While results can sometimes be very good, the treatment is much more aggressive than other treatments and must be done by a specialist with significant experience performing this technique to avoid complications.
Acne Scar Myth
One myth or misunderstanding about acne scars is that skin discoloration that occurs after an acne breakout heals is a type of acne scar.
Although many acne sufferers refer to red spots and dark spots that occur after an acne breakout heals as an acne scar, these skin discolorations are not true scars. The discoloration is only a temporary mark left over from the inflammation of the acne breakout and will completely disappear over time.
The use of sunblock and skin moisturizers can help the discolored marks to fade away more quickly. The most important treatment is to prevent new breakouts from forming in the first place which in turn will prevent further discoloration from occurring.
While various treatments can be used to improve the appearance of acne scars, the most important consideration is to strive for prevention by initiating treatment for active breakouts without delay. The sooner treatment can stop more acne breakouts from forming, the greater the chance of preventing permanent acne scars from forming.