Scars are the body's way of healing from an injury. It allows the skin to quickly recover, albeit in an imperfect way. Whenever the skin is damaged beyond the uppermost surface level, scars can potentially form. Acne has the potential of damaging deeper tissue, and thus, scarring is a possibility in acne. This is also a major reason why it is recommended that acne be treated early and aggressively to minimize the chance of scarring. Unfortunately with scars, once formed, they are very difficult to treat.
Types of Acne Scars
Ice pick scars: The most common of acne scars, these scars have narrow but deep pits. They are most commonly found on the cheeks, and resemble small holes in the skin. Box car scars: These angular scars often occur on the cheeks and the temple area. They appear sunken, and measure more than 3 mm in diameter. Rolling scars: Rolling scars get their name from their appearance. With these scars, the skin surface appears wave-like as irregular tissues form in the middle layers of the skin.
Hypertrophic/Keploid scars: For predisposed individuals, scarring causes the skin to rise, as the body creates excess rubbery tissue in response to injury.
Prevention
Scars can occur in response to any type of skin injury that reaches a certain level of depth, as it is the body's way of recovering quickly from an injury. As acne can affect the deeper layers of the skin if severe enough or if aggravated, scars are always a possibility. As such, the first and foremost consideration is to treat acne aggressively, and to maintain control of the condition. This is especially the case, if the acne spots are inflamed, creating pustules (pimples/zits) rather than blackheads and whiteheads.
Treat acne early and aggressively—do not ignore it, particularly if you have inflammatory acne
Don’t pick at pimples, blackheads, or whiteheads
Do not pick at existing scabs as it increases the chance of scarring
Try to avoid greasy cosmetic products as they tend to aggravate acne
Treatment
Once an acne scar has formed, they can be very difficult to correct. Unfortunately, prevention is not always possible, particularly if you have moderate or severe acne, as scars can form quickly, even without aggravating them yourself. There are several procedures that can help to improve the appearance of acne scars.
Microdermabrasion
Microdermabrasion is a procedure where fine aluminum crystals are used to remove the top layer of the skin. This procedure promotes a better overall appearance of the skin. Although this procedure is usually performed to improve sun damaged skin or pigmentation problems, it can also improve the appearance of minor acne scars.
Advantages:
Very little pain or discomfort
Quick procedure
No recovery time
Relatively inexpensive
Safe procedure
Disadvantages:
Multiple treatments may be required
Ineffective for larger or deeper scars
Skin Fillers and injectables:
There are various fillers that can be injected into depressed scars to correct its appearance. They are often used in cosmetic surgery as a temporary improvement, but the same principle can be applied to correct acne scars.
Advantages:
Quick procedure
Low recovery time
Disadvantages:
Most fillers are not permanent, lasting between 6 to 12 months
The cost of the surgery can be high, although they will vary widely depending on the performing surgeon and the location
Surgical Removal:
There are several techniques for surgically removing scars, but all involve cutting the scar tissue. In some procedures such as punch grafting, skin from another area is grafted on to fill in pitted scars.
Advantages:
Improves the appearance of deeper scars
Smoothes out pitted scars
Can be combined with minor procedures like chemical peels or microdermabrasion
Disadvantages:
Multiple treatments may be required
The costs of surgery can be high, although they will vary widely depending on the performing surgeon and the location
As with any surgical procedure, there will always be a risk of infection
Laser Resurfacing:
Lasers, and sometimes a combination of lasers can be used to remove the skin in layers, starting with the uppermost levels. In laser resurfacing, the skin is damaged in a controlled way, which prompts the re-growth of skin. During this process of healing, the scarred skin is naturally remodelled. This results in an improved appearance as the scars are smoothed out.
Advantages:
Improves the appearance of deeper more severe scarring
Smoothes out the skin in a natural way
Can be combined with other procedures
Disadvantages:
The final result can take up to 18 months as the improvement is the result of the skin’s natural ability to heal over time
The costs of the procedure can be high, although they will vary widely depending on the performing surgeon and the location
