Acne is the most common skin problem. It occurs when the pores or follicles of your skin become blocked with oil and dead skin cells and bacteria multiply inside the follicles. Acne affects many teenagers, and some people get it in their twenties and thirties. Most people grow out of it, but for other unlucky people, acne becomes a sustained problem. Acne can even follow you into adulthood. It’s not uncommon for adults to have acne in their 30s and 40s.
The Problem of Scarring and Why It Occurs
Acne isn’t dangerous but it can make you feel unattractive. It can also be distressing and sometimes disfiguring. One of the most concerning aspects is the scars that acne lesions can form. Why do some acne lesions lead to scarring? When a pimple forms on the skin, it’s filled with oil, bacteria, and dead skin cells. The bacteria produce factors that cause the wall of the pimple to expand. After about a week, it bursts, leaving behind a red mark that takes two to three weeks to heal.
The scarring process begins when the wound caused by the ruptured pimple does not fully heal. The healing process for a pimple wound consists of two phases. The first phase is inflammation, as white blood cells rush to the site of injury. This triggers collagen production, which repairs most of the damage to the skin within two weeks after the injury occurred.
Problems arise if there is a second round of inflammation before enough collagen forms. If insufficient collagen forms, a weak spot remains where more scar tissue can build up. If this happens, acne scars can result when you squeeze or pick at your blemishes. Acne-related scarring occurs when your body tries to repair itself after an injury caused by inflamed areas of acne.
Some People Are More Prone to Acne Scars
Some people are more likely to scar with acne. Genetics play a role in whether you develop acne and whether you’re likely to scar when you do. If an acne lesion produces a lot of inflammation (big red pimples), it’s more likely to scar. Also, cystic acne, where you develop red, inflamed nodules, is more likely to scar.
How you treat a pimple also affects the risk of scarring. Resist the temptation to squeeze or pop a pimple. If you squeeze it, that tissue breaks down and mixes with the pus, creating a bigger wound. And once the wound heals, it leaves behind a scar, just as if it had been an actual injury, not something self-inflicted.
Ways to Reduce the Risk of Acne Scarring
The first way to reduce the risk of acne scars is to prevent acne outbreaks. Wash your face twice daily with a non-foaming cleanser specifically formulated for acne-prone skin. Cleanliness, without drying out the skin, will help reduce the number of breakouts you experience and improve the condition of your skin over time.
Some dermatologists recommend other treatments to reduce acne outbreaks like a retinoid product. Retinoid is a vitamin A derivative that helps cells rebuild themselves. This kind of treatment may take a few months before you see results.
How to Treat Acne Scarring
Once you have acne scars, there are treatment options that will diminish their appearance. These treatments include chemical peels, dermabrasion, and laser treatments, which can be administered either by your dermatologist or at an outpatient surgical center.
These treatments work by removing the top layer of skin cells, allowing the skin to grow back smoother and more evenly than before. Although these treatments won’t eliminate scars, they will improve their appearance dramatically. A newer treatment called microneedling can improve certain types of acne scars with as little as two treatments.
There are several types of acne scars, and some are easier to treat than others. Some types of acne scars are raised off the surface of the skin. Because they produce too much collagen, they’re called hypertrophic scars. Other scars are depressed because they produce too little collagen. The most noticeable scar occurs when the skin tries to repair itself after a large inflammatory response. This scar, called a keloid, is where an excess amount of scar tissue forms outside the boundaries of the original wound and is quite noticeable.
The Bottom Line
Acne scars form as your body tries to heal an area of damage. Fortunately, some treatments can improve their appearance. Reducing the frequency of acne outbreaks will also lower the risk of scars forming. If you have persistent and acne and form cystic lesions that scar, it’s best to get the advice of a dermatologist. See also: How to Treat Cystic Acne and Why Topical Treatment Doesn’t Always Work
- Jacob, C. I., Dover, J. S., & Kaminer, M. S. (2001). Acne scarring: A classification system and review of treatment options. Journal of the American Academy of Dermatology, 45(1), 109–117. https://pubmed.ncbi.nlm.nih.gov/11423843/
- Fabbrocini G, Fardella N, Monfrecola A, Proietti I, Innocenzi D. Acne scarring treatment using skin needling. Clin Exp Dermatol. 2009 Dec;34(8):874-9. https://pubmed.ncbi.nlm.nih.gov/19486041/
- Rivera, A. E. (2008). Acne scarring: A review and current treatment modalities. Journal of the American Academy of Dermatology, 59(4), 659–676. https://pubmed.ncbi.nlm.nih.gov/18662839/
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