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Author: Leila Tan
30 August 2024

Ever wonder why some acne leaves behind stubborn reminders, while others vanish without a trace? The culprit? Acne scars, which come in all shapes and sizes, just like the pimples themselves. From deep craters to rolling hills, these scars can be a real drag on your confidence. But fear not, warrior! This guide will break down the different types of acne scars and equip you with the knowledge to fight and treat acne scars confidently.

1

Dealing with Skin Scars: What Acne Can Cause Scar & Common Acne Scar Types

Acne scars can significantly impact one's skin texture and appearance, and understanding the different types of acne scars is crucial for effective treatment. Generally, they are the result of damage to the skin tissue caused by inflammatory acne lesions. Here's a few type of acne lesions that may turn into acne scar:

Nodules and Cysts

Nodular acne and cystic acne are severe forms of acne characterised by large, deep-seated lesions beneath the skin's surface. These lesions are often inflamed, painful, and filled with pus. Due to their depth and the extent of inflammation, nodules and cysts can cause significant damage to surrounding skin tissue, increasing the likelihood of scarring.

Papules and Pustules

While papules and pustules are less severe than nodules and cysts, they can still lead to scarring if not treated properly. Papules are small, raised bumps that may be red or pink, while pustules are similar but contain pus. When these lesions become inflamed and rupture, they can damage the skin and result in scarring, particularly if they are manipulated or squeezed.

Inflammatory Acne

Inflammatory acne refers to any type of acne lesion that is red, swollen, and inflamed. This includes papules, pustules, nodules, and cysts. Inflammation plays a significant role in the development of acne scars, as it can cause damage to the skin's collagen and lead to the formation of scar tissue during the healing process.
If you are someone who has a tendency to pick, squeeze, or manipulate your acne, you are at a higher risk of developing scars. This behaviour can exacerbate inflammation, introduce bacteria into the skin, and disrupt the healing process, increasing the likelihood of scarring. Let's take a look at the common types of acne scars as follows, each with its own characteristics:

Atrophic Scars

Atrophic acne scars develop when the skin loses tissue, especially collagen, during the healing process after acne breakouts. These scars create indentations or depressions on the skin's surface. There are three main types:
- Boxcar Scars: Boxcar scars typically result from inflammatory acne, where the skin's collagen is destroyed during the healing process. The loss of collagen creates a depression with well-defined edges, giving the scar its box-like appearance. These scars can occur when the inflammation destroys the collagen bands that hold the skin together.
- Ice pick Scars: Icepick scars are narrow, deep scars that resemble small punctures or pits in the skin. They typically occur when acne lesions penetrate deep into the skin's dermal layer, causing damage to the skin tissue and collagen. Icepick scars are challenging to treat due to their depth and may form when the inflammatory response is particularly severe.
- Rolling Scars: Rolling scars are broad, shallow depressions with gently sloping edges, creating a wave-like appearance on the skin's surface. They typically occur when fibrous bands of tissue form between the skin's deeper layers, pulling the skin downwards and creating the characteristic rolling or undulating appearance.

Hypertrophic and Keloid Scars

- Hypertrophic Acne Scars: These scars develop when there is an excessive production of collagen during the wound healing process. As a result, the scar tissue becomes raised and may appear thicker than the surrounding skin. Hypertrophic scars typically remain within the boundaries of the original wound and may improve over time, but they can persist indefinitely.
- Keloid Scars: Keloid scars are similar to hypertrophic scars but extend beyond the boundaries of the original wound. They tend to be larger, thicker, and more prominent than hypertrophic scars and can be harder to treat. Keloids may continue to grow over time and are more common in individuals with darker skin tones and a genetic predisposition to keloid formation.

Post-inflammatory Hyperpigmentation (PIH)

PIH occurs when dark spots or patches develop after an acne pimple heals. These spots result from an overproduction of melanin in response to the inflammation or injury caused by acne. While PIH isn't technically a scar, it can persist long after the acne has resolved and can be distressing, particularly for individuals with darker skin tones. PIH can vary in severity and may fade gradually over time with proper treatment and sun protection.

Post-inflammatory Erythema (PIE)

PIE refers to red or purple discoloration left behind after inflammation, similar to PIH. These marks are caused by dilated blood vessels and can persist longer in some individuals. PIE is not a true scar but can be concerning for those affected, as it may take longer to fade compared to PIH. However, with proper skincare and sun protection, PIE can gradually improve over time.

2

Treating Acne Scars: Acne Scar Removal Treatments You Can Consider

Acne scars can persist long after blemishes have healed, affecting both skin texture and confidence. While some scars may fade over time, others may require more targeted interventions to achieve noticeable improvement. Here, we delve into advanced treatment options beyond topical remedies to address different types of acne scars effectively.

Topical Treatments

- Salicylic Acid: Salicylic acid is a beta-hydroxy acid known for its exfoliating properties. It works by penetrating deep into the pores, where it dissolves and removes excess oil, dead skin cells, and other debris that can clog pores and contribute to acne formation. By keeping the pores clear, salicylic acid helps to prevent new breakouts and minimise the formation of acne scars. Additionally, its exfoliating action can improve the appearance of superficial acne scars by promoting cell turnover and revealing fresher, smoother skin underneath.
- Alpha Hydroxy Acids (AHAs): AHAs such as glycolic acid and lactic acid are water-soluble acids that work to gently exfoliate the skin's surface. By promoting cell turnover, AHAs help to shed dead skin cells, smooth rough texture, and fade discoloration associated with acne scars. Regular use of AHAs can gradually diminish the appearance of acne scars and improve overall skin tone and texture.

Injections

- Steroid Injections: Steroid injections are commonly used to treat raised scars such as hypertrophic and keloid scars. These scars result from an overproduction of collagen during the healing process, leading to raised, firm bumps on the skin surface. Steroid injections work by delivering corticosteroids directly into the scar tissue, where they help to reduce inflammation and suppress collagen production. This process softens and flattens the scar, making it less noticeable over time. Steroid injections are particularly effective for reducing the size and prominence of raised scars and can significantly improve their appearance with repeated treatments.

Laser Therapy

- PicoWay Picosecond Laser Treatment: Laser treatments offer precise targeting of specific types of acne scars, stimulating collagen production and promoting skin regeneration. While traditional treatments offer some relief, advancements in laser technology have introduced a promising solution. Introducing the PicoWay Picosecond Laser Treatment, a breakthrough in non-invasive acne scar treatment. Unlike traditional treatments that are invasive, PicoWay offers a more even skin tone without causing any damage to the skin. Experience significant reduction in dark spots from the very first treatment session. Witness visible improvement as the shattered melanin undergoes metabolic removal, revealing clearer and more radiant skin over time. Unlike traditional methods that may result in post-inflammatory hyperpigmentation, PicoWay's rapid melanin shattering process ensures no rebounding pigmentation or unwanted side effects. Another key benefits of PicoWay is its ability to precisely target and address tiny pigmented lesions without affecting the surrounding skin area. Using advanced laser technology, PicoWay delivers ultra-short pulses in the picosecond range, allowing for precise targeting of specific types of acne scars.

Chemical Peels

- Superficial to Deep Peels: Chemical peels involve the application of a chemical solution to the skin, which causes controlled exfoliation of the outermost layer. This process removes dead skin cells, unclogs pores, and stimulates cell turnover, revealing fresher, smoother skin underneath. There are different types of chemical peels available, ranging from superficial to deep peels. Superficial peels use mild acids like alpha hydroxy acids (AHAs) or beta hydroxy acids (BHAs) to target the outer layer of the skin, while medium and deep peels penetrate deeper into the skin to address more severe scarring. Chemical peels can help improve the appearance of superficial acne scars by promoting skin renewal and collagen production. They also help to even out skin tone, reduce hyperpigmentation, and refine skin texture.

Dermal Fillers

- Injectable Dermal Fillers: are injectable treatments that use substances like hyaluronic acid to add volume and plump up depressed scars. They are particularly effective for filling in shallow acne scars and smoothing out the skin's surface. Dermal fillers provide an immediate improvement in the appearance of depressed scar by restoring volume and supporting the skin from beneath. They can help to minimise the depth and visibility of scars, giving the skin a smoother and more even texture. While dermal fillers offer temporary results, typically lasting from several months to over a year depending on the type of filler used, they can provide significant improvement in the appearance of acne scars with regular maintenance treatments.

Surgical Procedures

- Skin Grafts or Excision: In cases of severe scarring, surgical procedures such as skin grafts or scar excision may be necessary. Skin grafts involve removing healthy skin from another part of the body and transplanting it onto the scarred area, while scar excision involves surgically removing the scar tissue and suturing the skin back together. Surgical procedures can provide more dramatic and permanent improvement for severe acne scarring. They can help to reconstruct damaged skin and restore a smoother, more uniform complexion.

3

Wound Healing Process: Do's & Don'ts After Acne Treatment

After undergoing acne scar treatment, it's essential to follow specific post-treatment care guidelines to promote optimal healing and protect your skin from further damage. Here are some steps to consider:

Follow Your Professional Therapist's Instructions

Following your professional therapist's instructions is paramount for optimal post-treatment care. Your dermatologist or skincare specialist will provide detailed guidelines tailored to your specific treatment and skin type. These instructions may encompass a range of considerations, including the use of particular skincare products, avoidance of specific activities or products, and scheduling follow-up appointments. Adhering strictly to these instructions ensures that your skin heals properly and that you achieve the best possible results from your treatment.

Keep Your Skin Clean

This involves cleansing your skin gently but effectively twice daily using a mild, non-comedogenic cleanser. Harsh scrubbing or abrasive cleansers should be avoided, especially in areas that have undergone treatment, as they can irritate the skin and impede the healing process.

Moisturise Regularly

Regular moisturization is important for promoting skin health and facilitating the healing process. Opt for a lightweight, non-comedogenic moisturiser that won't clog pores or exacerbate any existing skin issues. Moisturising helps replenish lost moisture, soothe irritation, and maintain the skin's barrier function, which is particularly important if your skin feels dry or tight following treatment.

Protect Your Skin from the Sun

Sun protection is crucial after acne scar treatment, as UV exposure can worsen pigmentation issues and delay healing. Apply a broad-spectrum sunscreen with SPF 30 or higher every morning, even on cloudy days, and reapply every two hours when outdoors. Whenever possible, minimise sun exposure, especially during peak hours of UV radiation between 10 a.m. and 4 p.m. Wear protective clothing, such as wide-brimmed hats and long sleeves, and seek shade when outdoors.

Be Gentle with Your Skin

Avoid picking, scratching, or rubbing the treated areas, as this can disrupt the healing process and increase the risk of complications. Treat your skin with care and avoid any harsh or abrasive skincare products.

4

Last Few Words

To sum it up, learning about the different types of acne scars and the treatments available is crucial for dealing with this common skin issue. By teaming up with the professionals and take on the right plan, you can smooth out your skin, make it more even, and feel good about yourself again!

免費體驗

PicoCure Pigmentation Removal Treatment
1 Minute Self-Registration

Date should not be before minimal date

I have read and agree to the Terms and Conditions and Privacy Policy.

FAQ

1. What types of scars are more likely to develop from active acne lesions?

Active acne lesions, particularly those that are more inflamed, are prone to causing different types of scars. Hypertrophic scars are raised scars resulting from excessive collagen production during wound healing. These scars typically stay within the original wound area but can persist over time. On the other hand, depressed scars, such as those caused by severe acne, may form when there's damage to the skin's tissue, leading to indentations or depressions on the skin's surface.

2. What are hypertrophic scars, and how do they differ from other acne scars?

Hypertrophic scars are raised scars that develop due to an excess production of collagen during the wound healing process. Unlike other acne scars that may be depressed or indented, hypertrophic scars protrude above the skin's surface, often within the original wound area.

3. Can you explain what can stimulate collagen production and help with acne scar?

Methods like microneedling, fractional laser therapy, chemical peels, topical retinoids, dermal fillers, and platelet-rich plasma therapy can effectively achieve this, leading to noticeable improvements in skin texture and scar appearance over time.

4. What distinguishes boxcar scars from other types of acne scars?

Boxcar scars are wider depressions with well-defined edges, giving them a box-like appearance. Unlike icepick scars, which are narrow and deep, boxcar scars are shallower but still significantly affect skin texture. They are typically caused by inflammatory acne and can vary in size and severity.

5. What are the characteristics of rolling scars and how they form?

Rolling scars are broad, shallow depressions with gently sloping edges, creating a wave-like appearance on the skin. These scars often occur due to tethering of the skin to deeper tissue layers, resulting in a rolling or undulating surface texture. Rolling scars are typically caused by inflammatory acne and may be more challenging to treat due to their complex nature.

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