The scars that remain after the acne problem is over are a big problem for you too, aren't they? Every time you look at your face in the mirror, these scars appear and take away your happiness. Sometimes you don't even feel like going in front of people. But you are not alone, this is a problem that many people have. The best thing is, there are many good solutions for this now. So don't be afraid. Let's talk about this topic of acne scars from the beginning, very simply.
Let's first see, why do these pimples form?
To understand this, we need to know a little about our skin. Our skin has very small holes. We call these ``pores``. These holes are where sweat and oil (we call them ``sebum``) come out of the skin. This is normal.
However, sometimes these pores get clogged with dead skin cells, excess oil, and bacteria. That's when the pore becomes swollen, red, and appears as a pimple. Simply put, a pimple is a blocked skin pore that becomes infected.
If you have acne, it's a very common problem in the world. About 80% of people between the ages of 11 and 30 get acne. It is most common during adolescence due to hormonal changes. In adults, acne can be caused by stress, environmental factors, the menstrual cycle, oily cosmetics, and some birth control pills.
What types of acne can cause scars?
Not all types of acne cause major scarring. Types of acne, such as whiteheads and blackheads, usually do not leave a major scar when they heal. However, types of acne that are more inflammatory and cause deeper damage to the skin can cause scarring. Let's take a look at what those types are.
| Acne type | Appearance and nature |
|---|---|
| Papules | Small, pinkish-red bumps. These are painful to touch. There is no visible pus inside. |
| Pustules | These are what we call "pus cysts." They are red on the bottom and filled with white or yellow pus on the top. |
| Nodules | These are thick, large seeds. They can be caught in the hand. They go much deeper into the skin, so they are more painful than other types. |
| Cysts | These are the most severe types. They are very deep in the skin, filled with pus, and very painful. They are the most likely to cause scarring . |
How does a pimple turn into a scar?
This is very simple. Think about how your skin heals when you have a wound. Your body creates new tissue to cover the wound, right? A pimple is also a skin injury. Especially when you have deep pimples like the ``Nodules`` and ``Cysts`` that we talked about earlier, the walls of that hole break down and the infection spreads to the surrounding tissue.
So our body tries to "repair" this damage. The main ingredient used for this is a protein called collagen . This collagen is like the "cement" of the skin.
Now things can get a little messy here:
1. Dimples due to tissue loss: Sometimes when acne heals, collagen is not produced to fill the damaged area. This causes the skin to sag and form dimple-like scars.
2. Scars that are raised due to tissue growth: Sometimes, the body becomes overly excited and produces more collagen than necessary to repair the damage. This causes the skin to peel away from the surface of the area, forming a scar that looks like a tumor.
The important thing is, you don't necessarily have to have acne to get scars. Not everyone who has acne will get scars. But about one in five (1/5) people who have acne will have scars.
What are the main types of acne scars?
If you have acne scars, you probably have more than one of these types. Scars are rarely the same type. Treatments for each type are different.
| Types of scars and their descriptions | |
|---|---|
| Type 1: Atrophic or Depressed Scars | |
| Ice pick | Deep pits that look like a small ice pick stuck into the skin, wide at the top and narrowing as you go down. Most commonly seen on the forehead and upper cheeks. A bit harder to treat. |
| Rolling | These are not deep pits, but they create a wrinkled, wave-like unevenness on the skin's surface. They are common in the lower cheeks and chin area. |
| Boxcar | These are square-shaped, sharp-edged pits. They resemble the pits that appear when chickenpox develops. They are most common in the lower cheeks and chin area. |
| Type 2: Hypertrophic or Keloid Scars | |
| Hypertrophic / Keloid | These are, as we mentioned earlier, lumpy scars that have formed from excess collagen and have risen above the skin. They are most commonly seen on the chest, back, shoulders, and jaw. Sometimes they itch and hurt. |
Know this before treating scars!
This is very important. If you still have new acne on your face, that is, if you have active acne, you cannot start treating the scars. The first thing to do is to completely control the existing acne. The reason for this is that the medication given for acne and the treatment given for scars can conflict with each other. Therefore, first control the acne, and then think about the scars. For this, you should definitely see a dermatologist.
What treatments can be done at home?
There are some home remedies that you can use to treat minor scars and blemishes. However, it is best to consult your doctor before using them. He or she will be able to choose the best one for your skin type and the type of scar. These remedies usually contain:
- Alpha hydroxy acids
- Lactic acid
- Retinoids - These speed up the production of new skin cells.
- Salicylic acid
These work by removing the top layer of dead skin cells, making scars look less visible.
In-office treatments
For deep and severe scars, home care is not enough. It requires treatment under the supervision of a specialist. There are now many very advanced and effective treatments for this.
Resurfacing Procedures
These treatments involve removing the top layer of skin in a controlled manner, revealing the smooth, healthy skin underneath.
- Chemical peels: A special chemical is used to remove the top layer of skin. New skin is formed within a few days. This new skin is much less likely to cause scarring.
- Dermabrasion: This is like polishing a piece of wood. A special, rapidly rotating device is used to slowly remove the top layer of skin.
- Microdermabrasion: This is a treatment similar to dermabrasion, but gentler. Tiny crystal particles are rapidly applied to the surface of the skin, removing the top layer.
- Laser resurfacing: This is a very popular procedure. Laser light is used to heat and remove the collagen tissue that has caused the scars beneath the skin. It also stimulates the growth of new, healthy collagen. There are two types of this, `(ablative)` and `(non-ablative)`. Your doctor will determine the type that is best for you.
Other Procedures
- Steroid injections: These are used for keloid scars. When steroids are injected into the scar, the thickened tissue gradually softens and the scar flattens.
- Dermal Fillers: These are used for scars like dimples. A special filler is injected into the skin beneath the scar. This lifts the dimpled area and smooths the skin surface. The results are temporary.
- Microneedling: A device with many very fine needles creates tiny wounds on the skin's surface. Don't worry, this is done in a controlled manner. When you do this, your body naturally produces new collagen to heal those wounds. This new collagen fills in the scars and smoothes the skin.
- Subcision: Some pit-like scars are caused by fibrous bands under the skin that pull the skin inward. In this treatment, a special needle is used to break the pulling bands. The skin that is pulled in the pit is then released and lifted.
- Excision and Punch Grafting: These are like minor surgeries. They are used for deep, single scars. The scar is cut out and removed, and a small piece of skin, sometimes taken from behind the ear, is used to fill the gap and suture it.
Your dermatologist will determine which of these treatments is best for you and how many treatments you need after examining your scars.
How to reduce the appearance of acne scars?
Prevention is always better than cure. So these things will help you reduce the appearance of acne scars.
- Don't pick or squeeze pimples: This is the most important thing. When you see a pimple, don't pick or squeeze it with your fingernail. Doing so will only damage the skin further, deepen the infection, and leave a big scar. Keep your hands away from your face.
- Treat acne as soon as it appears: As soon as you start to get acne, see a qualified doctor and get the right treatment before it gets worse. The longer you wait to start treatment, the more likely it is to cause scarring.
- Protect yourself from the sun: If you are exposed to the sun frequently, use a good ``sunblock.'' When exposed to the sun, scars become darker and more visible.
- Avoid smoking: Smoking slows down the healing process of the skin, making it worse for not only acne scars, but any scars on the body.
Take-Home Message
- Acne scars can be a big deal for you. But don't worry, there are now many effective treatments for them.
- The best way to prevent acne scars is to seek proper medical treatment when acne appears, before it becomes severe.
- Before starting scar treatment, current active acne must be completely controlled.
- Treatment methods vary depending on the type of scar and skin type you have. So, instead of trying out things you see on the internet, be sure to see a dermatologist.
- Treatments may not be able to remove scars 100% of the time, but many treatments can significantly reduce the appearance of scars and smooth the skin.
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