Acne scars may occur on face, cheeks chin jawline chest, back, butt, nose, arms etc. Acne marks make one unattractive, ugly, have uneven skin and cause skin depressions depending on where they occur. Acne scars may occur deep or shallow on skin due to popping acne pimples or bumps. Acne leaves ice pick, boxcar, and rolling scars on your skin. Worry no more, dermatologists can treat your scars through laser resurfacing, dermabrasion, frictional laser therapy, surgical methods etc.
Dermatologists usually addresses the causes of bumps, pimples first before getting rid of acne scars to prevent occurrence of new marks. Acne scars and marks do get worse with age as production of collagen or fat decreases.
What causes acne scars?
Pimples on skin is usually a temporal issue whereas acne marks are permanent reminder. Acne marks are as a result of an inflamed lesion (cyst, pustule and papule). Acne scars may be shallow or deep depression on your skin. Shallow depressions occur when follicle become filled with excess oil, bacteria and dead skin cells causing follicle rapture near the skin surface. These lesions are minor and heals quickly. More serious acne scars arise when there is deep rapture in the follicle wall that spill into dermis and destroy healthy deep skin tissues. The skin repairs itself by forming new fibrous protein (collagen) that give flexibility and strength, unfortunately not as flawless and smooth as before the rapture. Whiteheads and blackheads and other non-inflamed bumps do not cause scarring. Deep break outs take time to heal as well as increases the probability of scarring on skin.
Types of acne scars and marks
Acne scars can be grouped as hypertrophic or atrophic. Atrophic scars (depressed) occur if as the wounds heals it result to loss of skin tissue. Hypertrophic marks (keloid or scarring) result due to production of too much collagen forming a raised tissue on your skin surface.
1. Ice pick scars
Ice pick scars are very deep holes on the skin that look like punctured. They occur when your body produces too little collagen in response to a skin injury or wound. Plastic surgeon Gerald Imber says they are most difficult to treat and they are due to infected sebaceous glands openings on your skin. Dermatologist Judy Hellman says, skin grafts, use of laser or radiofrequency device may be appropriate way to treat ice pick scars. The methods help to build collagen from the inside out and as a result the collagen fills the scars from within.
2. Boxcar scars
Boxcar are depressed, broader than ice pick scars. They form as a result of too little produced collagen during wound healing. According to assistant professor Nada Elbuluk, energy based skin resurfacing with laser or radiofrequency or ultrasound device may help treat the boxcar scars. Dr. Elbuluk states that the retinoid may be used to increase the cell turnover and thus boost collagen and skin healing.
3. Roller scars
Roller scars are broad deep depression with sloping edge that occur due to little production of fibrous tissue compared with the wound leaving a depression. The combination of different types of scars in a region gives it a rolling appearance on the skin. These scars get more visible as the skin ages and loses its original elasticity and smoothness. Derma roller is one of the method for treating roller scars. Scar excision, subcision, derma fillers, erbium laser, micro needling are other methods to treat acne scars on your body.
4. Keloid scars
Keloids are smooth benign hard growths that form when the scar tissues grow excessively. When skin is injured the fibrous tissue (scar tissue) forms over the wound to protect and repair the skin injury. Sometimes the tissue over grows being larger then original wound especially on earlobes, cheeks, shoulders and chest. Keloids are not harmful to your health although they create cosmetic concerns. Keloids are shinny rubbery lesions sometimes accompanied by itchiness, pain and texture changes.
- The risks factors include being younger than 30 years, pregnant or being Latino, African or of Asian descent. However, they are not contagious. The main cause of keloid is not known however, if you develop keloid after injury dermatologists advice you to avoid ear piercing, cosmetic piercing or surgery of any body part. Corticosteroid injections, laser, silicone gel (sheeting), interferon, radiation may be used to treat keloids. Surgery may also be used although it may end up forming another similar keloid. NEVER perform skin needling procedure on keloid.
- Atrophic and hypertrophic scars may never completely heal or fade away without additional scar treatment. Collagen production usually stops after a few weeks after injury. Derma-pen are used by dermatologists to make fresh holes that triggers body to produce more collagen as well as address the scars formed.
5. Erythema or Permanent redness condition
Erythema is a skin condition where small capillaries near the skin surface are damaged and permanently dilated. This condition is common on acne sufferers and more visible on light skin toned individuals. The treatment methods include topical medications, laser and light based treatments that targets hemoglobin.
6. Pigmentation and discoloration scarring
Inflammatory ace may cause abnormal skin condition beside formation of collagen. The most common long term effects are abnormal discoloration of the affected area. The discoloration and pigmentation include;
- Hyper- pigmentation: a condition that occur as a result of elevated levels of pigment melanin accumulate on the skin. This occurs when melanocyte cells begin to proliferate the injured part of the skin. Alternatively, hyper-pigmentation may occur if the amount of melanocytes begins to produce excess amount of melanin due to inflammatory acne bumps trauma. Laser treatment and medicinal prescriptions like hydro-quinolone that target melanin production may be used to treat hyper pigmentation.
- Hypo-pigmentation: a condition that occurs when melanocytes are depleted from the wound or injury site or lose the ability of producing more melanin (vitiligo). This skin condition is what happens when skin is replaced with light pinkish skin on the injured area. The condition is more visible on dark toned skin acne sufferers. Chemical peels and laser resurfacing may help in some individuals. Hypo-pigmentation has less effective treatments available.
What is the Meaning of acne vulgaris scars?
Acne scars are the result of inflamed blemishes. The blemishes are as result of excess sebum, dead skin cells and bacteria in an engorged skin pores. The engorged pores swells causing breakage of hair follicle wall. According to Dr. Hevia, scars are skin defects known as “pock marks” or dents which respond best to fillers. Shallow bumps usually leave minor scars and heals faster. Deeper acnes may lead to deeper breakage that spill to the surrounding tissues creating deeper lesion.
The deeper breakage may occur as a result of popping as well as without popping. These repairs will not leave smooth and flawless skin as it was originally. Sometimes they are mistaken with marks that are usual discoloration after skin blemishes has subsided. Stretch marks are scars that form inside out. As we age, acne scars often become more visible and noticeable as skin loses collagen.
Who is vulnerable to acne scars and marks?
Everyone is vulnerable to acne scars and marks. However, some people are more prone than others. The ricks of developing increases due to;
- Propping, squeezing and picking acne. This leads to inflammation and increases chances of acne scars and marks.
- Hereditary factors. If one has a blood relative who has developed acne scars and marks, the risk increases. Genes plays a vital role and increases the risk of developing acne scars and marks. However, it is not possible to tell who will develop scars or not since even those with risk factors, scars may not occur.
- Inflammatory acne. If one has inflammatory acne, a swollen, reddish and painful bumps such as cysts and nodule. These type of bumps develop deep into the skin increasing the risks of scarring.
- Delayed treatment of inflammatory acne. If one has inflammatory acne the longer they stay without treatment the higher the risk of scarring.
Effective ways to get rid of pimples scars and marks
Depending on the severity of the acne scars, many sufferers rely on chemical creams and costly treatment. The treatment using these chemicals may have far reaching effects on your skin. Safer alternatives that are effective with less effect may be used to get rid of scars. The remedies include
1. Aloe Vera
Aloe Vera is a wonderful moisturizer and a potent source of vitamins that help heal skin and fade acne scar and marks. Fresh Aloe Vera is best in combatting scars.
- Cut a small fresh piece of Aloe Vera leaf.
- Peel away the outer flesh to expose the gel.
- Massage gently into your skin.
- Let the gel soak for 30 minutes before washing it off.
- Repeat the process regularly.
2. Baking soda
Baking soda is composed of sodium bicarbonate crystals which help exfoliate skin if used as cleansing scrub.
- Mix 2 tablespoon of baking soda with water to make thick paste.
- Leave the mixture for 1-2 minutes.
- Apply the paste to cleanse pores and prevent further blemishes.
- Allow the paste to settle on affected area for a few minutes.
- Wash it off with lukewarm water.
- Apply a good natural moisturizer like coconut and olive oil.
- Repeat the process regularly.
Cucumber contain vitamin A, C, magnesium and has hydrating properties that are great for the skin.
- Pick a fresh organic cucumber.
- Cut it off to thin slices and lay it off on the scarred area.
- Leave the slice for about 30 minutes.
- Discard the slice and rinse the area with water.
- Repeat daily until the desired effects are met.
4. Lemon juice
Lemon juice contains natural –hydroxyl acid that may help heal, revitalize and help fade acne scars.
- Take 1-2 fresh lemon fruit, squeeze the juice from organic lemon in a small bowl.
- You can use it undiluted or mixed with water if you have sensitive.
- Apply the juice on the scars with cotton ball and let it dry completely.
- Rinse off with cool water and apply natural moisturizer.
- Repeat this treatment once every two days or three days.
5. Sugar scrub
Sugar cane contains glycolic acid that help remove dead skin and promote cell regeneration.
- Mix raw organic cane sugar with virgin olive oil at 2:1 ratio, you may add several drops of organic lemon juice.
- Apply the scrub to the scar infested area once for 2-3 days.
- Leave it for about 15 minutes and rinse off with water. Apply a good natural moisturizer.
- Repeat the steps regularly until desired results are achieved.
Other methods include;
Omega 3 fatty acids; enhance production of prostaglandin hormone that help produce healthy cells and prevent skin inflammation. Salmon, flax seeds and sardines are good source of omega 3 fatty acids.
Zinc; zinc is beneficial to your skin health.it help prevent acne break out, inflammation and scarring. Good source of zinc includes; soy, beans, legumes and high protein food such as poultry meat and fish.
Yoghurt, Zurich, sandalwood, tomatoes, Sephora, Vitamin c, Glycolic acid etc may also be used.
Dermatologist prescribed treatments
This is a skin resurfacing treatment that is marketed as dark skin friendly. The treatment usually involves three spaced 4-6 weeks apart.it is a sublative radiofrequency technology for scar remodeling.
2. Isotretinoin (Accutane)
Isotretinoin is a prescription medicine for severe acne scars. The dermatologists tailor made the treatment to each patient. This method is used under doctor supervision.
3. Fraxel laser treatment
Fraxel is a painless, non-ablative treatment where energy is sent through skin without ablating the superficial layers of the skin. It is performed in terms of series where improvement is notable after 2-3 Fraxel sessions. The treatment is not only for acne scars but will make dark spots and marks disappear. According to Dermatologist Zeichner, once you have scars unfortunately they are permanent. However, the laser technology can help significantly improve its appearance and in some scenarios become invisible.
4. Chemical peel
Applying a chemical solution on the skin and allowing it to soak in which it peels off the skin within 1-2 weeks. This method causes controlled injury to the skin in order to stimulate the growth of the new skin. The new skin in-turn improves the skin appearance and surface.
Other methods include;
- Steroid treatments; steroid injection help reduce inflammation and flatten out the rough/ thick scars on the skin surface to look softer and more even
- Punch Excision; punch excision closes a scar with sutures leaving behind faint tiny scars that can be eradicated with chemical peel, laser resurfacing or dermabrasion methods.
- Dermabrasion; this is a machine assisted exfoliation treatment that use tiny rough grains or crystal scrubs like aluminum oxide and sodium chloride to remove dead skin cells and few top layers of your skin.
- Subcision; dermatologist undermine the acne scar with scalpel or needle and break apart the fibrous tissue so that new collagen can form a smoother surface.
- Fillers; derma filler can help fill the depressions left behind providing instant results that can last up to 1 year.
Ways of preventing acne scars?
The best method of preventing acne scars is to get no acne at all. However, you cannot eliminate acne at all. Nevertheless, it is possible to prevent acne scars through avoiding picking, popping, timely and effective treatment. These steps are beneficial
- Practice proper hygiene. Washing your face twice a day help to prevent acne breakout that may lead to scarring.
- Use warm water and mild soap to wash your face or skin in morning, after workout and at night.
- Do not touch the areas with acne breakouts or squeeze the pimples.
- Avoid sun ultraviolet rays that may damage your skin and increases risk of acne and acne scars and marks.
- Avoid using vitamin E on scars. According to a study from university of Miami, vitamin E hindered the healing process on the 90% of the study patients.
- Avoid smoking since it narrows blood vessels and depletes oxygen from the skin slowing the healing process of acne. Smoking also accelerates the aging process in the skin. Minimizing or quitting smoking will allow the natural healing of the body to the fullest capability.
- Use topical acne treatment that contain benzoyl peroxide or salicylic acid to get rid of acne on your skin that may cause scarring.
- Consult dermatologists to treat your acne who may prescribe appropriate oral antibiotics, cortisone injection or topical creams to help get rid of acne as well as prevent scarring. According to dermatologist Jeremy Fenton “cortisone injection does not only help the pimples disappear but minimizes the risk of scarring when done early”.
- Keep yourself well hydrated to detoxify your body and shed off dead skin cells. You can add a slice of lemon to your glass of water to boost the detoxification process.
- Make dietary changes for a balanced diet. Healthy balanced diets full of minerals and nutrients is good for your skin and body health. Incorporate food rich in anti-oxidants (vitamin A, C and E) like carrots, mangoes, leafy green, citrus fruits, nuts, seeds, butternut squash etc.
- Avoid using hydrogen peroxide on acne as a home remedy it can burn your skin and make your skin acne worse.
Sources and References
Wikipedia: What are Keloids?
Dermnet: What is acne scarring?
Dermcoll: What causes scarring?
Dermnetnz: How to treat acne scars?