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Acne scars: Symptoms, causes, treatment and prevention

 Acne - Symptoms and causes

Acne scars on the face, chest, and back are very common. About 80% of people between the ages of 11 and 30 will develop acne , and one in five of these will develop scarring. Scar reduction requires treatment with over-the-counter medications or one or more procedures performed by a dermatologist. 
Acne scars: Symptoms, causes, treatment
Acne scars: Symptoms, causes, treatment


What causes acne?

An acne lesion (cystic acne) develops when bacteria, oil, and dead skin fill and inflame pores, the small holes in your skin through which oil and sweat float to the surface. About 40,000 cells fall out of your skin every hour but sometimes, those dead cells clog pores. Sometimes clogged pores get small and lead to "whiteheads or blackheads". Sometimes these pores become inflamed and lead to other types of acne. 

If you suffer from acne, you are not alone! Acne is the most common skin condition in the world. About 80% of people between the ages of 11 and 30 will have it. Teenagers suffer from acne due to their hormonal . Adults experience stress , from the environment, the menstrual cycle, oil products and birth control pills , although hormones may still play a role.

What are the types of acne and what do they look like?

Acne comes in many different forms. Whiteheads and blackheads are typical and tend to heal more often than not. Then there are the types that can lead to scarring:

  • Genital warts : Pink to red bumps that are painful to the touch.
  • Pustules: Lesions filled with pus . They are red at the base and white or yellow at the top.
  • Nodules: Solid lesions. They are larger than papules and pustules and can be more painful because they go deeper into the skin.
  • Cysts: Cysts are located deep in the skin. They are painful, filled with pus, and most likely leave a scar.

How does acne cause scarring?

Your skin is your largest organ. It has three main classes. They start with the outermost layer, the epidermis, the dermis, and the dermis. Your delicate inner layers protect from the elements, UV rays and bacteria, and they also help produce vitamin D through sunlight. Any area with sebaceous glands is prone to breakouts – especially the face, back, and chest.

Acne scars are the result of the inflammatory process of acne spots. The pores swell and rupture occurs in the pore wall. Some small pimples and scars are shallow and heal quickly. Sometimes the contents of a pimple spill over into the surrounding tissue and cause deeper scars. The skin's response is to repair the scar by forming new collagen fibers.

Acne scars come in two main forms: either scars that form when tissue is lost, resulting in an indentation in the surface of the skin; or scars develop protruding above the skin's surface. In fact, this type of acne scar is a sign that your skin is doing its job — but, perhaps, too well. Your skin makes collagen (“tissue repair”) to help heal an injury — acne — but if it makes too much collagen, scars form.

Remember that just because you have acne, it doesn't mean you will get a scar. And if you have (1 in 5 people with acne will also have scars), the good news is that not all acne scars are permanent! Treatment methods are available. Some treatments virtually eliminate scars while others help the skin heal itself with its own collagen.

What are the types of acne scars and what do they look like?

If you have acne scars, you may have more than one of the following types. Rarely does someone have only box scars, or just keloids, etc. Each type can be treated with varying degrees of success. 

Atrophic scarring or depression :

  • Ice Picker: Ice picker has a wide shaft that narrows down to the tip. This type of acne scar is tool-like in that it is a wide opening at the tip and narrows to a point as it deepens into the skin. Such indentations are common and also one of the most difficult scars to heal. You'll find them on the forehead and upper cheeks, where the skin is thinner.
  • Rolling: These scars are usually found on the lower cheeks and jaw, where your skin is thicker. Dimples with steep edges make the skin look uneven and wavy.
  • Boxcar: Boxcar scars are indentations with sharper edges. Those edges go down deep into the skin. These scars are commonly seen on examination of the lower jaw and jaw.

Hypertrophic or keloid scars: These scar tissue lesions protrude into the skin. They are created when the fibrous tissue, collagen, in the skin area overgrows. These scars are commonly found on the chest, back and shoulders, and jawline and can be itchy, tender, or painful.

How common are acne scars?

Very popular. About 80% of people between the ages of 11 and 30 will develop acne, and a fifth of that population will develop scarring. Teenagers are the hardest hit. Almost 90% of them will suffer from acne.


What causes acne?

Pores are clogged. Dead skin, oil, and bacteria build up in your pores and cause them to become inflamed. You may also have a genetic predisposition to acne.

What causes acne scars?

Scarring occurs because your body is trying to repair the acne. The only way your body reacts to an injury will determine whether or not you will have a scar and how much scarring it will have. The repair process involves the creation of collagen. If there is too much collagen, keloids will appear. Other types of scarring are caused by tissue loss, creating indentations or indentations in the skin.


How to diagnose acne?

A dermatologist will examine your skin and determine if lesions are consistent with acne or other dermatological processes.

How to diagnose acne scars?

A dermatologist will examine your skin and determine if you have acne scars and what type it is.

Are there any tests done to diagnose the type of acne scar?

Imaging examination by a dermatologist is sufficient to confirm the diagnosis. Your dermatologist can also determine the severity of your acne scars. A measurement system that has four grades of acne scarring: macular, mild, moderate, and severe. Primary scars are red but flat scars. Second degree, mild, is a scar that can be easily covered by makeup or facial hair. Third grade, on average, is “obvious at a social distance.” It is not easily covered by makeup or facial hair. Finally, grade four, severity, is scarring that is very visible at a social distance greater than 50 centimeters (1.64 feet). It is unlikely that facial hair or makeup will completely cover these scars.


Consult a dermatologist about treatment options and management techniques. They will determine the type of acne scar(s) you have and recommend the best treatments based on your wishes and the location of the scar. 

Contact as soon as possible. Delays in treatment increase the severity of acne scars.

Will my current acne condition interfere with my acne scar treatment?

It's correct! Your skin needs to be clear of acne before you can start treating your acne scars. Medications and treatments used on acne can interfere with medications and treatments used on scars.

What is the most effective home treatment to get rid of acne scars?

Over-the-counter creams are the best. Check with your dermatologist about which is best for your skin type and your type of scar. There are many effective creams on the market. These include the following chemicals or combinations of:

  • Axit alpha hydroxy.
  • Lactic acid.
  • Retinoids.
  • Salicylic Acid.

You can also choose to cover the scar with shaving or makeup. There are many over-the-counter makeup products available.

What in-office treatments are most effective for improving acne scars?

There are many cosmetic procedures to choose from. You and your dermatologist will discuss the best options for your acne scars. It is not uncommon for a patient to have to repeat procedures, or need two or more types of procedures to restore their skin.

Reshaping process:

  • Chemical peels: This treatment uses special chemicals to remove the top layer of old skin. Usually, whenever the top layer is removed, the new skin that grows is smoother and less scarred.
  • Abrasive Leather : This treatment uses a special tool that creates friction to remove the top layers of skin, much like a sander removes the top layers from a wood plank.
  • Microdermabrasion: Microdermabrasion, similar to dermabrasion, uses a special machine to remove the upper layer of skin.
  • Laser resurfacing : The laser transfers heat to the scarred collagen under the skin. This relies on the body's wound healing response to create new, healthy collagen. This encourages the growth of new skin to replace it. There are two different types of laser resurfacing: ablative and non-ablative. Your dermatologist will determine which is best for your skin type and the nature of your acne scars.

Other procedures:

  • Steroid injections: In this treatment, steroids are injected into a raised scar. Steroids soften fibrous tissue, flattening scars.
  • Dermal fillers: With this treatment, a substance is injected under the indented scar to lift the skin upwards.
  • Microneedling: This treatment uses tiny needles to intentionally injure your skin to stimulate collagen production that can smooth scars. Microneedling can be done alone or with heat (i.e. micro-radio frequency). Micro-RF has been shown to help improve skin texture from acne scars and may prevent further breakouts from forming.
  • Excision: With this technique, the dermatologist will make an incision in the skin, remove the acne scar, and then use sutures to close the wound.
  • Circumcision: This treatment uses a needle to break up fibrous bands to pull scar tissue down into the lower layers of your skin. The skin is released so that it can return to the surface and can lie naturally.
  • Hole grafting: With this treatment, the scar is removed like an excision, then a skin graft from another area of ​​the body, typically behind the ear, fills in the area where the scar was removed.
  • Cryosurgery: This treatment uses liquid nitrogen to coagulate raised scar tissue. The scar tissue dies and then falls off.

Ask your dermatologist about other options that may work best for you.

Is surgery necessary to remove acne scars?

Sometimes minor surgery is considered to treat certain types of acne scars. These surgeries lift the scar tissue closer to the surface of the skin to make the indentation less noticeable. They can completely remove the scar or break down the scar tissue, allowing new collagen to form and flattening the scar. The surgery is done in your dermatologist's office and you remain awake but the treatment area is numbed so you don't feel any pain. Often surgery is followed by other types of acne scar removal treatments. 

What is the treatment for acne scars that are not on the face?

Treatments used on your face do not have to be used on your back or chest. Your dermatologist will decide what's best for you depending on the type of scar and its location.

Are there any complications or side effects from acne scar treatments?

Yes, minor discomfort during and after treatment is common. Other complications include changes in skin color, darker or lighter.

Are acne scar treatments different for teens and adults?

The same treatments used in adults can be used in adolescents.

How to reduce the risk of acne scars?

  • Wear sunscreen: Sunlight is important because your skin uses energy to help make vitamin D. However, too much sun can darken scars. And the darker your skin tone, the more visible the scar.
  • Don't pick, scratch, or squeeze: Adds damage to your skin, promotes inflammation, and makes scars worse.
  • Treat acne immediately: The longer you wait, the greater the chance of scarring.
  • Don't smoke: Smoking increases your risk of scarring. Not only acne scars but scars on your body in general.
  • See a Dermatologist: Get Professional Help ASAP! Treat acne before it gets scarred.

How long does it take to get rid of acne scars?

The answer to this question depends on the type of scar and the type of treatment. Ask your dermatologist about the expected recovery time. Remember that not all scars will go away forever.


How to prevent acne scars?

Prevent acne scars by treating acne as soon as possible!


What can I expect if I have acne scars?

Acne is very common. It's likely that most of the people you know have had or have had it at some point, possibly as teenagers. Expect to make choices – choices about whether you will or will not receive treatment and choices about the type of treatment. You can expect to have scars for most if not a lifetime if you decide not to have treatment. Even with treatment, acne scars are difficult to heal. There is no 100% guarantee that acne scars will disappear completely. But most treatments reduce the size of acne scars and make them less visible.

How long will I have acne scars?

If left untreated, acne scars are likely to haunt you for the rest of your life.


How do I take care of myself?

Acne scars can cause psychological problems, self-esteem, and interfere with your social life or relationships. This is why it's important to get rid of your acne before it has a chance to leave a scar. See your dermatologist for acne treatment advice, follow instructions, and return to treating scarring—if scars appear—in the early stages when you have the best chance of reducing skin damage.

What makes acne scars worse?

Your own DNA plays a role in your scars! Your genes determine how well your skin heals, how much collagen is produced, and the depth of acne damage also control the severity of scarring. However, you can make scarring worse by smoking, squeezing and squeezing pimples. Try to keep your hands away from your face.

When should I see my healthcare provider about acne scars?

See your dermatologist as soon as possible. The longer you wait to treat your acne, the more likely it is to leave a scar.

What questions should I ask my healthcare provider about acne scars?

  • What is the best makeup I can use to cover my acne scars?
  • Which office procedure is best for me?
  • Are acne scar removal treatments painful?
  • What will my skin look like right after the procedure?
  • How long will it take for my skin to recover from the treatment?
  • Which over-the-counter medication is best for me?
  • How can I prevent scarring from coming back?
  • Are acne treatments covered?

A note from the Cleveland Clinic

Acne is common – very common – and so are acne scars. There are acne treatments and there are acne scar treatments. Some choose to just “live with” their acne scars while others decide that the scars disrupt their daily lives too much. You can decide to get treatment or decide not to. You have options and you are in control. 

Stay in touch with your dermatologist and any other healthcare providers you see and make sure you ask about treatment options (or expected outcomes without treatment). ), ask any questions and raise any concerns. You and your doctor will work together to make the decision that is best for you.

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