The method of acne scar removal depends on the types of acne scars you have. Acne scarring occurs when there is inflammation from an acne lesion that did not heal properly, resulting in tissue damage. White blood cells and anti-inflammatory molecules rush to the inflamed area to fight infection and help heal the damaged tissue.
As the skin heals, scar tissue forms and fills the gaps created in the skin’s surface. Although the inflammation will clear, the affected tissue remains in a damaged state, unable to return to normal. The difference between the skin and scar tissue is what makes the scar visible. The more inflammation, the more damage to the tissue.
The skin can reform itself if the injury is less than 0.5 mm deep or less than a fraction of a millimetre wide. Injuries deeper or wider than this cause scars. Avoid picking or squeezing an acne spot to avoid damaging your skin tissue. Acne scars can be raised, level with or lower than the surface skin.
Whether an acne patient will suffer from acne scarring depends on certain skin colouring and hereditary factors. What is the best treatment for acne scars for you will depend on the type of acne scars you have.
Acne lesions generally produce red blemishes, known as macules or pseudo-scars. These macules may change the skin’s color and leave a hyperpigmented mark on the skin, which in time may fade completely. These are considered a post-inflammatory change to the skin rather than an actual scar, where the redness or hyperpigmentation remains as the skin goes through its healing process.
Your skin can take anything from 6 to 12 months to heal, providing no more acne scars occurs in the area. Any remaining change in the skin which leaves a blemish after a year is considered a scar. Therefore, you may want to wait some 6 to 12 months before undergoing treatment for acne scars.
Generally there are two types of acne scarring: those that cause an increase in tissue formation, and those caused by tissue loss. The scars that increase tissue formation are known as hypertrophic or keloid scars. A hypertrophic scar occurs when the wound heals to become red, raised and itchy, but over time becomes flat and pale.
A keloid is very similar, but the scar continues to grow and can become several times larger than the original spot. Both of these scars tend to be found on the chest and back of young people with acne, but may also occur on the jawline or cheeks.
The video below provides more information on the causes of keloid scars and hypertrophic scars, as well as pictures of keloid scars that commonly result from cystic acne.
Two rare forms of acne, keloid acne or Acne conglobata (cystic acne), cause particularly aggressive scarring. Keloid acne stimulates the scar-forming process, sending it into overdrive. Excessive amounts of collagen are produced, and firm raised scar tissue forms. This is commonly along the jawline, the chest and the back.
How do you get rid of keloid scars? Very rarely are keloid scars treated by surgery, as they will often form or regrow in response to the surgery itself. If surgery is performed, radiotherapy may be given afterwards to prevent the scar from reforming and growing. The main treatment for keloid scars is the injection of steroids into the scar. This has to repeated every two months or so until the scar is soft and flat. Even when it is flat, the scar will still leave a visible mark on the skin.
Acne conglobata can leave large pink translucent scars, often referred to as “tissue paper” scars. They can be extremely difficult to treat. Each acne scarring case is unique. Your dermatologist will advise you on how best to treat these scars after a thorough examination.
If you have undergone treatment for keloid scars before, please feel free to comment and share your experience.