ACNE SCARS

Acne scars are permanent textural changes and indentations that occur on the skin as a result of severe acne. The term “scarring” is not used for the temporary red and brown marks left early after acne has occurred as these marks will almost always improve without treatment.

CAUSES

In severe acne, large pus-filled spaces known as acne cysts are formed. These cysts destroy skin tissue which is not replaced during the healing process.  When the cyst eventually empties and the area heals, it usually leaves behind an indentation (or scar) on the face. On the chest and back the scarring can be lumpy (known as “hypertrophic” or “keloid” scarring).

What does acne scarring look like?

Acne scarring on the face appears as damage to the skin texture with depressed (or indented) areas of various sizes. On the back and chest, scars tend be raised and lumpy.  Scars are usually a normal skin colour.  Some keloid scars can remain red for many years.

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TYPES OF ACNE

Box car acne scars

Box car scars are depressed scars which are shallow to medium in depth with well-defined edges, most commonly located on the cheeks and temples.

Ice pick acne scars

Ice pick scars are deep and narrow scars that extend into the lower layer of the skin. The foundation of ice pick scar treatment is either to raise the depth of scarring or excise (remove surgically) the pick itself.

Rolling, atrophic and depressed acne scars

Rolling acne scars appear as undulations and depressions on the skin. Some scar areas may be anchored to deeper structures. Mixed acne scars This is the most common form of acne scarring. Most people will have a mixture of acne scars, including tethered or anchored scars, ice pick scars, box car scars and rolling scars. Different types of acne scars will require different treatments and a tailored approach to scar revision therefore provides the best outcome.

Red acne scars – macular scars

Macular acne scars are commonly seen on the cheeks and forehead areas and present as red areas. They occur as a result of early acne scarring.

Lumpy hypertrophic and keloid scars

This type of acne scarring results in lumpy red scars, most commonly seen around the jawline, neck, chest and back areas. There are many treatments available for acne scars which can improve and soften the appearance of the scarring. A combination of treatments may be required. It is unrealistic to expect the return to completely normal skin following treatment.

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