Your skin is made up of three layers. When acne occurs, it penetrates every layer, thus damaging every tissue. Acne breakouts leave behind different kinds of marks on the skin. These marks are called acne scars. However, “scarring” is a fibrous process in which full-thickness injury is healed by collagen. 

Acne scars cause textural changes in the skin permanently. With aging, your skin starts losing collagen, thus making acne scars more noticeable. Acne scars can also be treated, but it is important to get rid of acne breakouts first. It is because inflamed skin is difficult to treat for acne scars [1]. 

As acne can occur everywhere on the skin, acne scars are also common on the face, back, shoulders, and chest. 

 

Who Gets Acne Scars?

Acne scarring is more common in some people. The chances of acne scars increase when an individual:

 

• Has painful and inflammation acne: Painful acne is either cystic or nodular with pus. This type of acne causes inflamed lesions on the skin. Cysts tend to damage the skin tissues by penetrating them.

• Does not prevent inflammatory acne: This type of acne should be treated without any delay. If a person takes a long time to treat acne inflammation, the chances of acne scarring increase.

• Squeezes acne on the face: Popping out acne pus increases inflammation, causing acne scars to occur [2].

 

What Causes Acne Scars?

Your skin has tiny pores in it, which bring oil and sweat to the surface. These pores become filled up with excess oil, dirt, bacteria and get inflamed. The result is acne lesions or zits.

Every hour, around 40,000 dead skin cells fall off the skin, but they can also clog up the pores instead of falling off. White and blackheads appear on the skin when the pores are small. But large pores get more inflamed and cause painful acne (cysts).

Indentation appears on the skin when the damaged area of skin heals and cysts clear out. These acne scars can sometimes take a longer time to disappear from the skin. 

 

Acne Scarring Can Be Of Many Types:

The following are common types of acne scars:

 

1. Rolling Scars: 

They are also called depressed or atrophic acne scars. These scars appear on the thicker areas of the skin and occur as depressions and undulations. Jaws and lower cheeks are likely areas for rolling scars. These scars give the skin a wavy and uneven texture. If inflammatory acne is not treated early, rolling scars can be the result. With aging, skin loses collagen, which gives skin elasticity and tightness, thus making the rolling scars more obvious. 

2.  Ice Pack Scars: 

They appear on your skin as if someone has punctured your skin with a needle and gave the skin an itty bitty appearance. As a result of acne breakout, the skin collapses because collagen is not produced and leaves a hole in the skin. Hormonal changes and cystic acne leave ice pack scars on cheeks, jaws, and chin.

3.  Boxcar Scars: 

When you have pustules and papules (inflamed, pus-filled acne), the horrible aftermath is boxcar scars. Unlike rolling scars which have round edges, boxcar scars have sharper edges.

4. Keloids: 

Raised scars on the skin are called keloids which are very severe. They appear discolored and bumpy. They usually occur after the skin heals itself but produces too many cells [3]. 

 

 

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References: 

[1]      Connolly D, Vu HL, Mariwalla K, Saedi N. Acne Scarring-Pathogenesis, Evaluation, and Treatment Options. J Clin Aesthet Dermatol 2017;10:12–23.

[2]     Goodarzi A, Behrangi E, Ghassemi M, Nobari NN, Sadeghzadeh-Bazargan A, Roohaninasab M. ACNE scar; A review of classification and treatment. J Crit Rev 2020;7:1108–14. https://doi.org/10.31838/jcr.07.07.204.

[3]      Betarbet U, Blalock TW. Keloids: A Review of Etiology, Prevention, and Treatment. J Clin Aesthet Dermatol 2020;13:33–43.

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