Acne is the term for the blocked pores (blackheads and whiteheads), pimples, and deeper lumps (cysts or nodules) that can appear typically on the face, neck, chest, back, shoulders and upper arms. Seventeen million Americans currently have acne, making it the most common skin disease in the country. While it affects mostly teenagers, and almost all teenagers have some form of acne, adults of any age can have it. Acne is not life-threatening, but it can cause physical disfigurement (scarring) and emotional distress.
Acne is a common condition that causes blocked pores, pimples, cysts and other lesions on the skin. While it is most common in teenagers, acne can affect people of all ages, most often appearing on the face, neck, chest, back, shoulders and upper arms.
For many patients, once these lesions are removed, they leave behind discolorations and indentations on the skin and prevent patients from achieving the clear skin they desire. Although not harmful, most people are bothered by the unattractive appearance of these scars and seek treatment to remove or significantly reduce their appearance.
Acne scarring is most often caused by larger acne lesions, such as cysts or nodules, which can swell and rupture, causing a break in the wall of the individual pore. Infected material from the inflamed lesion can spill out through this break and can affect the nearby healthy tissue, leading to the appearance of a scar.
Types of Acne Scars
Acne scars can vary in appearance and texture depending on the type and severity of the original acne lesions. In most cases, acne leads to depressed scars, known as atrophic, that develop from a loss of tissue. The most common types of acne scarring include:
- Icepick scars, which are narrow indentations that form deep within the dermis and subcutaneous layers of the skin, creating an appearance that the skin has been punctured with an icepick.
- Boxcar scars, round depressions in the skin similar to chickenpox scars, which may be superficial or deeper, depending on the severity of the pimple.
- Rolling scars, which create a wave-like appearance to the skin as a result of bands of tissue that develop deep within the skin and pull the epidermis down in certain spots.
Each type of acne scar may require a different type of treatment in order to repair the damaged areas of the skin and produce a smooth, clear appearance that patients will be proud to show off.
Treatment of Acne Scars
Treatment for acne scars depends on the type and severity of scarring, as well as each patient’s individual skin and amount of correction desired. Your doctor will develop a personalized treatment plan for you, which may include:
- Tissue fillers to “fill in” depressed scars for a smoother appearance
- Dermabrasion to remove the surface layer of the skin, which can completely remove surface scars or lessen the appearance of deeper scars
- Laser treatments (Fraxel) to burn away the surface layer of the skin and promote new skin cell production
- Surgery (punch excision) to remove indented scars by cutting them out of the skin, which may include the use of a skin graft
For many patients, a combination of treatments may be most effective in improving the appearance of acne scars. Treating acne scars is often a complex process that involves trial and error of treatments.
Preventing Acne Scars
The most effective way to prevent acne scars from developing is to stop the lesions that lead to scarring from forming. It is also important for patients to avoid picking or popping active lesions, as this can lead to infection and increase the risk of scarring. Picking at scabs should also be avoided to allow natural healing to occur without interruption. Sun exposure can lead to further damage of the skin and may delay healing of scars and lesions, and should be avoided as much as possible to maintain the health of the skin.
Some patients are naturally prone to developing scars from acne and will not be able to prevent these scars from occurring. Fortunately, there are many treatments available to reduce the appearance of acne scars and allow patients to achieve the beautiful skin of their dreams.