About Acne Scars

Acne does damage not only once but it leaves a mark. As you outgrow the acne from adolescence, acne scars remain and causes more damage, for instance self – esteem. In adults, 12%–14% of the population may experience psychological and social implications in higher degree.

This acne is basically due to the fact that the body is bounded by many pilosebaceous glands especially in the face, back and chest. Eventually, acne lesions result in scars which can be permanent. The degree of damage of the condition varies. If it is not treated early, the effect could be worse. There is no extensive study that supports the prediction of occurrence and harshness of acne scars within the population. However there are presented literature stating that it is linked with the severity of acne. A study conducted on a group of people from the general population showed that 1 in 7 of the participants have "disfiguring scars." There is an effect physically and psychologically brought by the severe scarring.¹

How Do Acne Scars Begin?

Acne scars are brought about by damage to the skin due to the healing process of acne. These can result from either loss or too much of collagen .

Basically the extent of acne scarring is connected to the severity and lifetime of the initial acne. According to a study, a group of adolescence where examined for the presence of acne. About 88% to 99% have acne. However few have severe acne therefore acne scarring is minimal. Advancement in treatment and preventive measures probably reduced the problem.

Types of Acne Scars

There are two (2) basics types of scar. This is determined by loss in or gain of collagen. The population of people with acne scars due to loss of collagen or atrophic scars is about 80% to 90%. Only a few experience gain in collagen or hypertrophic scars and keloids.

1. Atrophic scars - more common scar compared to keloids and hypertrophic scars. Its sub-classification includes ice pick, boxcar and rolling scars. 60% - 70% accounts to the ice pick type, 20% - 30% to boxcar and 15% - 25% to rolling scars. The following is a brief description of each.

• Icepick – it is narrow about 2mm in size, deep scars thus its name. The opening looks like a "V" shape.

• Rolling – it is usually wider than the icepick scars, approximately 4 – 5 mm. It seems to give a rolling appearance to the skin, an "M" shape.

• Boxcar – oval or round with vertical edges. They can be shallow or deep. Unlike the icepicks, boxcar scars are "U" shaped.

2. Hypertrophic and keloidal scars – collagen deposition is observed. The usual hypertrophic scars are raised, pinkish and firm. The border of the scar is filled with thick hyalinized bundles of collagen . Keloids appear to be reddish – purple papules and nodules which goes beyond the borders of the healed wound.¹

Can Acne Scars Be Healed?

It is not assured that the acne scars would be gone. The only way to escape these is to take care of the acne problems as its onset. With this the chance of scarring is decreased. However, there are commercially available remedies to it. Just make sure to consult your dermatologist to avoid causing more problems.

Acne Scar Prevention

To date, the best prevention of acne scars is to treat acne as early one can get. Approximately, ten million Americans experience scarring as a result of acne. There is no guarantee who will acquire acne scars but there are some presented literature that support the factors that affect scarring. Genes can be the primary culprit in the severity of the condition and having frequent scar development. On the other hand, 95% of those experienced acne have the chance of being scarred. However the phenomenon behind this is still a mystery. It only states that the degree of scarring is dependent on the severity of acne.²

Acne Scar Treatment

Prevention is still the best cure. But let us take into consideration that acne can’t be controlled easily. There are procedures in dermatology nowadays that can solve scar problems. Before undergoing treatment, you must be familiar that each procedure is particular to the type of scar.

For atrophic scars, there are chemical peels namely glycolic acid, Jessner’s solution, pyruvic acid, salicylic acid, trichloroacetic acid, TCA cross. Another technique is dermabrasion or microdermabrasion. It is done by physical abrasion, it was said that this stimulates facial resurfacing of skin. Then of course there is the most popular laser treatment procedure. This is usually done for boxcar and rolling scars. There are also two types of laser treatment, nonablative and ablative. Nonablative technique is used to remodel skin with facial rhytides and acne scars. Next, the punch technique used to treat deeper scars. Another one is dermal grafting, usually done to repair unstable scars such as those chronic leg ulcers or x-ray scars. Other techniques include tissue augmenting agents, needling and combined techniques.¹

On the other hand, treatment for hypertrophic scars can be silicone gel, the most common and yet effective solution in preventing or treating acne scars in the long run. This is one of the most recommended merchandise in the market. Also one can opt to undergo Intralesional Steroid Therapy. This can decrease the volume, thickness and texture of the scars. Moreover, it has anti – inflammatory properties along with its vasoconstrictor and antimitotic capability. Cyrotherapy is another method wherein it can improve the appearance and thus severity of the hypertrophic scars and keloids. A method called pulsed dye laser is one of the first procedures however it is not that prevalent nowadays because of its nominal effect of the improvement of the scars. There is also surgery and other kinds of approaches that can be done. It is always important to remember that the kind of treatment still lays on the type or severity of scarring.¹

References

1. Gabriella Fabbrocini, M. C. Annunziata, V. D'Arco, et al., "Acne Scars: Pathogenesis, Classification and Treatment," Dermatology Research and Practice, vol. 2010, Article ID 893080, 13 pages, 2010. doi:10.1155/2010/893080
2. Kunin, Audrey. The dermadoctor skinstruction manual: the smart guide to healthy, beautiful skin and looking good at any age. New York:Simon & Schuster,2005.