What Causes Acne Scars (And How To Get Rid Of Them)
It is not uncommon for people to struggle with acne well into their adult years. Even those individuals who are lucky enough to experience a dramatic decline in acne related symptoms over time may still be left with acne scarring, which can give the skin an irregular appearance.
What Are Acne Scars?
Acne scarring is the direct result of deep trauma to the skin related to acne. External factors, such as picking, can traumatize even small acne lesions and result in scarring. Acne scars manifest as areas of pitted or raised skin and can occur on the face or body. Not to be confused with post acne erythema (redness) or hyperpigmentation (brown spots) which are flat, temporary changes related to inflammation that tend to resolve over time, acne scarring changes the overall texture of the skin and does not always improve with time.
Acne scars result from the body’s natural attempt to heal itself. Skin pores that become clogged with dead skin cells slowly fill with excess oil and can allow bacteria to grow. These pores (or follicles) can become engorged resulting in acne lesions (i.e. whiteheads or blackheads). When these lesions rupture, the material spilling out into the skin is irritating and cause inflammation which presents as redness, tenderness and sometimes thick white fluid that can be expressed from the acne lesion. To repair this issue, the skin will naturally form new collagen fibers. Raised acne scars occur when the skin overproduces collagen, while pitted acne scars result when not enough collagen is produced.
What Type of Acne Typically Causes Scarring?
There are many different types of acne, some of which are more prone to scarring than others. Whiteheads and blackheads rarely result in scarring. Inflammatory acne, such as acne cysts or nodules, is most likely to create long-term scarring as this type of acne affects deeper layers of the skin.
Am I More Likely To Get Acne Scars?
There are several variables that can make an individual more prone to developing acne scars.
- Genetics: If you have family members with acne scarring, you are more likely to also experience the issue.
- Non-Treatment: Individuals who do not treat their acne are more likely to scar. It is best to get early treatment for acne in order to prevent scarring.
- Picking and Touching: Picking at acne causes trauma to the skin that is more likely to result in scarring and prolong the healing process. Some people are not aware that they are picking at their skin.
How Can I Treat My Acne Scars?
Acne scars can affect one’s self-esteem, confidence, and overall quality of life. The best first step is to treat any active acne lesions to prevent future scarring. However if you are already left with scarring, there are many effective treatments that can improve skin texture and reduce acne scarring.
Depending on the type and severity of the scarring, effective treatments to consider include:
- Chemical Peels: An acid-based solution is applied topically to either the entire face or just in areas of pitted scarring to remove the outer layer of skin and stimulate collagen repair. Multiple sessions are necessary to optimize results. A series of chemical peels can leave the skin looking smoother and less scarred in appearance, as well as improve skin discoloration.
- Dermal Fillers: Injectable hyaluronic acid (a natural sugar molecule that absorbs water and acts similar to a moisturizer), such as Belotero, Juvederm or Restylane, can be injected into depressions in the skin from acne scarring to help smooth out the skin texture. Dermal fillers are temporary and often need multiple sessions to maximize scar repair.
- Laser Resurfacing: A fractional laser delivers pixelated columns of laser heat in a controlled and predictable manner to either heat the skin (Fraxel Re:Store) or remove the skin (Fraxel Re:Pair or Active/Deep FX) to elicit scar remodeling. The number of recommended treatment and the amount of downtime involved with these lasers varies. It is best to ask an expert about which laser would best fit your needs and lifestyle.
A consult with a board-certified cosmetic dermatologist will help determine how to customize these options for your acne scarring.