Monday, August 6, 2012

A Simple Guide to Acne Scars

Acne, or more commonly known as “pimple”, is a common skin condition seen more frequently these days due to environmental pollutants and “environmental hormones”. The redness and horrible break outs is not only devastating during its active period, but could also lead to scars. Even without picking, acne lesions, particularly cysts, can lead to scarring because of the intense, collagen-damaging skin inflammation with which they are associated with.

What are Acne Scars and how do they look like?

Acne scars develop in areas where former cystic blemish lesions have been present. This happens when the most serious types of spots – nodules and cysts – burst and damage nearby skin. Scarring can also occur if you pick or squeeze your spots, so it is important not to do this.

There are four main types of acne scars:

Ice pick scars – small, deep holes in the surface of your skin that look like the skin has been punctured with a sharp object

Rolling scars – caused by bands of scar tissue that form under the skin giving the surface of the skin a rolling and uneven appearance

Boxcar scars – round or oval depressions, or craters, in the skin

Hypertrophic scars - Hypertrophic scars occur when the body overproduces collagen, which causes the scar to be raised above the surrounding skin. Hypertrophic scars take the form of a red raised lump on the skin. 

People with darker skin tones may also notice darkening (or hyperpigmentation) within the scars, while people with lighter skin tones may show redness (or erythema) within the scars. 

What Makes Acne Worse?

Exposing scars to the sun can cause them to darken and slow the healing process. Therefore, it is important to put on a broad-spectrum sunscreen with an SPF 35 or above for skin protection.

Picking and Squeezing
Acne scars are typically indented because of collagen loss from intense inflammation. Picking leads to further inflammation and injury of the skin, which adds to the skin’s discoloration and scarring. Squeezing or trying to pop a pimple causes pus and bacteria to filter deeper into the skin, resulting in more collagen damage.  

Vitamin E
You may have heard that applying topical vitamin E to a scar will help it heal faster. But according to a study from researchers at the University of Miami, applying the nutrient directly onto a scar can actually hinder its healing. In the study, vitamin E had no effect (or made matters worse) for 90% of the patients, and 33% who used topical vitamin E developed a contact dermatitis.

What Makes Acne Scars Better?

Cortisone and Fade Creams
First, if the scar is red or swollen, use an over-the-counter cortisone cream to calm the skin. The cortisone is absorbed by skin cells and reduces inflammation. Next, you’ll want to concentrate on lightening any hyperpigmentation left from the acne scar.  Hydroquinone, a potent skin lightener, can help reduce the hyperpigmentation. Kojic acid, arbutin, and vitamin C (ascorbic acid) are great alternatives for hydroquinone.

How to treat acne scars?

While treatment can certainly improve the appearance of your scars, it will not be able to get rid of them completely. After treatment for acne scarring, most people notice a 50% to 75% improvement in appearance.

Medium-Depth Chemical Peels
Chemical peels are increasingly popular because of their affordability in treatment of permanent skin conditions. Medium-depth chemical peels require more than one treatment to be effective and are normally only used on moderate scarring and especially good for treatment of ice pick scars. Medium-depth chemical peels contain between 10%-40% TCA (trichloro-acetic acid). It should be done at the doctor’s office, and the wait between each treatment is normally about two weeks because the skin flakes off for several days.

Laser treatment
Laser treatment can be used to treat mild to moderate acne scarring. There are two types of laser treatment:
ablative laser treatment – where lasers are used to remove a small patch of skin around the scar to produce a new smooth-looking area of skin, and also stimulate the collagen production.
non-ablative laser treatment – milder form of laser with similar profile, but less effective.
The most powerful of these lasers is the CO2, which aggressively penetrates the skin to resurface it. Er. YAG is less powerful laser resurfacing but still has many of the same side effects as the CO2 laser. Fractional CO2 laser is the mainstream of treating acne scar these days, giving you pronounced results after few sessions, but you'll experience a week of downtime with possibility of darkening of the skin if necessary precautions such as sunblock and skin lightening creams are not used.

Punch techniques
Punch techniques are used to treat ice pick scars and boxcar scars. There are three types of punch technique:
Punch excision is used to treat mild ice pick scars. The scar is surgically removed and the remaining wound is sealed. After the wound heals, it will leave a smoother and more even area of skin.
Punch elevation is used to treat boxcar scars. The base of the scar is surgically removed leaving the sides of the scar in place. The base is then reattached to the sides but lifted up so that it is level with the surface of the skin. This makes the scar much less noticeable.
Punch grafting is used to treat very deep ice pick scars. As with a punch excision, the scar is removed, but the wound is then "plugged" with a sample of skin that is taken from elsewhere on the body (usually from the back of the ear).

Subcision is a surgical treatment that can be used to treat rolling scars. During surgery, the upper layer of the skin is removed from the underlying scar tissue. This allows blood to pool under the affected area. The blood clot helps form connective tissue that pushes up the rolling scar so that it is level with the rest of the surface of the skin.

For more information about acne scars and its treatments, please contact +603-79601211 or write to us at


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