Acne scars are some of the most common — and bothersome — skincare concerns among teens and adults alike. The underlying cause of acne scars depends on the type of scar they are, though most types of acne scars can be made worse by popping pimples or picking at scabs. Therefore, the best way to try to prevent acne scars from forming in the first place is to avoid popping pimples or picking at acne.
Sometimes acne scars are not preventable, however, and will form even if you are diligent about not popping pimples. When you are left with bothersome acne scars, the key to finding the most effective cosmetic treatment is to first understand what type of acne scarring you have and then choosing an experienced skincare provider who can customize your acne scar treatment to best meet your needs.
Atrophic Acne Scars
Atrophic scars appear as indents within the skin and can form at varying depths. These scars happen when your skin does not produce enough collagen to adequately “fill in” the wounded area, resulting in a depression that heals lower than the normal layers of your skin. Atrophic acne scars often appear after severe acne, cystic acne or chickenpox.
There are three main types of atrophic acne scars: boxcar scars, icepick scars and rolling scars. While your exact acne scar treatment plan will depend on which subtype of atrophic scar you have, the most common treatments for indented acne scars include chemical peels, microneedling and dermal fillers.
- Chemical peels work by peeling away the outermost layer of skin, revealing a fresh new layer underneath. This process can help to even an imbalanced skin texture caused by atrophic acne scars, as well as accelerate the natural cell turnover and rejuvenation process.
- Microneedling works by creating tiny “micro channels” within your skin, stimulating collagen production and cell renewal. This process can help atrophic scars to heal more evenly.
- Dermal fillers can be used to “fill in” the depressions that atrophic scars leave in the skin. Fillers do gradually wear away over time, so you may need periodic maintenance treatments, depending on the severity of acne scarring.
Icepick scars are the most common type of atrophic acne scar. They appear as small, narrow depressions in the skin that are wider at the surface and then narrow to a point in the deeper layers of skin. Because they can be quite deep, icepick scars tend to be more difficult to treat than boxcar or rolling scars.
The second most common type of atrophic acne scar, boxcar scars are round- or oval-shaped depressions in the skin with sharply-defined edges. They are broader than icepick scars and do not taper like icepick scars.
Unlike icepick and boxcar scars, rolling scars have rounded edges, which can make the skin appear bumpy and uneven. Rolling scars can vary in depth, but are generally not as deep as icepick scars.
Hypertrophic Acne Scars
Hypertrophic scars appear as thick, raised bumps on the skin and form as a result of excess collagen production during the wound-healing process. While hypertrophic acne scars can form anywhere on your face or body, they are most commonly seen in areas like the jawline, chest and upper back, where the skin is taut.
The treatment options for hypertrophic scars differ from those for atrophic scars, as the aim is to decrease collagen growth and inflammation, rather than to promote collagen. Common hypertrophic scar treatments include corticosteroid injections, laser treatments, cryotherapy and surgical excision.
Keloid scars are similar to hypertrophic scars in that they are raised from the surface of the skin. However, there are a few notable differences between keloids and hypertrophic scars. Keloid scars expand outside of the borders of the original wound, whereas hypertrophic scars are confined to the wounded area of skin. Keloid scars will not regress over time, while hypertrophic scars may gradually regress over time on their own.
If non-surgical keloid treatment options like steroid injections, cryotherapy and laser treatments are not effective, surgical excision may be necessary to remove the growth.
Although not technically a scar, post-inflammatory hyperpigmentation (PIH) often occurs after an acne breakout. Post-inflammatory hyperpigmentation is a type of skin discoloration caused by excess production of the pigment melanin, resulting in a discolored spot or patch of skin where an acne lesion or other wound has healed.
Broadband light (BBL) treatments, chemical peels, topical skin-lightening ingredients and retinoids are among the most common treatments for post-inflammatory hyperpigmentation.
Sarasota Facial Aesthetics recognizes that you have a choice when it comes to your facial rejuvenation and skin care needs. The practice is founded on providing patients with an honest, healthy, realistic approach to revitalizing unwanted facial and skin conditions.