Acne scars got you down? Well you are not alone. About 80% of people in their early teens through their twenties and roughly 5% of adults struggle with the skin condition known as acne. Most recover without any problems, but some develop lifelong effects and disfiguring scars. While there are some topical products which will aid in helping small scarring, surgical procedures and skin resurfacing is often needed for the deeper, more pronounced scars.
Understanding the Types of Acne Scarring
Acne can leave changes in the skin right when it is healed, this is known as hyperpigmentation. It is the slight discoloration that is left after the acne lesion is healed. It isn’t a scar in the truest sense of the word, but rather the changes that occur to the skin while it heals itself. It is the result of inflammation and most times can take 6 – 12 months to disappear. If the change lasts after a year, then it would be considered a scar. The best way to minimize permanent inflammatory changes to the skin after acne is to prevent them from occurring. This requires the use of correct treatments for specific acne. There are different types of acne scars. The following are a description of 4 types of acne scarring.
Ice Pick Scars
A very common type of acne scarring, ice pick scars manifest with deep pits. They are embedded deep into the skin and are about 2mm across. The skin looks like it has been pricked by an ice pick.
Box Car Scars
This is another type of common acne scar found on the cheeks and temples most often. More angular with sharp edges they look a lot like chicken pox scars.
Often the result of damage beneath the skin, rolling scars are wide and shallow and almost look like waves across the skin.
These scars are the lumpy scars that are found a lot on the back and chest. Sometimes they appear on the neck and face but more often on the back and chest. They are actually due to collagen being laid down in the skin from a severe inflammation in the skin. They are usually more related to the most severe forms of acne such as cystic acne.
Early Acne Scars
So how do you go about treating acne scars and helping your skin to look better? If your problem is due to early acne scars and you wish to get rid of the darker pigmentation caused from slight skin inflammation here are some tips to follow.
- Wear good sunscreen! This is a must because the skin is very sensitive and while being tan may seem to hide skin flaws, it actually can delay healing of the skin.
- The product known as tretinoin which is found in products such as Retin-A actually speeds up the skins healing process and can help your skins pigmentation problems
- DON’T PICK YOUR ACNE! This is one of the most important causes of permanent scarring. Scabs are part of the body’s healing process and are actually there to protect the skin and let the new skin underneath grow and heal. If you pull the scab off to early it can hinder the healing process and actually potentially prevent the true healing from occurring.
- The use of alpha-hydroxy acids can help the skin heal because they can actually help balance the pH of the skin
Some of the numerous acne treatments in existence today have their own set of risks and benefits that need to be weighed carefully. Some of the more common treatments are listed below.
Usually conducted under general anesthesia this treatment is used to treat icepick and boxcar scars. The scar is removed with the use of a punch biopsy tool as pictured below. The scar and tool are matched according to size and the entire scar, including the walls of the scar, is removed and then the edges of the remaining skin are then stitched together. Sometimes this technique is also combined with the use of a skin graft. Usually some skin is removed from just behind the ear and then instead of stitching the skin together, the extra skin is placed over the area from where the scar was removed. Then a few weeks later the skin can be touched up and smoothed. This technique is called punch excision with skin graft.
Used with the same punch tool pictured above and discussed in the punch excision method, the base of box car scars are removed but the walls of the scar are left in place. Then the base is attached to the surface of the skin with either stitches or skin glue. This is sometimes a better alternative to the skin graft procedure because the skin more closely matches the skin on the face.
Dermal fillers are composed of fat, cow or human collagen, or some hyaluronic acid byproducts which are injected into the acne scars to level out the pitted scar and the skin. It can assist with creating a smoother look for the skin; however it isn’t a permanent solution. Often times more injections are necessary.
This is a very highly common treatment for a lot of skin problems. Laser resurfacing works by actually burning the surface layers of the skin deep enough to remove the scarred skin and then when the skin heals it heals with a smoother surface. It is critical to care for the healing skin in order to obtain the best results.
Incision underneath the Skin
This process known as subcision is often used for rolling scars. The procedure is conducted under local anesthesia and a needle is inserted directly under the skin, but parallel to it. So the needle runs just under the skin and is moved back and forth and basically breaks up the fibrous bands that created the scars in the first place. The side effects of the procedure is bruising that will fade in a week or so. Risks can include bleeding or additional formation of lumps however these can be treated with corticosteroids.
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