What are acne scars?

Acne scars are produced when acne blemishes become inflamed. Acne spots penetrate the skin at a level that’s deep enough to reach and damage the tissues underneath them. There are several different types of acne scars.

Acne scarring is particularly common around the face, where atrophic (depressed) scarring can develop. Variations of this type of scarring include:

Ice pick 

This type of scar is named after an ice pick tool due to its resemblance. It is wide at the top and becomes narrow as it deepens within the skin. These scars often appear on the forehead and cheeks, where skin is thinner.

Rolling

Rolling scars often develop around the jaw and lower cheeks, where skin is thicker. They have sloping edges and cause the skin to look uneven and wavy.

Boxcar

Boxcar scars have sharp, indented edges which develop deep within the skin. They often develop around the lower cheeks and jaw. These types of scars are the most common ones which are produced due to acne.

However, other scars can develop as a result of acne. These include:

• hyperpigmented scars
• atrophic scars 
• hypertrophic and keloid scars

What's the outlook for acne scars?

The development of and type of scars varies from person to person and are influenced by several factors such as the size and depth of the scars. There are various treatments available to lessen the severity of acne scarring and to prevent future breakouts of acne.

What are the causes and appearance of acne scars?

• Hyperpigmented scars are caused by a concentration of pigmentation surrounding the spot during its healing process. This leaves behind a pink or brown mark once the spot has disappeared.
• Atrophic scars as a result of acne are characterised by flat and shallow indents in the skin due to a lack of collagen. In this case, not enough tissue was produced during healing to cover the entire area of the spot.
• Hypertrophic and keloid scars are raised lumps of scar tissue. These are caused when scar tissue builds up. While hypertrophic scars tend to be the same size as acne spots, keloid scars can grow larger than the original blemish.

Can acne scars be prevented?

Although it´s tempting, you must resist the urge to pick or squeeze blackheads, pimples and other imperfections with your fingers or any other object. Excessive pressure on spots (especially those that are not yet fully formed) can damage the fine veins, glands, and surrounding tissues. This can make acne symptoms worse and increase the risk of scarring.

There are some steps you can take which reduce the risk of hyperpigmentation post acne. These are as follows:

• Wear sunscreen - Wearing sunscreen is extremely valuable to your skin. You should wear at least SPF 30 daily, all year round, because sun damage can darken acne scars and spots. Daily use of SPF will visibly reduce any scars due to acne as skin is not exposed to sun damage.
• Use moisturiser: Keeping your skin hydrated will help its healing process as well as reducing the visibilty of exisiting scars. We also recommend reducing the number of hot showers you take because this dries out the skin.

How are acne scars treated?

Acne scars or acne scars can be removed with different methods. The best one will depend on your skin type and the type of acne scar:

• chemical peels
• dermabrasion
• hyaluronic acid injections
• microneedling
• fillers
• laser resurfacing
• CO2 laser
• laser pigmentation removal

The application of a laser is not painful. It consists of aiming the laser light (emitted from a specialised device) at the scar to reduce the lesions of the first layers of the epidermis and to smooth the skin irregularities. This will eliminate the scars gradually as it causes the renewal of the surface layers of the skin. In the case of hypertrophic and keloid scars, techniques such as surgical removal, cryotherapy and 5-fluorouracil infiltrations can be used.

Can acne scars fade naturally?

There are several home remedies which can aid the healing of scars. These include:

• aloe vera
• vitamin E
• honey
• coconut oil
• apple cider vinegar
• lavender and olive oil
• lemon 
• potato
• rosehip and frankincense essential oil
• baking soda

How long do these scars take to heal?

Healing time for acne scars depends on the type of scar which develops. Treatment will aid this process rapidly.

After undergoing treatments such as laser resurfacing or microneedling, scars can heal as quickly as four weeks or may take up until six months.

More mature scars will take longer to heal, six months or more. On the other hand, healing time for mild to moderate scars can vary between four to six weeks.

How can I reduce the risk of hyperpigmentation?

Salicylic acid can be used to reduce the risk of post-acne hyperpigmentation. It reduces swelling and redness, exfoliates skin and also clears pores.

We recommend that you use salicylic acid daily in order to improve the appearance of your acne. However, it is advisable to seek advice from your dermatologist as they may wish to use it less frequently for chemical peels.

What type of specialist treats acne scars?

Dermatologists specialise in diagnosis and treatment of skin conditions. They can assist in diagnosing, treating and preventing acne scars. If you find that using skin care products and making changes to your lifestyle isn´t helping then it may be the time to book an appointment with the dermatologist.