Reasons Behind Common Acne Scars and Ways to Eliminate Them

Overcoming acne is just half the battle, the other half is dealing with nasty-looking scars that seem almost impossible to get rid of. Although benign, they can be a source of embarrassment for many. The condition is not uncommon, especially if you struggle with pimples well into your adulthood. For those who have experienced years without acne-related symptoms, you are not entirely out of the woods since you might still be at risk of scarring, leading to an irregular appearance. To find out more about this issue, read on and educate yourself on how to get rid of them.


What are Acne Scars?

The condition is strongly correlated to the deep trauma caused by pimples. However, there are other factors that can contribute to blemishes. For instance, picking at your pimples or blemishes can exacerbate the condition of the epidermis and can cause small acne lesions, which can result in scarring. These blemishes can appear in several areas around the body, including the face and the body. Although these can change in shape and texture over time, they do not always improve with time.


6 Factors Behind Common Acne Scars

It goes without saying that there are many different types of pimples. Unfortunately, some pimples and lesions are more prone to blemishes than others. For instance, whiteheads and blackheads are less prone to scarring. However, inflammatory acne, including cysts or nodules are more likely to lead to long-term blemishes. These types of blemishes begin at the deeper layers of the epidermis. And that’s not all, there are other factors that can lead to acne, some of these include your immune system’s response to acne-related bacteria down to your hormones. Let’s delve into the various factors that lead to blemishes caused by acne.

1. Genetics

Unfortunately, genetics plays a huge role in both the development of acne and the subsequent formation of scars. Although most research do not isolate a specific gene that causes pimples, genetics can determine if one is prone to pimples. Scientists came to this conclusion after running studies on twins with acne and discovering that they had particular genes present in their DNA that were linked to the prevalence of pimples and ensuing blemishes.

2. Overproduction of Dead Skin Cells and Sebum

If you discover your parents have a history of their body overproducing dead skin cells that lead to clogged pores, there is a high chance that you might be on the receiving end as well. When you encounter clogged pores, there is a high chance that it would lead to acne and increase your chances of blemishes, long after the pimples are gone. That is not all, the lack of cell turnover would also lead to a dull and oily complexion. This would be similar for those whose body is guilty of overproducing sebum, leading to oily skin that would trap bacteria in its pores and ultimately lead to acne and potential blemishes.

3. Lack of Treatment

It is important to treat this skin issue as soon as possible to decrease the chances of scarring in the future. Treating any and all pimples will not only keep your skin flawless, but if you are already suffering from scarring, it will give you a much easier time to treat existing blemishes. If you are unsure what kind of treatment would be best for your skin type, consulting a dermatologist will save you a lot of time and effort. Their professional opinion will go a long way in ensuring you treat your skincare issues effectively should they arise in the future.

4. Picking and Touching

Many of us have a tendency to touch and pick their lesions against better judgement. It is important that you don’t do this. One major reason is that our hands carry a lot of bacteria. We touch numerous surfaces throughout the day, which causes bacteria to accumulate on our hands. At the same time, picking and touching your lesions will lead to further inflammation and if the lesion spills out onto the surrounding skin, that will increase bacterial infection and subsequently, pimples.

5. Diet and Lifestyle

Needless to say, our diet and lifestyle play a vital role in contributing to the sebum production in the epidermis. Leading a sedentary lifestyle coupled with an unhealthy diet will cause your skin to be oily increasing the chances of a breakout. Since the formation of blemishes is first caused by pimples, it is crucial that you take steps to improve your diet and lifestyle before tackling your flawed complexion. If you are already prone to oily skin, including more foods that are high in fibre, such as vegetables and fruits, and avoiding food high in fat, sugar and salt will drastically improve your overall appearance.

6. Hygiene

Apart from watching your diet and lifestyle, ensure that you are practising good hygiene. Washing your hands frequently will reduce the chances of bacterial infection and prevent the worsening of your breakouts, especially if you are the sort to touch and pick at your pimples. Washing your face with a pH balanced skincare product will also help to support and accelerate the healing process.


How do You Identify the Types of Acne Scars?

Acne blemishes can present themselves as a swollen keloid, tiny pockmarks, or even a discoloured area on the epidermis. Typically, acne blemishes can be divided into two main categories, atrophic and hypertrophic. Atrophic are caused by a loss of tissue while hypertrophic are caused by an excess of tissue. And within the two categories, these are the three main types of acne blemishes.

1. Ice Pick

An ice pick is essentially a small depression on the epidermis. It looks almost as if numerous needles have punctured and caused indentation on the surface of the epidermis. They look like deep, very narrow scars that extend all the way into the dermis.  Although these usually appear as thin, small and deep holes in the epidermis, some resemble large, open pores.

2. Boxcar

Like ice picks, the boxcar variant similarly presents itself as a depression on the epidermis. However, there is a stark difference between a boxcar and ice pick; although both contain similar attributes, a boxcar has deep indentations with sharp edges. Additionally, boxcar tends to be wider than an ice pick, and gives the epidermis an uneven, pitted appearance.

3. Rolling

The distinct rolling or wave-like depressions are the typical characteristics of rolling scars. Unlike the boxcar, the rolling variant isn’t sharply defined, causing the complexion to look uneven and craggy. They are defined by their sloping edges and they do not always appear as the same size as the original acne lesion that caused them. Essentially, the size of this kind of scarrings is heavily dependent on how the skin heals. They are also more common in places where the skin is thicker, like the lower cheeks and jaw.


How Each Type of Acne Scars Is Formed

Acne scars are usually caused by the body’s natural response to heal itself. However, each type of acne blemishes is formed differently. To understand the differences, take a peek at our easy-read explanation of how they came to be.

1. Ice Pick

The inflammation caused by breakouts not only harms the epidermis, but also affects the many layers beneath it. Typically, an inflammatory response leads to the loss of collagen causing the top layer of the surface to collapse. That would then lead to a conspicuous depression and a long, column-like blemish.

2. Boxcar

Essentially, a boxcar is understood to be a depression that contains hidden damaged tissues. The cyst that remains under the surface can lead to the destruction of collagen beneath the skin. With that in mind, when the cyst goes away, the displacement would subsequently create an indentation on the surface level, with its severity ranging from minor to severe. In essence, the formation of a boxcar is highly dependent on the amount of tissue that is lost.

3. Rolling

These develop when fibrous bands of tissue grow between the epidermis and the subcutaneous tissue. When the bands contract and pull the epidermis and bind it to the deeper structures and layers beneath the epidermis, the pulling action of the epidermis from within the skin creates the rolling appearance of the blemishes.


What are the Ways to Eliminate Acne Scars?

Since these can come in a variety of forms, shapes and sizes, there isn’t a one-size-fits-all solution that can be administered the different types of blemishes. That is why it is important to take advice from a dermatologist who will inspect your issue and prescribe the right procedure(s) to help you eradicate these blemishes. Some of the common procedures to reduce the appearance of spots and other irregularities on the epidermis could be:

  • Chemical Peels
  • Lasers
  • Fillers


The Treatment Options for Each Type of Acne Scars

1. Punch Excision for Ice Pick Scars

One of the most common ways to treat ice pick is punch excision, the utilisation of a small, cookie-cutter like tool to cut out the scar. Following which, the epidermis would be glued back together to heal. Punch grafting is another alternative to address these blemishes as well. Usually, this procedure is done for severe ice pick blemishes. Similar to punch excision, the affected tissue is removed from the skin, before it is filled with a graft of skin. This piece of skin is typically taken from behind the ear. A thing to note is that both procedures might leave tiny flat scars, however, they are not as noticeable since they aren’t raised. Microneedling is also seen as another viable option since it works by stimulating collagen production beneath the epidermis. The procedure is mildly invasive as compared to the previous two and it has been found to be very effective.

2. Punch Excision or Microneedling for Boxcar Scars

Like the ice pick, the boxcar issue can be treated with the punch excision or microneedling procedure. It is also possible to consider dermal fillers since they can help reduce the appearance of them quickly. During the session, fillers are injected into the scar and help raise the depressed areas. Derma fillers are well regarded as simple and quick solutions, however, their disadvantage is in their permanence. Most fillers typically last for a period between 18 months and two years. Others also consider the laser resurfacing treatment to stimulate the growth of new skin tissue and boost the production of collagen. These procedures would ultimately lead to an overall improvement in both texture and tone.

3. Subcision for Rolling Scars

These kinds of blemishes are treated with a procedure known as subcision. This surgical treatment is typically done under local anaesthesia as an outpatient. The main idea behind it is to remove the base of the scar that is pulling on the skin. How that is done is with the use of a scalpel inserted parallel to the skin and the cutting of the fibrous base of the scar that is exerting pressure on the skin from below. After the procedure, the epidermis would look smoother.


The Bottom Line

As mentioned, your acne scars would fall under one of these three main types in the ice pick, boxcar or rolling. Although they develop in their unique ways, they are typically caused by similar factors that lead to the development of blemishes and an uneven epidermis. To treat these skin issues at the root of the problem, it would be best to consult a skincare professional to determine which is the best treatment for your situation. That typically entails the professional doing a detailed examination before advising on a procedure that best suits your skin in terms of skin type, scar type and even cost-wise.

There are many aesthetic centres in Singapore that provide such services; one trusted aesthetic centre is Geo Aesthetics, who has dedicated specialists with the know-how to treat each issue efficiently and effectively. By tapping on the expertise of these skincare professionals, it will go a long way in maintaining your beautiful complexion, while saving you plenty of time and money.