Your Guide to Acne Scars

Acne scars have been a common aesthetic problem for many people, for the longest time. Picking the scabs and popping those pimples are some of the reasons why these blemishes develop on the skin. They come in many forms and in many cases, can be near impossible to get rid of. However, with the advancement of technology, this issue can be treated in more ways than one. Read on to find out more on what causes the common types of acne scars, how you can prevent and treat them to help you attain a flawless complexion.


Causes of Acne Scars

1. Inflamed Lesions

An inflamed lesion such as a cyst or a papule (a type of lesion) is the most common cause. These inflamed blemishes appear when the pore or follicle in question is swollen due to an excess of dead cells, oil and bacteria. As the pore swells, it will then cause a break in the wall of the follicle. Minor inflamed lesions tend to heal quickly since the rupture of this pore or follicle occurs near the surface of the epidermis. However, there are some instances when a serious lesion surfaces on the epidermis experience a deep break in the follicle wall and spill out onto the dermis — the thick layer of tissue that exists below the epidermis,— causing immense destruction to the surrounding healthy tissue. Essentially, inflammation the main reason for the development of these marks. It is also the case whereby the greater the inflammation on the epidermis, the more likely it is susceptible to blemishes.

2.  Collagen Fibres

Collagen is a fibrous protein that provides strength and flexibility to the epidermis. As the most abundant protein in the body, collagen is a major component of connective tissues that make up several body parts such as ligaments, tendons, and muscles. When acne has caused damage to the deeper layer of the skin, collagen fibres are essential to aid for the healing process. However, with a lack of or overproduction of collagen fibres by the body, there will be irregularity or depression in the skin, resulting in different types of acne scar.


Types of Acne Scars

Knowing what may be the reason behind the pesky blemishes, let us now look at the common types that you may be facing. Keeping in mind that the layers of the skin go by the epidermis (the surface or also known as the top layer), dermis (beneath the epidermis) and finally hypodermis.

1. Boxcar

A boxcar typically appears as a wide indent, U-shaped scars that have sharp edges. These can be either shallow or deep. They are usually caused by the lack of collagen fibres while the skin repairs from acne. For the shallow boxcar marks, treating them can be as effortless as ensuring that regular skin resurfacing treatments are being done.

2. Ice Pick

Ice pick scars present themselves as narrow, V-shaped scars that penetrate deep into the epidermis. They usually appear as small round or oval holes, much like a chickenpox blemish to the naked eye. They tend to be the most difficult kind to treat as they can extend far below the surface of the epidermis.

3. Rolling

Thirdly, rolling scars are wide depressions that often that have rounded edges and an irregular, rolling appearance. Typically, these commonly occur on the back and the chest. They are like a road hump, formed above the surface of the surrounding skin due to the overproduction of collagen during the healing process.

On a Side Note

It is common to find discolouration that remains after the zit has cleared. However, it isn’t actually an acne scar, per se. Instead, it is a type of post-inflammatory hyperpigmentation (PIH). Although a misconception that is made by many, the reddish-brown and purple discolouration of the skin will dissipate in time. Using certain topical medications, like Retin-A. may speed up the overall healing process, so don’t you worry.


Preventing Acne Scars

Although you can’t completely prevent scarring, there are few things that you can do to minimise the chances of developing them.

1. Treat Acne Once it Develops

Ever hear of the old adage of prevention is better than cure? Well, one of the best things that you can do when you encounter acne is to get it under control as soon as you notice it. If your acne persists or gets worse over time, try using creams or over-the-counter treatments to speed up recovery. By treating the acne quickly, especially during the onset of pimple or acne, you will be able to keep breakouts to a minimum and prevent the condition from exacerbating. Essentially, keeping pimples and zits at bay will prevent damage on the epidermis.

2. Reduce Inflammation

As we have discussed, large, inflamed acne blemishes have a higher chance of leaving blemishes behind compared to blackheads and non-inflamed breakouts. When encountering these kinds of inflamed acne blemishes, it is important that you calm the inflammation and resist the urge to do anything that might cause irritation and further exacerbate the condition. So avoid scrubbing your face aggressively and/or using products that are too harsh on. These kinds of products can dry out and worsen your acne condition.

3. Avoid Squeezing, Popping or Picking at your Pimples

Needless to say, squeezing or picking at your pimples will definitely worsen your skin condition. Although the temptation to touch your pimples might seem overwhelming, it is best that you keep your fingers away from your face.  Simply by doing this, you can prevent the debris from entering deeper into the dermis, which can lead to the spreading of infection to the surrounding tissue. If you indulged in the temptation of picking or touching of the inflamed bumps, you will have to face the consequences of worsening the inflammation on the epidermis. This means a result of deep and serious blemishes such as cysts and nodules to form. Popping pimples can extend the healing time and increase the risk of blemishes, thus, it is better to let the blemish heal on its own.

4. Don’t Pick at Scabs

Apart from popping the pimples, do ensure that you are not picking at scabs. A scab is the skin’s natural way of “bandaging” the wound, this allows the said wound to heal. If you find it hard to resist picking a scab, while the wound is healing, chances are that more damage will be caused and the healing process for the affected area will be prolonged. The delay in healing, partnered with inflammation, can lead to permanent scarring on the skin. So think again when you are tempted to scrape the scab off the wound.

5. You Might Be Prone to Scarring

Every individual’s skin is different. Be it the time for a cut to heal down to the rate of how melanin is produced per second,  there are some people who are more prone to serious blemishes than others. In fact, one can suffer a severe case of acne and be prone to scarring after the pesky zits dissipate, while another person can suffer through the same thing without having any scarring on the face. If you are of the former, it is best to consult a dermatologist for effective treatment options that are more suitable for your skin issues.

6. Consult a Doctor if You Get Severe Breakouts or Acne Cysts

Smaller blemishes may cause a semi-permanent mark on the skin. They can be managed with over-the-counter creams to help you revert to the flawless complexion. On the other hand, larger and deeper breakouts or acne cysts that cause greater damage to the skin have a greater chance of destroying the tissues, leaving serious cases of blemishes. Unfortunately, to fully relieve these types of breakouts, you need the aid stronger treatment methods, administered by a medical professional. So consult a dermatologist if and when you encounter them. Addressing the issues with a quick and effective treatment can go a long way in reducing the chances of scar formation and even a relapse of it.


Treatments For Acne Scars Singapore

1. Dermabrasion

Noted to be one of the most effective and common procedures for facial issues, dermabrasion is a skin-resurfacing procedure that utilises a device that rapidly rotates to sand and smoothe out the outer layers of the skin. After the procedure, the skin will grow back looking more youthful and smooth. In addition to reducing the overall appearance of acne scars, this procedure can also diminish fine facial lines. Before the procedure, doctors will numb the troubled area with anaesthetics. Do note that the epidermis that is treated with dermabrasion will most likely be sensitive to the touch and might stay pink for several weeks before the skin fully heals. Additionally, the pink hue on the epidermis will take at least three months to fade completely.

2. Chemical Peels

Chemical peels contain a strong acid formula aimed at removing the top layer of the skin, which in turn decreases the appearance of various issues. Although there are some chemical peels that are mild enough to be used at home, the medical ones are typically stronger and provide better results. As there are many different types of chemical peels out there, it is highly advised that you speak to your healthcare provider or dermatologist to find out which works best for you. Chemical peels are best used on all types of acne issues, but are usually aimed at tackling deeper scars.

3. Laser Resurfacing

Laser resurfacing is similar to a chemical peel and dermabrasion in terms of removing the top layer of the epidermis, where the acne scars are. This procedure, however, uses the technique of directing short, concentrated pulsating beams of light at the area to be treated, removing layer by layer of the epidermis. Do note that if you are undergoing a laser resurfacing procedure, you might need to keep the area treated covered with a bandage until it is completely healed. So do prepare for a short downtime if the area to be treated is significantly large. Though it sounds like a great treatment to get rid of scars, this procedure is not for or will be effective for everyone, especially those with a darker skin tone (the use of energy and/or heat bursts can cause risk of hyperpigmentation or scarring for them) or is still experiencing breakouts.

4. Fillers

Typically dermatologists utilise fillers to fill in the depression caused by acne scars. These kinds of fillers will help even out indents on the epidermis. Fillers either consist of collagen or fat to boost the healing of your skin and to close the indents. Essentially these fillers are injected to help the epidermis become plump. The injected fillers will also aid to even out the epidermis by filling out the depressions that cause uneven texture. As most fillers last between 6 and 18 months, you would need to undergo the treatment again to maintain the smooth complexion. This treatment is the best fit for someone with a small number of boxcar or rolling scars.

5. Microneedling

Microneedling is a newer treatment that utilises a hand-held, needle-studded roller or a hand-held pen on the surface. The process is fairly simple, the needles puncture the numbed skin; and as the epidermis heals, it produces collagen. Studies have found that microneedline aids in the reduction of the depth of acne scars. However, although effective, microneedling can take up to at least nine months to achieve visible changes. Fortunately, microneedling is a safe process that works for all types of skin and is best for people with depressed blemishes. However, those who are still facing breakouts at the point of treatment for the blemishes, this is not for you.

6. Injections

There are a number of medications that can be injected into raised blemishes which will help soften and flatten them. These kinds of injections are typically performed by medical professionals and they will administer them every few weeks. Do consult a dermatologist to see if the condition that you are experiencing is suitable for this procedure.


The Takeaway

Before you decide to embark on one of the mentioned treatments, be sure to do thorough research to see which kinds will be most suitable for your skin condition. Most of the time, you may require a combination of them. Needless to say, consulting a professional is key to ensuring that you get the most effective treatment.