Types of Acne Scars :

There are two general types of acne scars, defined by tissue response to inflammation: (1) scars caused by increased tissue formation, and (2) scars caused by loss of tissue.

Scars Caused by Increased Tissue Formation
The scars caused by increased tissue formation are called keloids or hypertrophic scars. The word hypertrophy means "enlargement" or "overgrowth." Both hypertrophic and keloid scars are associated with excessive amounts of the cell substance collagen. Overproduction of collagen is a response of skin cells to injury. The excess collagen becomes piled up in fibrous masses, resulting in a characteristic firm, smooth, usually irregularly-shaped scar. The photo shows a typical severe acne keloid:

(Photo used with permission of the American Academy of Dermatology
National Library of Dermatologic Teaching Slides)

The typical keloid or hypertrophic scar is 1 to 2 millimeters in diameter, but some may be 1 centimeter or larger. Keloid scars tend to "run in families"—that is, abnormal growth of scar tissue is more likely to occur in susceptible people, who often are people with relatives who have similar types of scars.

Hypertrophic and keloid scars persist for years, but may diminish in size over time.

Scars Caused by Loss of Tissue
Acne scars associated with loss of tissue—similar to scars that result from chicken pox—are more common than keloids and hypertrophic scars. Scars associated with loss of tissue are:

Ice-pick scars usually occur on the cheek. They are usually small, with a somewhat jagged edge and steep sides—like wounds from an ice pick. Ice-pick scars may be shallow or deep, and may be hard or soft to the touch. Soft scars can be improved by stretching the skin; hard ice-pick scars cannot be stretched out.

Depressed fibrotic scars are usually quite large, with sharp edges and steep sides. The base of these scars is firm to the touch. Ice-pick scars may evolve into depressed fibrotic scars over time.

Soft scars, superficial or deep are soft to the touch. They have gently sloping rolled edges that merge with normal skin. They are usually small, and either circular or linear in shape.

Atrophic macules are usually fairly small when they occur on the face, but may be a centimeter or larger on the body. They are soft, often with a slightly wrinkled base, and may be bluish in appearance due to blood vessels lying just under the scar. Over time, these scars change from bluish to ivory white in color in white-skinned people, and become much less obvious.

Follicular macular atrophy is more likely to occur on the chest or back of a person with acne. These are small, white, soft lesions, often barely raised above the surface of the skin—somewhat like whiteheads that didn’t fully develop. This condition is sometimes also called "perifollicular elastolysis." The lesions may persist for months to years.

Causes of Acne Scars :

Causes of Acne Scars :
In the simplest terms, scars form at the site of an injury to tissue. They are the visible reminders of injury and tissue repair. In the case of acne, the injury is caused by the body’s inflammatory response to sebum, bacteria and dead cells in the plugged sebaceous follicle. Two types of true scars exist, as discussed later: (1) depressed areas such as ice-pick scars, and (2) raised thickened tissue such as keloids. When tissue suffers an injury, the body rushes its repair kit to the injury site. Among the elements of the repair kit are white blood cells and an array of inflammatory molecules that have the task of repairing tissue and fighting infection. However, when their job is done they may leave a somewhat messy repair site in the form of fibrous scar tissue, or eroded tissue. White blood cells and inflammatory molecules may remain at the site of an active acne lesion for days or even weeks. In people who are susceptible to scarring, the result may be an acne scar. The occurrence and incidence of scarring is still not well understood, however. There is considerable variation in scarring between one person and another, indicating that some people are more prone to scarring than others. Scarring frequently results from severe inflammatory nodulocystic acne that occurs deep in the skin. But, scarring also may arise from more superficial inflamed lesions. Nodulocystic acne that is most likely to result in scars is seen in these photos:

(Photos used with permission of the American Academy of Dermatology
National Library of Dermatologic Teaching Slides)

The life history of scars also is not well understood. Some people bear their acne scars for a lifetime with little change in the scars, but in other people the skin undergoes some degree of remodeling and acne scars diminish in size. People also have differing feelings about acne scars. Scars of more or less the same size that may be psychologically distressing to one person may be accepted by another person as "not too bad." The person who is distressed by scars is more likely to seek treatment to moderate or remove the scars. Prevention of Acne Scars
As discussed in the previous section on Causes of Acne Scars, the occurrence of scarring is different in different people. It is difficult to predict who will scar, how extensive or deep scars will be, and how long scars will persist. It is also difficult to predict how successfully scars can be prevented by effective acne treatment. Nevertheless, the only sure method of preventing or limiting the extent of scars is to treat acne early in its course, and as long as necessary. The more that inflammation can be prevented or moderated, the more likely it is that scars can be prevented. (Click on Acne Treatments for more information about treatment of mild, moderate and severe acne). Any person with acne who has a known tendency to scar should be under the care of a dermatologist. (Click on Find a Dermatologist to locate a dermatologist in your geographic area).

article from www.skincarephysicians.com/acnenet/scarring.html

Treating The Acne!

1. What is Acne?

Ask any teenager and they will be be able to tell you. Whiteheads, blackheads, pimples, zits, red bumps – these are all cases of acne. Acne appears most commonly on the face, but can also occur on your back, chest, shoulders and neck.

2. Is Acne Common?

You are not alone. It is estimated that 85% of people between the ages of 12 and 25 suffer from some kind of acne. In most cases, acne clears up as we get older. In some cases, it not properly treated; it can cause permanent scarring of the skin.

3. How does Acne Happen?

Acne usually starts in puberty, when the body is experiencing changes in levels of hormones. This affects the activity of sebaceous glands, which produce an oily substance called sebum. Sebum travel through hair follicles to the surface of your skin. However skin cells which shed from your hair follicles stick with the sebum, causing the follicle and the skin opening to be clogged. Bacteria begin to grow, and whiteheads and blackheads will appear.

Your body will attempt to clear the clogged pores, and this results in the wall of the follicle weakening and rupturing. In the end, swelling or redness will develop, resulting in the red bump or pimple characteristic of acne.

4. How to treat Acne?

Acne therapy aims to unclog the plugged pores and to keep them clear. By doing this, the bacteria that grow in our clogged pores will be controlled and acne flare-ups will be reduced. Effective treatment should also regulate the secretion of sebum to a more manageable level.

5. How Often Should I Clean My Face?

It is important to remember that acne is not caused by dirt. Excessive washing can aggravate your condition. You should clean your face and twice a day is quite sufficient. A mild non-soap cleanser will do the job, without drying or irritating your skin.

Remove Acne Scar