Types, Diagnosis, and Treatment for Acne Scars
It starts with a pimple. Then two. Then one day you wake up and your face, neck, and even back may seem covered with those pesky — and sometimes painful — red bumps. Yep, you have acne.
As if that’s not bad enough, your skin doesn’t get a break once you’ve successfully treated the acne. Unfortunately, you may be left with scarring in the place of pimples.
What can be done? Is there a cure-all treatment for acne scars?
In many cases, you can clear up the pitting and pocks with some form of acne scars treatment. We’ll walk you through the types of acne scars and how they’re best treated based on your skin type.
Table of Contents
What Are Acne Scars?
Acne scars are permanent textural changes or blemishes on the skin that are caused by severe and persistent acne. Acne scars come in several forms and may vary in appearance and severity.
Acne scars may be distressing for some people, as they can affect self-esteem and confidence and can be difficult to treat.
What Are the Types of Acne Scars?
Not all acne is created equal. As a result, acne scars can vary from person to person. Some scars are superficial, while others leave depressions on the surface of the skin. Based on their characteristics and appearance, acne scars are categorized into three main types.
Atrophic
This is a general term that includes:
- Ice pick scars – small scars that mimic a pinprick
- Boxcar scars – large indentations with clear edges
- Rolling scars – rolling or undulating appearance with no clear edges
These scars are caused when the skin does not produce enough fibroblasts during the healing process. Fibroblasts are cells that are important to collagen production and the healing process.
Hypertrophic
Unlike most acne scars, which are depressions in the skin, hypertrophic scars are raised and appear as thick, lumpy tissue at the site of the original acne lesion. They result from an overproduction of collagen during the healing process.
Keloid
Keloid scars are similar to hypertrophic scars but extend beyond the boundaries of the original wound or acne lesion. They are raised, often larger than the initial injury, and can be thick and firm.
Keloids are less common but tend to occur more frequently in people with a genetic predisposition.
What Causes Acne Scars?
Acne scars are the result of damage to the skin’s tissue that occurs while the skin is healing from acne lesions. However, not all acne leaves scars. Preventing acne may be the best way to reduce the risk of scarring, but some acne is unavoidable.
The primary causes of scarring from acne include:
- Inflammation: When acne lesions become inflamed, they can damage the skin tissue and disrupt normal collagen production and the healing process.
- Cystic acne: This severe form of acne occurs deep within the skin and can lead to significant lesions that may result in deep scars.
- Picking or squeezing: When you pick at your acne, you may exacerbate inflammation, damaging the skin even further by pushing bacteria deeper into the skin.
- Genetics: Some people are genetically predisposed to, or have the type of skin that is susceptible to, scarring from acne.
- Hormones: Conditions like PCOS (polycystic ovary syndrome) and hormone imbalances can lead to severe acne that persists over time and eventually leaves scars.
Do Acne Scars Go Away?
Minor scarring may clear on its own, but in most cases, treatment is required. Whether the scars can be completely eliminated or made significantly less noticeable depends on:
- The type of scar
- Severity of the scarring
- Sun protection
- Treatment type
- Consistency of treatment
- Skin type and individual response to treatment
With the right treatment and skin care regimen, most people will experience a noticeable improvement in the appearance of their scars.
How Are Acne Scars Diagnosed?
You likely already know if you have acne scars, but you may be wondering what the steps are to determine what type of scarring you have and what your treatment options are.
Scheduling a consultation with a dermatologist will help clear up some of these questions. A dermatologist will start by exploring your medical history with acne, including the type of acne lesions you’ve had, their severity, and how you’ve treated your acne in the past.
From there, the dermatologist will conduct a physical examination of the affected area to classify the acne scars and determine the most effective treatment options.
Your skin type, tone, and texture will be taken into consideration as this may influence the type of treatment prescribed and any potential side effects. With various acne scars treatments available, it’s important that a medical professional monitors your progress.
At Goodskin Dermatology, our medical professionals are highly trained and experienced in the treatment of acne scars of all kinds. With four convenient locations in Oregon to serve you, Goodskin is your top choice for acne scars treatment in the areas surrounding Portland.
How Are Acne Scars Treated?
It’s important to consult with a dermatologist or skin care professional to assess your specific acne scars and determine the most suitable treatment plan.
Some people may benefit from a combination of treatments to achieve the best results. Treatments may vary depending on the type and severity of scarring and the individual patient.
After treatment, proper skin care and sun protection are essential to maintain the improvements and prevent further scarring.
Topical Treatments
Over-the-counter (OTC) or prescription topical treatments can help improve skin texture and reduce the appearance of mild acne scars and post-inflammatory hyperpigmentation (PIH). These acne scars treatments contain ingredients like:
- Retinoids – Promote collagen production, enhance skin cell turnover, prevent new acne lesions, improve skin texture, and increase the absorption of other treatments for acne scars.
- Alpha hydroxy acids (AHAs) – Exfoliate, stimulate collagen production, reduce hyperpigmentation, improve skin texture, and increase the absorption of other acne scars treatments.
- Beta hydroxy acids (BHAs) – Exfoliate, unclog pores, reduce swelling and redness, prevent PIH, manage and prevent breakouts, and increase the absorption of other acne scarring treatments.
- Vitamin C – Brightens skin, stimulates collagen production, protects against free radical damage, reduces swelling and redness, aids in healing damaged skin, and improves skin texture.
For the best results, these products should be used as prescribed and under the care and supervision of a dermatologist.
Chemical Peels
Chemical peels help improve the appearance of acne scars by exfoliating the top layer of damaged skin, stimulating collagen production, and promoting the growth of new, healthier skin cells.
This process can lead to a smoother skin texture and a reduction in the visibility of certain types of acne scars. Chemical peels should always be done by a qualified professional.
Microdermabrasion
Microdermabrasion is a non-invasive cosmetic procedure that can help improve the appearance of acne scars. The degree of improvement may vary from person to person and it may not be an appropriate treatment for severe or deeply indented scars.
Here’s how microdermabrasion may help with some acne scars:
- Exfoliation
- Stimulation of collagen production
- Improved skin texture
- Enhanced penetration of skincare products
Microdermabrasion requires little to no downtime, making it a popular option for patients whose scars may see an improvement from the treatment.
Microneedling
Microneedling is a technique that involves inserting tiny needles into the tissue surrounding the scar to stimulate collagen production.
This technique may be especially effective on people with atrophic or indented scars. One study showed a 31-62% improvement in the appearance of scars, but when combined with collagen gel, the results were significantly better.
Microneedling may cause some side effects, such as:
- Pain
- Redness
- Inflammation
Laser Treatment
Laser treatment is another effective option for improving the appearance of acne scars, but this treatment must be conducted by a certified laser therapy specialist.
Laser acne scars treatment helps by:
- Stimulating collagen production
- Resurfacing the skin
- Reducing scar pigmentation
- Stimulating blood flow
Another benefit of laser treatment for acne scars is that it is highly precise and adjustable to target specific types of scars and skin conditions.
Patients also need very minimal downtime when compared to surgical procedures, needing only a few days before normal activities can be resumed.
Dermal Fillers
Dermal fillers are a minimally invasive option that’s best for someone with boxcar or rolling scars. They help improve the appearance of these acne scars by filling in the depressions and creating a smoother, more even surface.
Dermal fillers are injectable substances made with materials such as:
- Hyaluronic acid
- Collagen
- Synthetic polymers
- Your own fat
Results are immediate, but temporary. They gradually break down over time and more treatments are needed.
Subcision
For many people, subcision seems counterproductive. Making a new scar to replace an old one? But, dermatologists can remove a noticeable acne scar and leave behind a smaller scar that will fade over time.
They may also lift the scar by using needles to loosen the fibrous tissues beneath and bring the scar closer to the surface. This procedure makes the scar less noticeable.
Punch Excision or Grafting
Punch excision is another surgical procedure that involves a small, circular surgical tool called a punch biopsy instrument. A dermatologist will carefully cut out the scar tissue and suture or stitch together the healthy skin to close the wound. As it heals, the skin becomes smoother and less indented.
Punch grafting is a variation of punch excision that utilizes a healthy piece of skin taken from another part of the body that is transplanted into the wound. The graft is then sutured into place.
Both of these procedures must be performed by a dermatologist or plastic surgeon and usually under local anesthesia.
Fractional Radiofrequency
Fractional radiofrequency (RF) for acne scars is a non-invasive cosmetic procedure that uses controlled radiofrequency energy to stimulate collagen production and improve the appearance of acne scars.
It works by delivering precise heat energy to the deeper layers of the skin, promoting tissue remodeling and scar reduction. This treatment can lead to smoother skin texture and reduced scar visibility.
The treatment is safe for all skin colors and tends to be more affordable than some other treatments, but it requires repeat appointments. Patients are required to use sunscreen and night cream every day for at least a week after treatment.
Goodskin Dermatology Provides High-Quality, Patient-Based Treatment for Acne Scars
You want to put your best face forward every day, but acne scars may be affecting your self-confidence. At Goodskin Dermatology, we want you to look and feel your best.
With our experience and expertise in the treatment of acne scars, we can determine the best course of treatment for the type of acne scars you’re dealing with. We use various treatment techniques to help reduce the appearance of your acne scars and give you smoother, healthier-looking skin.
We take an individualized approach to every case, which means your treatment plan will be designed specifically for you.
Why wait? A new lease on life awaits with Goodskin Dermatology.
Contact us to schedule a consultation for acne scars treatment today.
The content in this blog should not be used in place of direct medical advice/treatment and is solely for informational purposes.