Acne can be a difficult thing to have to deal with; it can affect as many as 80 per cent of people during their life time. Normally acne will develop when an individual reaches the age of 11 and can carry on until they reach 30; very often even later in life.
For the individuals who suffer from acne it can be a real test of their self-confidence and wellbeing, especially when you consider that in most cases acne will start when the individual concerned reaches puberty; this important time of life is fraught with many other potential issues as well as acne. Hormones can go crazy at this period in time, manifesting in severe changes in an individual’s personality.
Even when acne clears up there is still the very real likelihood that the skin will be left damaged, this is referred to as acne scars. Very often the method of treatment when trying to deal with acne can have a bearing on whether or not the individual will suffer from these acne scars. Some people will make their situations much worse by picking and squeezing at their acne, whilst this can have a very short term gain the longer term effects of having to deal with the scars is much more serious.
What Type of Acne Scarring is Likely?
Ice pick scars:
These scars get their name because their appearance is similar to how skin would look if it was pierced by a needle or other sharp implement. The scars seem to have a small but deep hole in the skin, they occur due to the body’s response to inflammatory lesions.
Very few topical acne scar removal treatments are effective with deeper ice pick scars, many people will find that they will need to resort to some kind of laser treatment. However it is perhaps important to understand that in some occasion’s treatments such as chemical peels or dermabrasion can also provide some success. Other options for dealing with boxcars can include the following:
- Punch excision: The entire scar area is removed, leaving behind a small wound; the skin is then sealed with sutures. Very often the healing process will produce a much smoother skin with a more even texture.
- Punch grafting: This method uses a small tool to cut out the scar tissue; it is then replaced with skin that has been grafted; in most occasions the skin is provided from an area behind the ears. Sometimes a small scar is left after the treatment, and there might be a very slight colour change or texture on the grafted skin to its new surrounding area. Most of the time this method will produce a vast improvement over the previous scar area.
These scars are normally oval or round depressions that feature steeper vertical sides, with the skin gaining a pitted appearance; this type of scarring is normally bigger than the ice pick variety. This type of scarring is generated when collagen tissue is lost, leaving a sunken area where the scar forms. The skin over the missing tissue is left without its usual support and the subsequent depression area is then created. Very often boxcar scars will range from being superficial to more severe; this of course will depend on the amount of tissue that is lost.
Laser resurfacing is proven to work very well in repairing the skin damage that has resulted from these boxcar scars, although for many people this can prove to be quite and expensive option. Other options for dealing with boxcars can include the following:
- Punch excisions: This is where the entire scar area is removed, the small wound is then sutured; once the healing process gets underway the skin is left smoother and has a more even texture.
- Elevation: In this method the base of the scar is elevated and held in place with sutures, steri-strips or sometimes skin glue. As the skin heals its appearance becomes more even and the pitted nature is left greatly reduced.
- Dermal filling: This method tends to be least favoured as very often the results can be temporary and repeat treatments are very often required. Although when this method works well it can be one of the very best to improve the overall physical appearance of the scar area.
These get their name from the wave like or rolling undulations that feature after the scar is formed.
It is thought that this type of scarring happens as the fibrous tissues develop below the layer of skin, bands of tissue pull on the epidermis which in turn binds it tighter to the structures of the skin. Treatment for rolling scars can include:
- Subcision: This is performed under local anaesthetic, a needle is inserted into the scar area and the fibrous bands are broken by a constant fanning movement. After the needle is removed the localised area is cleaned up to remove excess blood, normally an ice pack is then applied to help with the initial healing process.
Hypertrophic or Keloid Scars:
This type of scarring will look like a raised area, with the tissue forming a hard firm mass. For most people this type of scarring will actually grow larger than the original damaged skin area. Thankfully hypertrophic scarring that result because of acne is usually found on the body area as opposed to the facial regions.
In the opposite way to how boxscars are generated, hypertrophic scars are generated because of an increased volume of collagen. Treatments for hypertrophic of keloid scars can include:
- Steroid or cortisone treatment: This involves the use of creams, or injections. They can be very effective in helping to flatten and shrink the scars.