Making a Mark: Learn About the Types of Acne Scars & How To Manage Them

Who hasn’t felt the urge to pop that annoying zit? As tempting as it may be, being patient and not picking your skin is usually worth the wait. But patience or not, it’s important to not let acne scars dictate your self-esteem. Consider them a part of your life that can be improved with a little bit of care and lots of self-confidence.

Lifestyle changes like avoiding junk food, quitting smoking, and maintaining skin cleanliness can help prevent or reduce the impact of acne or acne scars. It is important to know that treatment options are available to reduce the impact and severity of acne scars. This blog will give you insights into dealing with acne and acne scars, the types of scars, and tips for acne scar prevention.

When your skin is oily and dirty, the pores get clogged and blemishes form. These are known as acne or acne vulgaris. Adolescents are the most affected by acne, and it becomes a part of their lives until appropriate measures are taken to treat or prevent further blemishes. In some individuals, once the acne clears, it may leave behind some scars or marks. You must consult your dermatologist when a persistent blemish is noted on the skin.

In India, approximately 29% of individuals with acne experience scarring.

Acne scars, also known as pimple scars, are formed due to deep acne wounds that can cause permanent blemishes on the skin. As a result, your skin appears oily, dark, and sticky. Medically explained, the collagen in the skin either increases or decreases depending on the type of scars, resulting in raised or indented scars in skin texture. In some individuals, the skin is very dry; this, too, could lead to the opening of pores and result in acne. 

A few of the typical characteristics of acne scars are:

• Skin texture becomes irregular
• Scars penetrate deep into the skin; they are generally not superficial
• They are permanent and do not fade with time

While it’s fine to search for ways and means to get rid of your acne, it makes good sense to know the causes.

Causes of acne

• Hormonal changes occur during puberty. Hormones such as oestrogen and progesterone are released, which cause physical and emotional changes. A spike in these hormones, along with testosterone, stimulates the production of sebum (oil), triggering acne.  
• In women, menstrual cycles and pregnancy cause fluctuations in hormone levels, which may lead to acne. In men, the production of sebum (oil) is regulated by the hormone testosterone. A spike in this hormone would also lead to acne. Insulin resistance contributes to the onset of acne.  
• Excess use of cosmetics, skin cleansers, and other topical preparations
• Excessive sweating
• Acne may worsen when an individual is stressed, gets little sleep, and eats junk food.

Causes of acne scars

Once acne is cleared, the body begins the process of healing the skin affected by the acne blemish. In some cases, this healing occurs within 7 to 10 days, often without leaving any visible marks.

Scars are more likely to be seen in certain conditions:

• Genetics plays a role: If there is a history of acne scarring in your family, chances are you may get acne scars too.
• Picking, squeezing, pinching, or scratching the acne: This worsens the lesion or wound and the risk of scarring

Acne in its severe forms can express itself as different types of scars:

1. Ice pick acne scars

This scar resembles the mark left by an ice pick. It features a broad opening at the surface that narrows as it descends. 

2. Boxcar acne scars

These appear as if a square or circle has been imprinted into your skin. 

3. Rolling acne scar

If your skin has a ‘rolling’ and irregular appearance, with wave-like depressions, these could be signs of a rolling acne scar. They make your skin look uneven.

4. Hypertrophic acne scars

These appear as flat or raised scar tissue at the site of previous acne lesions, resulting from excessive collagen production.

5. Keloid acne scars

They are characterised by raised lesions that may appear darker than the surrounding skin. These scars can also be larger than the original acne lesions. 

Your dermatologist will evaluate the type and extent of scarring as well as your skin type, health status, and lifestyle and help recommend a personalised treatment plan. They can also suggest a skin care regimen to be followed at home. 

Do note that treatment of acne or acne scars may require considerable time and investment. Hence, it is a must to discuss all treatment options and anticipated outcomes with your skin specialist. Delays in treatment can increase the severity of acne scarring.

“The longer the inflammation/zit is in the skin and the deeper the zit is there, the more likely there is a scar. So, your job is to treat the acne as fast as you can,” says Dr Kiran Sethi, MD, Dermatology, New Delhi.

Acne scars can be prevented by treating the acne as soon as possible. Improving lifestyle conditions such as a healthy diet and a good sleep pattern will keep your skin glowing and healthy.

Following a good skincare routine will go a long way in preventing the formation of marks and scars.

• Cleanse your skin softly using a mild cleanser
• Moisturise the skin after cleansing
• Use sunscreen to avoid getting tanned
• Use exfoliating products to remove the dry skin

Depending on the type and extent of the scar and the scar removal treatment, the time to see results would vary. Your dermatologist will assess these points and suggest a time for improvement.

Acne scars, if not treated, will remain permanent for life. However, some treatments can help them look less prominent.

Yes, some treatment methods may cause irritation, swelling, skin discolouration, or other side effects. These may vary from person to person.

Most at-home treatments do not work for acne scars, but they may help reduce pigmentation, wound healing, and future scarring. 

Acne scars can be removed with treatment. However, they take time to fade. The treatment will vary with the type and extent of the scar and skin type.