Almost everyone suffers from acne at one time or another during their lives. Most people experience acne during their teen years, but acne can be a problem for people at any age. Even after acne clears up and goes away, the marks that it leaves can create a permanent scar that could last a lifetime. If you suffer from acne, there are preventative measures you can take to prevent acne marks from becoming scars. Even if you have permanent acne scars, a dermatologist can help. To tell whether acne scars will become permanent or not, there are a few factors to consider.
Types of Acne
Acne comes in different varieties, and some are more likely to cause a scar than others. Acne starts when a hair follicle becomes blocked by oil and dead skin cells. When this blockage is irritated by squeezing or infected with bacteria, it can become inflamed and be far more likely to leave a scar. Inflamed acne comes in four basic types. Papules are the small inflamed blemishes on the surface of the skin that do not contain pus or a whitehead. When white blood cells invade an inflamed papule, it progresses to a pustule. Pustules are what people think of as a typical pimple, which is red and usually painful, with a visible whitehead that contains pus and dead skin cells. Papules and pustules can usually be treated with a simple cleanser. Nodules are inflammation that occurs deep within the dermis layer, and appears on the surface of the skin as a red and painful bulge. The risk of infection and scarring with nodules is very high. Cystic acne is similar to nodules, occurs deep in the dermis layer, and is visible on the skin as a very large, soft and painful red lesion. Like nodules, cystic acne creates a high risk of scarring, especially with large breakouts.
Post Inflammatory Hyperpigmentation
In addition to permanent scars, acne can cause a condition called post inflammatory hyperpigmentation (PIH), which fades over time, even without treatment. PIH is the term doctors give to the discoloration that can show up after inflammatory acne or other wounds have healed. PIH causes an excess of melanin in the affected area, which can show up as a pink, purple, brown or black mark, depending on the color of your skin. Unlike most scars, PIH is flat against the surface of the skin and doesn’t leave a pit or a protrusion. It often looks like a freckle, and is not permanent, although it may take three months to two years, or even longer, to fade.
Types of Scars
Permanent acne scars fall into two different categories, with a few different variations within those categories. Atrophic scars are a depression caused by loss of tissue, and hypertrophic scars are a protrusion cause by excess of tissue. Atrophic scars include ice picks scars, which are very narrow and deep, and boxcar scars, which are round or oval shaped and produce a pitted appearance. This is caused when acne damages the natural collagen in the skin, resulting in tissue collapse. Hypertrophic scars include rolling scars, which give the skin surface a wavy appearance, and keloid scars, which protrude from the surface of the skin. The opposite of atrophic scars, these are the result of an overproduction of collagen, which creates excess tissue.
Treatment is Possible
All of these types of scars are permanent, but they can be treated. Atrophic scars can be treated with collagen fillers or laser resurfacing. Hypertrophic scars can be treated with cortisone injections, or even removed with surgery. If you suffer from permanent acne scarring, see a dermatologist to discuss your options.