ACNE CAN BE AN EMOTIONALLY DISTRESSING CONDITION

London Dermatology | 23 February 2025

Acne scars and hyperpigmentation are two consequences of acne that can make the emotionally upsetting condition even worse. You’re not the only one who has acne scars. From teenagers to adults, acne scarring is a widespread problem that impacts a large number of people globally. The goal of this book is to provide a thorough understanding of acne scars, their types, and the most effective treatments.

Inflammatory acne lesions including cysts, pustules, and papules cause acne scars. These lesions develop when the follicular wall ruptures due to the pore becoming engorged with germs, dead skin cells, and excess sebum (oil). Deeper lesions are produced when this occurs because the substance spilt into the surrounding tissue from deep within the skin. Collagen, the building block of skin tissue, is produced by the skin in an effort to heal these lesions. An acne scar may develop if the body generates too much or too little collagen.

Acne scars come in several varieties. The kind and severity of the acne that caused them can have a significant impact on how they look. Knowing how they differ is crucial since it dictates the best course of action for treating acne scarring. The most prevalent kinds of acne scars are shown below.

Boxcar Scars

Boxcar scars are broad, U-shaped scars with distinct, sharp edges. These can be deep or shallow. Resurfacing treatments can be used to treat the shallower ones, while more intrusive techniques, such as punch excisions, may be necessary for the deeper ones. The cheeks and temples are where they are most frequently found.

Ice Pick Scars

These scars, which are usually deep and less than 2 mm broad, are named for their narrow, V-shaped appearance that resembles tiny round or oval holes, as if created by an ice pick. Ice pick scars are frequently the most difficult to cure with surface-level therapies because of their depth; punch grafting or TCA CROSS (Trichloroacetic Acid Chemical Reconstruction of Skin Scars) may be necessary.

Rolling Scars

These scars, which are large indentations with sloping edges brought on by injury beneath the skin’s surface, are characterised by their wave-like or rolling look. Long-term inflammatory acne frequently results in rolling scars, which are made up of bands of scar tissue that develop beneath the skin’s surface and give it an uneven, rolling look. For these kinds of scars, subcision or laser treatments are frequently advised.

Hypertrophic Scars and Keloids

These two scars are solid and elevated. Hypertrophic scars, which typically occur from severe acne types like nodular or cystic acne, remain inside the original acne lesion’s limits. Keloid scars, on the other hand, can expand over time and go beyond the limits of the initial lesion. They are typically darker than the surrounding skin and have an elevated appearance. Corticosteroid creams, tapes or injections, silicone sheets, cryotherapy, laser therapy, and, in extreme situations, surgical removal are all effective therapies for both kinds.