Acne scars are common on the back, chest, and face. Between the ages of 11 and 30, about 80% of people will experience acne. One in five people will also develop scarring. Scarring can be reduced by using over-the-counter medication or having one or more procedures done by a dermatologist.
What causes acne scarring?
Your largest organ is your skin. There are three main layers to your skin. These are the epidermis (or dermis), the hypodermis (or outermost) and the epidermis (or dermis). These layers protect your delicate insides from the sun and ultraviolet rays, as well as from bacteria. Acne can occur in any area that has sebaceous glands, especially on the chest, face and back.
Acne scars can be caused by inflammation of acne blemishes. The acne pore will swell and then the pore wall will collapse. Some acne blemishes can be small. The scars that are created are usually very minor and heal quickly. Sometimes, the contents of blemishes can spread into surrounding tissues and cause deeper scarring. The skin responds by creating new collagen fibers to heal the scar.
There are two types of acne scars: one is when tissue is lost, which results in an indentation on the skin’s surface; and the other is when the scar is raised above the skin’s surface. This is an indication that your skin is performing its job well, but not too well. To heal acne, your skin produces collagen (“repair tissues”), but if too much collagen is produced, it can cause raised scars.
Remember that you don’t have to get scars just because you have skin problems. Even if scarring is a possibility (about one in five acne sufferers will have scarring), it’s not permanent. There are many options. There are many treatments that can be used to remove scarring. Others help the skin to heal with its own collagen.
The Best Treatment for Acne Scars
Acne scars can be stubborn so there is no one treatment that will work for everyone. You may find that one or more of these approaches can improve your skin’s appearance, depending on the severity of scarring, scar type, and skin type.
- Sunscreen can be used to reduce the contrast between scarred and unscarred skin. You might also benefit from medicated creams such as those containing azelaic or hydroxyl acid.
- Soft tissue fillers. Injecting fat, collagen or other substances under your skin can plump up the skin to cover indented scars. The goal is to minimize scarring. The effects are temporary and repeat treatments may be necessary to maintain the effect. There is little chance of skin color changes with this method.
- Steroid injection. Injecting steroids in certain types of raised scars may improve your skin’s appearance.
- Laser resurfacing. This technique is becoming more popular. It is used to treat scarring that was previously treated with dermabrasion. People with darker skin and a history of keloids are at greater risk from side effects.
- Other energy-based treatments. Pulsed Light Sources and Radiofrequency Devices make scarring less visible without causing damage to the skin’s outer layer. You might need to repeat the treatment if you are not satisfied with the results.
- Dermabrasion. This is usually reserved for severe scarring. The top layer of skin is removed by your doctor using a rotating brush or another device. The surface scars can be removed completely, but deeper scarring may not be as obvious. Scarring and color changes are possible side effects.
- Chemical peel. To remove the skin’s top layer and reduce the appearance of deeper scarring, your doctor will apply a chemical solution. To maintain your results, you can do mild or medium peels. One deep peel is allowed. Side effects that may occur include changes in skin color, particularly if deep peels are used on darker skin.
- Skin needling. A doctor will place a needle-studded device on the skin to stimulate collagen production in the underlying tissues. This is a simple, effective and safe way to reduce acne scarring. There is minimal chance of skin discoloration. The results are subtle and may require repeat treatments.
- Your doctor will use a minor procedure called punch to remove individual acne scars. Then, he or she will repair the wound with stitches and/or a skin transplant. Subcision is a method where your doctor inserts needles beneath the skin to loosen scar tissue.
- Botox (OnabotulinumtoxinA). Sometimes, the skin around acne scars can pucker. Botox can be used to relax the skin around acne scars. The effects are temporary and repeat treatments may be necessary to maintain the effect.