acne scars

How do acne scars develop?

If acne develops scars, these are usually very serious illnesses or the pimples, pustules or blackheads were treated unprofessionally. If you express pimples and blackheads yourself, bacteria enter the wound very quickly, which can proliferate well in the secretion and cause inflammation. The normal connective tissue is destroyed and replaced by non-specific tissue. This differs in appearance from the rest of the tissue, is less well supplied with blood and can harden and move inwards. That’s why acne scars are so noticeable. Acne scars are initially red in color, then they turn white.

Whether or not acne scars develop depends not only on the type of acne but also on the individual skin type and age. In older people, the skin does not regenerate as well as in younger years, so acne scars are a common consequence of the disease.

Various acne scars

Acne scar is not the same acne scar. Depending on the place of origin and expression one differentiates:

• Atrophic acne scars: Atrophic acne scars are slightly below the level of normal skin – they look as if they have been pulled inward. This is because not enough new connective tissue was formed during tissue repair. Atrophic acne scars are mainly caused by long-term inflammation and suppuration, as they can occur, for example, when you push yourself around pimples.
• Hypertrophic acne scars: Hypertrophic acne scars come off the skin and form visible thickening because too much new tissue has been formed to repair the wound. They may itch or even hurt. Hypertrophic acne scars are found mainly on the shoulders and in the décolleté of people with genetic predisposition.

How to remove acne scars

Depending on the size, shape and location of acne scars on the body, different methods are used to remove them. Basically, the following procedures are available for the treatment of acne scars:

• laser therapy
• Surgical scar correction
• icing treatment
• grinding treatment
• Chemical peels
• acid treatment
• Dermabrasion
• Microdermabrasion
• Injections
• Injection of collagen

These treatments are performed by a dermatologist or a plastic surgeon. The treatment of very large acne scars may sometimes require a hospital stay depending on the procedure. In many cases, however, the treatment is outpatient. Most of these treatments require several sessions with the doctor.

Surgical scar corrections, icing treatments and laser therapy require extensive follow-up care. Those affected may be out of work and health for a few days after treatment.

The treatment options in detail

laser therapy

Laser treatment can be used for both hypertrophic and atrophic acne scars. There are various laser techniques to choose from:

The standard method Removing acne scars is the functional laser therapy with a CO2 laser. This small holes are shot in the skin. These heal again with healthy connective tissue, which smoothes and tightens the skin.

Alternatively, excess scar tissue can be removed layer by layer with a laser. Thereafter, a small needle delivers a heat pulse into the skin, stimulating the growth of normal, smooth collagen tissue that replaces the hardened collagen tissue of the acne scars.

If people want to have acne scars, they need to plan for some pre- and post-treatment. Overall, the treatment extends over several appointments. One potential treatment risk is the misapplication of the technique. Then the surrounding tissue can be destroyed and the skin can be greatly irritated.

Surgical removal of acne scars (surgical scar correction)

Acne scars can also be removed by surgery. The surgeon first removes the excess tissue with a special cutting technique, then places the wound edges tightly together and sutures them together. It can not be ruled out that there will also be a scar, albeit a smaller one. A surgical scar correction is made but only for larger acne scars.

icing treatment

In an icing treatment, the scar tissue is frozen at minus 180 degrees with liquid nitrogen. Thus, the tissue dies off and can be subsequently removed in a surgical procedure.

abrasive treatments

Abrasive treatments are used for acne scars with sharp edges and for hypertrophic acne scars. In the process, excess tissue is abraded with a diamond bur. After treatment, however, small bumps often remain. The treatment is under general anesthesia.

Chemical peels

Chemical peels are used in very severe cases of acne scars. They are performed under anesthesia and are associated with some side effects.

acid treatments

Acid treatments are suitable for both acne and acne scars. Mostly today fruit acids are used. The acidity can be between ten and 70 percent. Acid peeling can be carried out independently up to an acid content of 30 percent, from 30 percent by a cosmetician or a dermatologist and from 40 percent only by a dermatologist. In the beginning, the skin must gradually get used to the acid, so first very short exposure times are recommended, which are then increased over several weeks. Acid treatments tighten and smooth the skin. Affected individuals should avoid direct sunlight for up to seven days after treatment.

Acid treatment can cause irritation and redness of the skin, depending on the skin type. In addition, it does not always improve the appearance of acne scars.

Dermabrasion

In dermabrasion (translated: skin abrasion), the uppermost layer of the skin is abraded with a fine milling machine. This will also remove excess scar tissue and make the skin smoother and more uniform. The dermabrasion is mainly used for large-area and sharp-edged acne scars.

Microdermabrasion

In Microdermabrasion fine, small crystals are shot on the skin to remove the uppermost layer of skin. This method is a little gentler than the previously mentioned and does not leave any marks on the face after the treatment. Depending on the size and depth of the acne scars, several sessions over several weeks are necessary. A session lasts about 15 to 30 minutes and is usually painless.

Injection of acne scars

With an injection, cortisone is injected directly into the scar. As a result, the scar tissue dies, and the scar flattens off. However, with this method, the tissue is not renewed, that is, the slightly whiter scar tissue still lifts off the skin after treatment.

Injection of collagen

This treatment is used for atrophic acne scars. Collagen is injected into the scar, so it is artificially filled. The scar tissue lifts up and adapts to the level of the rest of the skin.

Acne scars: prognosis

In recent decades, the field of possible treatments for acne scars has greatly increased: Adapted to the respective skin type and acne type those procedures are used, which cause the skin as little harm. Which therapies are suitable for you, decides the dermatologist on the clinical picture of your acne. Likewise, the result of the treatment depends on the skin type.

Generally, the prognosis in the treatment of acne scars is good. In many cases, acne scars can be removed so that they are hardly or not at all visible.

In general, of course, superficial and minor acne scars can be treated faster and with better results than larger and deeper acne scars. In some cases, deep scars can not be completely “invisible” even with multiple treatments.

Prevent acne scars

Not in all cases you can prevent acne scars. It is helpful if you do not express pimples and blackheads yourself, so that it does not come to “homemade” inflammation on the skin. In severe acne cases, however, the inflammatory processes of the skin can no longer be controlled by itself. Acne should therefore be treated as early as possible so that inflammation of the hair follicles and the skin can be reduced and bacterial infections can be combated early. That can help later acne scars submissions.