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Acne Scarring - Causes and treatments
Usually, the mild form of acne occurring in most people does not leave
scars, or if it does, the scars heal naturally over time. But people
suffering from severe forms of acne such as Nodulo cystic acne might
be left with deep scars in the skin.
There are also spots and pigmentation related with acne that are not
exactly scars but resembles them in appearance. These disappear eventually
but are visible enough to cause embarrassment for the patient. Macules
are such pseudo- scars, which are sometimes left behind by an inflamed
acne lesion. These macules are nothing but a flat, red spot that are
the final stage of any inflamed lesion. Unlike a scar, macules might
take time to disappear, but once it vanishes, it leaves no trace behind.
Then there is the discoloration of skin after the healing of any inflamed
acne lesion. It is more frequent in dark skinned people, but might take
place in white skin also. This is called "Post inflammatory pigmentation."
It may require treatment by a dermatologist.
Based on the shape of tissue, acne scars are divided in two categories.
One type of scar consists of increased skin tissue, and the other is
specified by the decrease in tissue on the site of acne. Overgrowth
of scar tissue is called iKeloidsi and is more pronounced in African-Americans.
The deep, linear scar formed by acne is called the ice-pick scar. These
are quite deep and removal of these scars is difficult.
Different people show different response to acne scars. In some people
scars heal easily while some people carry scars for a lifetime. Psychologically,
people show different responses to acne scarring. Some people accept
scarring as normal, while there are others who are worried about even
the slightest of scarring and go to great lengths to get them removed.
Keloids are small in diameter, around 1-2 millimeters. Keloids are
formed due to excessive amount of the cell substance collagen. Collagen
gets deposited as fibrous mass and results in firm, smooth, but irregularly
shaped scars. Keloid scars seem to be determined by heredity as those
people show more susceptibility to keloids that are related to people
already suffering from this kind of scarring. There is no definite proof
of this assumption.
More common than keloids are acne scars caused by the loss of tissue.
These are similar to scars left by chicken pox. These scars include
ice-pick scars, soft tissue scars and depressed fibrotic scars. Ice-pick
scars usually occur on the cheek. These are small but with steep, jagged
edges which makes their healing or treatment difficult. Sometimes these
small scars become quite large and steep, with sharp edges, which are
then called depressed fibrotic scars. Then there are soft scars, both
superficial and deep. These are small with rolling edges merging with
the normal skin. They are either circular or linear in shape.
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One more cause of acne scarring is the pinching and squeezing of acne.
This spreads the infection to nearby skin and damages unhealed tissue,
which results in pit-like scars.
Treatment of acne scarring ranges from simple skin creams to laser
treatment, skin graft, and painful dermabrasion . Filling agents are
also used to remove acne scars. Most filling agents are temporary, like
collagen. For deep ice-pick scars the useful treatment is to cut them
and replace them with skin graft taken from behind the ear. This technique
is called ipunch grafting.i Dermabrasion is almost the reverse of the
cutting down technique because the normal skin is cut down to bring
the acne scar to a lower level. This way, the scar remains the same
but the level of rest of the skin changes, making them shallower and
removing shadows. It gives skin a smoother surface.
For acne scarring treatment, another method is laser treatment. In
this treatment carbon dioxide is used, which removes skin very finely,
layer by layer, thus minimizing the damage to healthy tissue. Like dermabrasion,
this method also leaves skin red for months.
In peeling treatments, chemicals are used to remove the outermost layer
of skin, the epidermis. To remove different kinds of scarring, superficial
peels, medium-depth peels, and deep peels are used. It is most helpful
for shallow, superficial scars. Scars left by cystic acne and acne rosacea
are treated by this method. Peeling is a long process which needs a
preparation period of several weeks before the actual procedure.
Other Resources:
http://www.derm-infonet.com/acnenet/scarring.html
http://www.acne-treatment.ca
http://www.derm-infonet.com
http://www.derm-infonet.com/acnenet/scarring.html
Solano
Dermatology Associates, http://www.solderm.com
http://www.acne-treatment.ca
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