Acne scars aren’t just marks.
They generate discomfort for those who have them, they kill self-confidence.
Here we try to analyze this concern by starting with the causes of acne scars, the types and prevention of scars, the available treatments as well as natural remedies that can be applied to reduce them.
The skin macule
Skin lesions also called macules or pseudo-scars are pink or red, flat spots, which are the final stage of acne inflammation.
When the inflammation eventually subsides, a macule forms and delineates the lesion for about 6 months.
When the latter also disappears, it leaves no mark, unlike the scar.
Post inflammatory pigmentation is the discoloration of the skin at the exact spot where an acne lesion has occurred.
A dermatological treatment started very early can contain this pigmentation.
This white mark can persist for up to 18 months and become more pronounced on exposure to the sun.
A chemical peel can speed up the disappearance of post-inflammatory pigmentation.
Causes of acne scars
Scars form at the exact spot where the skin is injured.
In acne, the injury is caused by the body’s inflammatory response against sebum, bacteria and dead cells lodged in the sebaceous follicle.
When the skin is damaged, the body rushes to repair and fight the infection.
And when its task is done, it leaves a mark, visible scar tissue.
White blood cells and inflammatory molecules can linger in the area of an active acne lesion for days and months.
And for people who score easily, this results in an acne scar.
The frequency of this scar is somewhat unexplained. Some people are more likely to stay tagged than others.
Frequent scarring is the result of severe inflammatory nodulocystic acne.
But more superficial lesions can also leave a scar.
The evolution of a scar
Here too, its evolution is poorly defined.
Some people keep acne scars throughout their lives without much change, for others the skin seems to reshape and the scar becomes less visible.
People’s perception is also quite different.
Scars of more or less the same size which are heartbreaking for one may well be accepted by the other.
In any case, it is the one who despairs of it who will try a treatment to fade it or make it disappear.
It’s unclear who will keep acne scars, how they will look, and how deep they will be.
It is also difficult to know the true effectiveness of an acne treatment for scars.
The only way to prevent or limit their impact is to treat acne very quickly and for as long as needed.
The better the inflammation is under control, the better the prevention of scarring.
Anyone who knows to scar easily should be treated by a dermatologist.
The different types of acne scars
In fact, there are two types of scars defined by the skin’s response to inflammation:
– scars caused by increased tissue formation
– scars caused by tissue loss
Scars due to increased tissue formation
We call it keloid or keloid scar or hypertrophic scar.
The word hypertrophy means an abnormal increase in volume.
Hypertrophic and keloid scars are linked to excess collagen and this overproduction is the skin’s response to injury.
This excess collagen deposits in fibrous masses to form an irregular scar.
The typical keloid has a diameter of 1 to 2mm but can sometimes reach 1cm and more.
Cheloid scars unite most of the time and can persist for years.
However, their size decreases over time.
Scars from tissue loss
Acne scars associated with tissue loss are quite similar to chickenpox and are more common than cheloids.
– the ice pick scar: it is mainly found on the cheek.
It is usually small and in the shape of an injury generated by an ice pick.
It can be shallow or deep and hard or soft to the touch.
If the surface is soft, it can be improved by stretching the skin.
Otherwise, it will not be erased.
– the fibrous scar: it is often quite large and its base is firm to the touch.
Note that an ice pick scar can develop into a fibrous scar over time.
– the soft scar: whether superficial or deep, it is soft to the touch and presents a sloping that joins the normal skin. It is generally small, often circular.
– the atrophic macule: it is generally very small when located on the face but can exceed a centimeter when ‘she is on the body.
It is soft to the touch, has a wrinkled appearance, and may be slightly bluish due to the blood vessels just below the scar. </ span>
Over time, it fades and becomes almost invisible.
– the perifollicular elastolysis: it mainly appears on the chest and back of people with acne.
The markings are small, pale, soft, barely emerging from the skin surface.
The skin has a wrinkled appearance, in crumpled patches.
They can persist for months and years.
Acne scar treatments
Many treatments are available through dermatologic surgery.
The intervention method is chosen according to your skin type, the cost and the expected results.
You should be aware that some treatments can make the situation worse if your skin is too sensitive.
The choice of surgical treatment is subject to various factors:
1- How you feel about scars
The dermatologist asks you if these marks are affecting your psychology, if you don’t prefer to live with them and wait for them to fade over time.
The decision is therefore a personal choice.
2- The severity of the scars
The marks you present are objectively unsightly and require treatment in the opinion of the dermatologist.
The goal of treatment is to restore the skin to an acceptable appearance.
The perfect restoration to what it was before acne is often impossible, but the treatment aims to significantly improve the rendering.
Currently possible treatments are:
- Collagen injection
Collagen is a substance found in the body.
It is injected into the skin to stretch it and fill in some superficial scars.
This treatment is insufficient for ice peak scars and keloids.
The effectiveness of a collagen treatment lasts 3 to 6 months.
One-off additional injections are necessary to maintain the result.
- Autologous fat transfer
Fat is taken from your body, processed and injected into the skin.
This so-called autologous method, that is to say from your own body, is used to treat the deep contours of nodulocystic acne.
But the fat is reabsorbed after 6 to 18 months, which implies a new procedure.
Under local anesthesia, a high-speed burr removes the superficial dermis.
Light scars are completely erased, deeper scars are significantly reduced.
Dermabrasion is not effective for all types of scars.
It can make ice pick scars even more visible.
It can also create pigmentation spots on darker skin tones.
This technique is more superficial than dermabrasion.
Instead of a high speed bur, aluminum oxide crystals are propelled to remove the dermis.
A tiny part of the dermis is affected so as not to create new wounds.
This treatment requires multiple procedures and the results are often disappointing.
- Laser treatment
Different lasers can be used to reshape tissue, reduce redness around acne lesions.
In some cases, a single intervention is sufficient to obtain a permanent result.
However, persistent redness may appear for several months after this treatment.
– Ice pick scars can be treated by excision of the subcutaneous fat layer. The hole thus created is closed with sutures.
– Subcision is a technique that involves peeling the skin from the acne scar with a microneedle so that a blood clot rises to the surface and take the place of the mark.
– Sometimes a skin graft may be necessary.
Treatment of keloid scars
Some keloids are treated with steroid injections.
Topical retinoids can be applied directly to this type of scar.
Scars and makeup
There are many specific makeup products available for scar camouflage.
They are effective in masking scars as much as hyper pigmentation, rosacea, burns or even tattoos.
Most of these products offer a range of colors to perfectly match your skin tone.
You mix the two tones to find your skin tone.
Camouflage makeup is made from natural pigments and is fragrance and oil free so it won’t cause irritation.
Its finish is natural and gently covers scars.
Natural remedies for scars
- There are many creams that can gradually erase scars.
Mederma is available without prescription.
Of course, they don’t promise to get rid of scars for good, but they will fade significantly.
- Daily exfoliation and application of natural vitamin E is an effective and inexpensive way to fade superficial scars.
- Lemon juice is as effective as it contains citric acid.
Its action is radical to remove dead cells, improve skin elasticity and help cell renewal.
Note that it can be irritating to sensitive skin.
- Aloe vera gel is already known for its multiple virtues, it can also help fade scars.
- An exfoliant serum based on amino acids helps lighten dark scars.
- A sandalwood paste may help reduce scarring due to its antiseptic, anti-inflammatory and healing properties.
Sandalwood is emollient, astringent and disinfectant.
Tip: mix a tablespoon of sandalwood powder with rose water to make a thick paste.
Apply once a day to the scar, leave on for 30 minutes then rinse with clean water.
Acne scars are caused by the body’s inflammatory response to the lesions.
The best way to prevent them is to treat acne quickly and for as long as it takes.
If, despite everything, scars do appear, there are many treatments available.
You should discuss this with your dermatologist.
You can also try natural solutions to eliminate those marks that make you sad.
How about you? How do you deal with this problem?
I await your comments.
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