Commonly, the mild type of acne occurring in most people does not produce scars, or if it does, the scarring fades naturally over time. But people suffering from severe types of acne like nodular cystic acne might be left with deep scarring in the skin.
There are also spots and pigmentation that relate to acne that are not precisely scars but resemble them physically. These disappear eventually but are evident enough to produce embarrassment. Macules are like pseudo- scars, which are sometimes left behind by an inflamed acne lesion. These flat red spots are just the last stage of any inflamed lesion. Unlike a scar, a macule might take time to fade, but once it vanishes, it leaves no marks behind.
A discoloration of the skin my occur following 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 named "post inflammatory pigmentation." It may need treatment by a dermatologist.
Scar treatment possibilities
Based on the shape of tissue, acne scars are divided in two categories. One type of scar consists of augmented skin tissue, and the others are recognized by the diminution in tissue on the site of acne. Overgrowth of scar tissue is known as Keloid and is more noticeable in African-Americans. The deep, linear scar created by acne is called the ice-pick scar. These are quite deep and removal of them is difficult.
One more cause of acne scarring is the pinching and squeezing of acne. This spreads the infection to surrounding skin and harms weakened tissue, which results in pit-like scars.
treatment of acne scars ranges from simple acne scar cream to laser therapy, skin graft, and painful dermabrasion. Filling agents are also used to remove acne scars. Most filling agents are provisional, like collagen. For deep ice-pick scars, the most appropriate treatment is to extract the scars and replace them with a skin graft taken from behind the ear. This technique is called punch grafting.
Dermabrasion is virtually the opposite of the cutting down method. Here, the healthy skin is eliminated 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. It confers skin a smoother surface.
In acne scar therapy, another method is laser surgery. In this treatment, carbon dioxide is used, which removes skin very finely, layer by layer, thus minimizing the harm 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 diminish different types of scars, superficial peels, medium-depth peels, and deep peels are used. These are mostly useful for shallow, external scars. Scars left by cystic acne and acne rosacea are treated by this method. Peeling is a long process that requires a preparation period of several weeks before the actual intervention.
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