Your Ultimate Guide to Acne Scarring

Introduction
Acne Scarring and a Common Misconception
Different Types of Acne Scars
How to Prevent and Treat Acne Scars
Sources & Works Cited

Introduction

Have you ever felt the helplessness that comes with the effects of acne and its scarring? Have you ever logged into Google, going down a spiral of AI-generated responses and claims, trying to find solutions? If this is the case, you are not alone. Acne affects 80 percent of people that are between the ages of 11-30 years, [1] and 1 in 5 of those people develop scarring as well [2]. Many adolescents, including myself, have all experienced similar stories which is why I have compiled a variety of common questions and misconceptions I have heard, which I will aim to answer in the following text.

Acne Scarring and a Common Misconception

So what are acne scars and why do so many people get them? Acne scars result from inflamed acne blemishes and while some of them heal relatively quickly, others last longer, becoming deeper scars. These scars can develop from loss of skin tissue, leaving a dent on one’s skin, or, they can be raised towards your skin's surface [2]. Moreover, chances are that if you have researched acne scars, you have also come across the term “hyperpigmentation”.

A common misconception I have noticed around teenagers like me is that many of us view acne scars and hyperpigmentation as the same thing. And while you can have both acne scars and hyperpigmentation, hyperpigmentation affects someone's skin pigment and is essentially a darkened area of one’s skin while acne scars change the skin's texture instead [3]. Post-inflammatory hyperpigmentation results after acne heals and a discolored patch of skin subsides [4]. Hyperpigmentation can be treated with sun protection efforts where acne scarring requires more effort.

Different Types of Acne Scars

When examining acne scars, it is important to know the different types so we can learn how to treat them. There are three main types of acne scars: atrophic (the most common), hypertrophic, and keloid scars. Hypertrophic and keloid scars are described as scar tissue that appears when a part of the fibrous tissues of one's skin overgrow [2]. Keloid scars can become bigger than the acne they were caused by, whereas hypertrophic scars remain the same size [4]. These types of scars are often seen as a texture that rises from the skin.

As for atrophic scarring, they appear in three different ways: icepick, rolling, and boxcar (and yes, the scars have some relation to these names). Ice pick scars cause an indent in one’s skin that can be quite difficult to heal. These scars seem like “icepicks” because they indent a wide hole on the skin's surface and narrow deeper into the skin [2]. Rolling scars, on the other hand, provide indents that make the skin look uneven with their sloping edges [2]. Lastly, boxcar scars are broad and look like sharper edges on the skin. These scars appear in thick areas of the skin and are often a result of widespread acne or chickenpox [4]. While these scars can seem scary, it is important to remember you are not alone in your worries and that there are prevention and treatment options.

How to treat and prevent acne scars

When it comes to atrophic scars there are a variety of treatment options including ablative and nonablative lasers, microneedling, chemical peels, and more [1]. These types of treatments can often be administered in a dermatologist's office. There are also some over the counter options when trying to treat atrophic scars, including retinoids like Differin [4]. Furthermore, there are also dermatologist and home treatments that work towards abating hypertrophic and keloid scars. This includes laser therapy in the dermatologist office or skin massaging in order to reduce the height of one's scar [4]. While these are several options to treat acne scars, working to prevent these scars from forming is equally important and seemingly less scary. For instance, working to protect the skin by reinforcing your skin barrier through using a good moisturizer and using gentle ingredients on your skin is one of the best ways to prevent both acne scars and hyperpigmentation [2]. All in all, I believe that widening your horizons on the different aspects of acne scars and how to treat it makes one more informed about their skin and concerns. Personally, as a teenager, I have struggled with acne before but learning about prevention techniques has helped me build a stronger and healthier skin barrier. When you are within the 80% of people from ages 11-30 experiencing acne, it is important to understand the concerns you have regarding your skin and consult with a dermatologist to help with these concerns.

Sources & Works Cited

[1] “Acne Scarring—Pathogenesis, Evaluation, and Treatment Options,” 09/01/2017, National Library of Medicine: https://pmc.ncbi.nlm.nih.gov/articles/PMC5749614/

[2] “Acne Scars: Causes, Diagnosis, Types & Treatment,” 06/23/2020, Cleveland Clinic: https://my.clevelandclinic.org/health/diseases/21222-acne-scars

[3] “Hyperpigmentation or Scars From Acne, Here’s How to Tell The Difference & Why it Matters,” 02/22/2024, City Skin Clinic: https://cityskinclinic.com/hyperpigmentation-scars-acne/

[4] “5 Types of Acne Scars and How to Treat Them,” 01/26/2024, Healthline: https://www.healthline.com/health/skin-disorders/types-of-acne-scars#types-of-scars