Acne Scars
Believe it or not, many people who put up with acne suffer even more after their acne has been treated. This is because they face a bigger and an even more permanent problem, acne scars. There’s nothing like finally getting
rid of your acne to find out it has left behind some life-long scars. Forming a scar for every pimple you have would be scary right? Note that the information provided here is for your general use. It does not replace the information you should receive from your dermatologist or other doctor.
If we are to understand completely how and why acne scars develop, we have to go down to cellular levels. Not everyone can absorb medical jargon as quickly as we wish we could so I will explain this in the simplest way I know how so you do not have to worry about having a brain freeze while reading this article. Sit back, relax, hold on to your pimples, and together let us understand acne scars (remember if you can understand how scarring works then you will better understand acne scar treatment works).
Anatomy of the Skin
The skin is probably one of the most interesting organs of the human body. It is not only our largest organ; it is also our first line of defense against foreign bodies. You can think of your skin as a coat that is waterproof, washable, permanently pressed, and automatically repairs small cuts and wounds. Our body, indeed, is a wonderland!
The skin has four basic functions: (1) protection of the deeper tissues from mechanical, chemical, and bacterial damage; (2) aiding in body heat loss or retention; (3) aiding in the excretion of urea and uric acid; and (4) synthesis of vitamin D. Moreover, the skin is divided in to two layers: epidermis and dermis. The two layers have individual and unique functions. Furthermore, your skin is home to several glands that are invisible to the human eyes. However, in relation to acne and acne scars, we will focus on a single gland – the sebaceous gland.
Sebaceous glands, or more commonly known as oil glands, are found all over our skin except for the soles of our feet and the palms of our hands; no wonder we can get acne vulgaris (the scientific name) practically anywhere on our body. Take note that the ducts of your sebaceous glands usually empty to hair follicles and skin pores (Elaine N. Marieb, 2010).
Sebum oils, or the product of your sebaceous glands, are composed of oily substances and fragmented cells or dead skin cells. If they are within normal levels, sebum actually helps fight off skin infections as they have anti-bacterial components. However, when they are released in excess – coupled with dead skin cells – and lodge in your skin pores, they develop in to the oh-so-dreaded acne.
Acne Scarring
I found a very shocking revelation in my process of understanding acne scars – these scars are actually part of our body’s tissue repair or wound healing processes! In other words the skin renewal process is the same process that causes scarring. It is only one of the human body’s techniques for protecting itself from injury. How can we hate pimple scars now if they are actually created to protect us?
However, I got over it right away because no matter how anatomy experts like Elaine Marieb put it, acne scars are still extremely unattractive. Luckily, I found out that although we cannot stop our organs from healing (as we shouldn’t), we can do things to eliminate their unsightly effects afterwards (more on acne scar removal in a minute).
We will now focus on tissue repair or our body’s natural way to heal its own wounds. The healing process occurs in two major ways: regeneration and fibrosis. We do not have to worry about regeneration because it only replaces destroyed tissues with the exact same tissues i.e. there is no scarring when regeneration occurs. Fibrosis, however, is a completely different story.
Fibrosis repairs damaged tissues by replacing them with dense (fibrous) connective tissues. Do scar tissues ring a bell? Surprise! Surprise! This is why we have scar tissues. This process takes place depending on the damaged tissues and the extent of the damage. Epithelial tissues are the ones that make our skin regenerate beautifully. However, when the damage is too deep or to wide, fibrosis takes over. Severe acne lesions or cystic acne are skin diseases that often lead too deep or wide damage to the skin which leads to fibrosis setting in.
This is the process that tissue healing normally follows:
- Permeability of Capillaries Increase (dilated blood vessels in common tongue) – Your blood vessels enlarge so that fluids rich in clotting proteins to go to the injured area. That way, the bleeding is controlled and no further damage occurs. Clots that are exposed to open air – the ones we see – they easily harden and form in to scabs (another very familiar thing to those of us who are or were plagued by pimples).
- Granulation Tissue Formation – Granulation tissues form the delicate pink layer we all see after we have been deeply wounded by acne.
- Surface Epithelium Regenerates – The epithelium regenerates from the inside out, until it reaches the layer just beneath the scab. The end result includes fully regenerated epithelial tissues that cover the fibrosis (alright, the SCARS!). The fibrosis tissues are either visible or invisible; again, depending on the extent of the injury. This means bigger pimples may develop into uglier scars.
What is Post Inflammatory Hyperpigmentation (PIH)?
Now that you understand the process for skin healing, it’s not as hard to understand post inflammatory hyperpigmentation. When the blood rushes to heal the skin, the outer skin inflames (forms delicate pink skin). Post inflammatory changes are everything that happens after this pink skin develops. Pigmentation usually refers to the coloring of the skin. So PIH simply means extra coloring of the skin after the healing has occurred.
Different Types of Acne Scars
It’s important to realize that there are different types of acne scars because each type of scar is treated differently. The common types of scars include hypertrophic, boxcar, rolling, and ice pick scars. Here is a great page for helping you identify which type of scar you have and what types of treatment work best for your individual type.
What is Acne Keloidalis?
Some people just aren’t very lucky when it comes to genetics and skin care. Some people are natural born keloid formers. Do you notice that some of your scars bulge and “grow”? Scars that do this are known as keloids; not all scars develop in to keloids. Imagine if you formed a keloid for every acne scar you have; scary and embarrassing, right?
Treatments
In this section, we will simply list some of the common treatments. There is much more information included throughout the site. Some treatments include dermabrasion, microdermabrasion, fractional laser treatment, chemical peels, laser resurfacing, punch techniques, subscision, and augmentation. There are a lot of acne scar treatments available, but the best is to try and avoid acne in the first place.
All this medical mumbo jumbo may sound like too much but you need to find a way to understand the skin’s healing process in order to avoid harmful side effects. Here is one thing I need you to remember from all of this: scars may be inevitable in some cases but there are steps you can take in order to lessen the impact of the scars. The resources below are designed to help you with this.
References:
Marieb, E. N., & Hoehn, K. (2010). Human Anatomy & Physiology (7th ed.). Benjamin Cummings.
Photo Courtesy of Suat Eman / FreeDigitalPhotos.net
How to Get Rid of Acne Scars
Saying that acne is only a small problem is basically like saying that it’s okay to be stuck on a small piece of wood surrounded by sharks in the middle of an ocean with nothing but your clothes on. If you think having acne is bad, try dealing with acne scars! If you read my [...]
Home Remedies for Acne Scars
Acne is a common skin disease that affects almost everyone at certain times in their lives. It mostly affects people who are in their teens and those women who are in their menopausal ages. Acne can be embarrassing especially when the pimples linger or become very large. These pimples often leave us with terrifying scars [...]
Mederma Acne Scars Review
Experience is a good teacher and you one thing you learn quickly about acne is that when it heals, it can leave an ugly scar. If you’re lucky, the scars are sometimes unnoticeable (especially with make-up) but when luck is not on your side, it will take a whole lot of make-up to cover up [...]
