Why Does Acne Leave Scars?
Acne is the name given to a collection of related skin blemishes that can form on your face, back, neck, scalp, shoulders or chest. In most cases, mild or moderate acne does not produce permanent scars. However, you may develop scars if you have severe acne, disturb acne-affected skin or have a genetic tendency toward scar formation.
Acne scarring stems from destructive changes caused by acne inflammation, according to the American Academy of Dermatology, or AAD. Most frequently, these changes result in tissue loss in affected areas.
Depending on individual circumstances, you may develop types of tissue loss-related scars that include deep or superficial soft scars; depressed scars with sharp margins called fibrotic scars; soft, flat scars called atrophic macules; and deep or superficial ice-pick scars, which are named for their characteristic appearance.
In some cases, inflammation can trigger the formation of raised acne scars, which result from an abnormal increase in tissue production. Collectively, these raised scars are called hypertrophic scars.
Most scarring comes from severe forms of acne, including pus-filled lumps and cysts called nodules, according to the Nemours Foundation. Nodules develop in deeper layers of skin than pustules, pimples, blackheads or whiteheads. However, they result from the same basic causes as these milder forms of acne, including the combined interactions of excess skin oils, pore blockages, inflammation and P. acnes bacteria.
Depending on individual circumstances, you may develop single or multiple acne nodules of varying severity.
You may also develop scars from a severe form of acne called acne conglobata, according to the New Zealand Dermatological Society. This form of acne occurs when nodules located in the same area of skin link together, forming pus-filled abscesses in tunnels under your skin. If you have acne conglobata, you may develop both raised hypertrophic scars and flat atrophic scars.
Even if you have mild or moderate acne, you can trigger scar formation by squeezing, scratching or popping acne lesions, the AAD explains. You also have an increased chance of developing acne scars if scarring or severe acne run in your family.
Although genetic history cannot guarantee that you will develop scarring, the AAD recommends treating lesser acne symptoms as soon as possible if you have a known family history. Doctors cannot predict who will develop acne scarring, regardless of behavior or heredity.
If you have a known tendency toward scarring, your doctor will typically only consider scar treatment after your main acne symptoms are well-controlled, the AAD notes. Otherwise, additional acne outbreaks would merely produce more scarring.
Depending on the severity of your condition, potential treatments for scarring include use of cosmetic creams or gels, chemical peels, a scar erosion procedure called dermabrasion and laser resurfacing of your affected skin, according to the AAD.
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