Types Of Scars

Scars form when wounds heal. Pimple ruptures can cause small wounds that when healed are sure to leave a trail of small scars. Depending on the severity of the acne outbreaks, the scaring can often be mild or in severe cases, may require cosmetic treatment.

Hypertrophic or Keloid Scars

These are scarred tissues raised above the skin surface and are essentially tissue overgrowth that can result with an overproduction of collagen fibers that produce more tissue than is necessary to cover a healed wound.

Hypertrophic scars caused by acne are rare on the face but are more likely to appear elsewhere like on the neck, chest and upper arms, especially in men.

Treatment: They can be treated with cortisone steroids in cream form or injections that can shrink, flatten or dry out the skin outgrowths. Interferon injections are also used to soften scar tissues that have hardened over time.

Ice Pick Scars

By far the most common scarring caused by acne attacks that produce the classic pimple scars, the Ice Pick scars are deep and narrow pinpoint skin depressions that pit the skin where the pimples used to be. The name comes from the look on the scars as if a sharp ice pick had caused “holes’ on the skin.

Unlike keloid scarring caused by an overproduction of tissue, ice pick scars are caused by the loss of tissue under the skin which has been destroyed in cystic or moderately inflamed acne pimples that ruptured to spill out its damages tissue under the skin.

Treatment: These types of scars can be treated using punch excision or grafting methods.

Boxcar Scars

These are often round or irregularly shaped skin depressions with steep vertical sides formed with normal skin and are the next most common scar formation after ice pick scars caused by acne outbreaks.

Wider than ice pick scars, boxcar scars account for what makes the skin look like the lunar surface from a telescope and are similarly caused by a loss of tissue under the skin when two or more adjoining pimples sill out their damage tissues and form a continues skin break.

Treatment: Like ice pick scars, they can be mild enough to disappear over time or get unnoticed or can be severe enough to be as embarrassing as any scaring on the face. Treatment often calls for punch excision and cosmetic dermal filler and laser resurfacing methods.

Rolling Scars

The type of scarring produce a wave-like undulations on what should otherwise be a smooth skin surface. They produce depressions that have smoother edge with normal skin and are often caused by fibrous bands of tissues developing between the skin and subcutaneous tissue layer under it to pull the epidermal layer to the lower structures of the skin to cause the rolling appearance.

This type of scarring caused by acne is likewise seldom seen are more commonly found elsewhere in the body than on the face.

Treatment: They are best treated with subcision.

Hyperpigmentation / Post Inflammatory Hyperpigmentation (PIH)

This is the medical jargon for skin discoloration ranging from pink, red, brown or purple that happens as the acne attacks start to heal and is the skin’s natural response after the inflammation caused by acne.

It is not a true scar and is directly attributed to the production of melanin, the protein responsible for skin pigmentation and excess production in the area can darken it while healing. Unfortunately, it can remain discolored even after affecting both sexes and occurring in all skin types after a bout with inflammatory bout with acne, PIH can be treated with OTC medication but only after the acne has fully healed.

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