What are the Different types of Acne Scars?

Acne is a common enemy that causes irritating pimples and occasionally more permanent memories in the form of acne scars. Even though we may be able to get past the initial breakouts, these marks may remain and affect our overall skin tone and confidence. But worry not! This is a detailed guide about understanding and eventually eliminating those irritating acne scars.

What is Acne?

Acne is a common skin ailment that affects millions of individuals worldwide. It arises when dead skin cells and oil clog hair follicles, causing pimples, blackheads, and whiteheads to develop. Although acne may impact people of all ages, it is typically linked to teenage years. The disorder, which can be minor or severe, may result in permanent harm and severe emotional anguish if proper treatment is not provided.

Types of Acne

The word "breakout" is often used to refer to acne or pimples. The name, however, is incorrect for the skin condition. Various types of pimples appear differently on the skin. However, acne can be divided into two categories: inflammatory and non-inflammatory acne. Let's check out the different types of acne under these categories:

Non Inflammatory Acne

Usually, these kinds of pimples don't cause swelling. They are distinguished by open or closed skin pores or hair follicles clogged due to excess oil, dead skin accumulation or bacterial buildup. There are 2 non-inflammatory acne types.

Blackheads

Blackheads, also known as open comedones, are small bumps on the skin's surface. The bumps are called blackheads because the surface appears dark or black. Blackheads are acne on the face but can also develop on other body parts, such as the neck, back, chest, arms and shoulders. A clog or plug that develops in the opening of your skin's hair follicles is what causes blackheads.  When the skin over the bump opens, exposure to the air leads to oxidation, which causes it to look dark and a blackhead forms. Because of their dark colour, blackheads are easy to spot on the skin. They’re slightly raised, although they are not painful.

Whiteheads

Whiteheads, also known as closed comedones, are a kind of acne that typically develops in the body's oiliest regions. They are a common facial acne type in the T-zone (forehead, nose, and chin). They can also be found on your chest, back, shoulders and arms. Whiteheads appear in tiny pores and are covered by the epidermis, the skin's outermost layer, making it appear the same colour as your skin. If left untreated, whiteheads can turn into inflamed, painful pimples.

Inflammatory Acne

These acne types look red and swollen. Bacteria can add to clogged skin pores, excess sebum, and dead skin cells. Some infections that are deeply rooted and arise from bacterial accumulation deep within the skin's surface can form severe acne lesions that are tough to treat. The following are the 4 kinds of pimples in this category:

Papules

Papules are acne that leaves your skin with tiny, sensitive, swollen lumps that don't leak fluid. The term most frequently used for them is skin lesions. When there is severe inflammation, the walls surrounding the skin pores break down, forming papules. However, this causes the pores to become sensitive to the touch, complex, and congested. Usually, the skin around these pores has a pink tint. Blemishes typically have a size of less than a centimetre.

Pustules

Pustules arise from the breakdown of the walls that surround your pores. The main difference between pustules and papules is that the papules are stuffed with pus, while pustules are not. These pimples usually are red and frequently protrude from the skin. However, their heads are frequently yellow or white. Although they may happen on the back and chest, this pimple is commonly found on the face.

Nodules

A nodule is an abnormal tissue that builds below the skin's surface. It forms when clogged or swollen pores become troublesome. However, these nodules are deeper under the skin than papules and pustules. This form of acne cannot be treated just by following home remedies; it demands proper and careful medical treatment. With the help of medical treatment, the size of the oil glands within the pores decreases.  

Cysts

A severe type of acne, cystic acne, develops when bacteria, dead skin cells, and sebum block skin pores. These clogs build more below the skin's surface than nodules. This pimple makes large, red, or white bumps that are painful to touch. However, the big type of acne, cysts, are mainly the result of a serious condition. Moreover, this type of acne can cause a scar as well.

Types of Acne Scars

Acne scars can be categorised into multiple types depending on the underlying skin damage and appearance. The main types of acne scars are atrophic, hypertrophic, and post-inflammatory hyperpigmentation scars.

Atrophic Scars

The most common type of acne scars are atrophic scars, which are caused by a loss of tissue that leaves the skin with pits or depressions. Among them are:

Boxcar Scars

These are broad, rectangular depressions with well-defined borders. They usually appear on the cheeks and temples and are caused by collagen breakdown.

How to Treat Boxcar Scars

1. Dermal Fillers: Fillers can be placed into the depressed area to elevate the skin's surface and reduce the visibility of scars.
2. Chemical Peels: By removing the outermost layers of skin with a chemical solution, scars may become less noticeable and new skin can be allowed to develop.
3. Microneedling: This treatment stimulates the formation of collagen and enhances the texture of the skin by puncturing it with tiny needles.
4. Laser Therapy: Boxcar scars can be filled in using fractional laser treatments, which smooth out the skin and increase the production of collagen.

Ice Pick Scars

These are deep and narrow scars that extend into the dermis region. However, they appear due to severe acne that damages the skin tissue, leaving deep and small holes.

How to Treat Ice Pick Scars

1. Punch Excision is a type of surgical process in which the scar is removed and the wound is closed with stitches or a skin graft.
2. TCA Cross: It is performed by applying a high concentration of trichloroacetic acid (TCA) into the scar which helps stimulate collagen production and decreases the scar depth.
3. Microneedling: This can also assist by fostering collagen production, although it is mainly used with other skin treatments for better outcomes.

Rolling Scars

These are wide depressions with sloping edges that give the skin a wavy texture. They grow when fibrous bands of tissue build up between the skin and the underlying tissue, eventually pulling the skin down.

How to Treat Rolling Scars

1. Subcision: It is a kind of minor surgical process in which a needle is inserted into the skin to break up the fibrous bands, pulling the skin down.
2. Microneedling: By promoting collagen production, this technique can assist in reducing the appearance of rolling scars.
3. Laser Therapy: This therapy can resurface the skin and boost collagen production to lessen the visibility of rolling scars.

Hypertrophic and Keloid Scars

Hypertrophic scars are thick, elevated scars that stay inside the original wound's boundaries, whereas keloid scars spread beyond them. Nevertheless, the root cause of both is excess collagen production during healing.

How to Treat Hypertrophic and Keloid Scars

1. Steroid Injections: This procedure involves inserting corticosteroids, which can lessen the inflammation and remove the keloid and hypertrophic scars on the skin.
2. Silicone Sheets: Silicone sheets are used here for the scar and can help soften and flatten it over time.
3. Laser Therapy: This is the pulsed dye laser treatment that can lessen redness and flatten the scars.
4. Cryotherapy: In this case, the scar tissue is frozen with liquid nitrogen that can lessen its size, which is mainly effective for keloid scars.

Post-inflammatory Hyperpigmentation

Post-inflammatory hyperpigmentation (PIH) is a condition of skin darkening where acne lesions have healed rather than a real scar. When the skin produces excessive melanin in reaction to inflammation, it arises.

How to Treat Post-inflammatory Hyperpigmentation

1. Topical Treatments: Products containing ingredients like retinoids, vitamin C, or hydroquinone can help lighten dark spots and even skin tone. 
2. Chemical Peels: These are performed by removing the outermost layers of the skin, which can foster the growth of new skin and lessen pigmentation.
3. Laser Therapy: Excessive melanin can be broken down, and skin tone can be enhanced with targeted laser treatments.
4. Sun Protection: Applying sunscreen daily is crucial for protecting the skin from UV rays and preventing the darkening of PIH spots.

Even though there are multiple treatments for acne scars, seeking treatment from a medical specialist like Dr. Batra is crucial to choosing the right plan of action, given your unique skin type and degree of scarring. In addition to giving access to professional therapies that might not be available over the counter, a dermatologist may provide tailored guidance.

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