The ABCs Of Acne Scars
Before we get too carried away with the ways of removing acne scars, we should know a bit more about them!
Even with the most vigilant skin care, acne scars can still happen.
Acne scars come in different types. Generally, acne scars can be divided into two categories: those caused by a loss of tissue (atrophic), and those caused by an excess of tissue (hypertrophic). Within these categories, acne scars fall into one of four types: ice pick, boxcar, rolling and keloid scars.
Ice Pick Scars
- Appearance: Ice pick scars are deep, very narrow scars that extend into the dermis (the second layer of your skin). They are called ice pick scars because the skin looks as though it was poked with an ice pick repeatedly (kinda nasty, we know). An ice pick scar is a small deep hole in the skin. Some may look like a large, open pore.
- Development: Deep rooted infection making its way to the surface cause ice pick scars. Skin tissue is destroyed, leaving a long column-like scar.
- Common treatments: Ice pick scars can be treated with punch excision or punch grafting.
Boxcar Scars
- Appearance: Boxcar scars are round or oval depressions with steep sides. Boxcar scars are wider than ice pick scars, but both are a deeper scar and cause the skin to look pitted.
- Development: If a breakout destroys collagen in the skin, tissue is lost. The skin over this area is left without support, and a depressed area is created. Boxcar scars may be superficial to severe, depending on the amount of tissue lost.
- Common treatments: Treatments for boxcar scars include punch excision or elevation, dermal fillers, and laser resurfacing.
Rolling Scars
- Appearance: Rolling scars have that name because they can look almost like waves rolling across the skin.
- Development: Rolling scars arise when fibrous bands of tissue develop between the skin and the subcutaneous tissue below. Those bands bind the outer skin to the deeper skin structures. It is this pulling of the epidermis from within that creates the rolling appearance of the skin.
- Common treatments: Rolling scars are best treated with subcision.
Hypertrophic or Keloid Scars
- Appearance: As you recall, hypertrophic is a way of saying “too much tissue”. Thus they look like a firm, raised mass. These types of scars often grow larger than the original wound. Hypertrophic scars caused by acne are most often found on the torso, especially in men.
- Development: These scars are not caused by A LOSS of tissue, like with a boxcar or ice pick scar. Rather, they develop because of an overproduction of collagen.
- Common treatments: Cortisone (steroid) ointments, tapes, or injections are used to smooth and reduce these scars. Interferon injections are also used to soften scar tissue.
There you go, now you know. “And knowing is half the battle”!