If you have a superficial injury that only scratches the epidermis, then you usually will not scar. However, once the dermis is damaged, the skin begins to scar. Scarring is the body’s way of addressing this type of injury.
Acne scars are frustrating and difficult to treat. Acne scars happen when the acne lesion becomes inflamed, usually after an acne cyst has formed. This happens when a hair follicle or a pore becomes full of dead skin, bacteria, and excess oil.
As the bacteria and oil lead to swelling, the follicle wall breaks. When this lesion takes place deep in the follicle wall, the infected material damages the dermis, destroying the healthy skin tissue around it.
This is when the body’s repair system kicks into action. It tries to repair the damage that the acne caused to the dermis by encouraging the body to build more collagen. Unfortunately, as the body quickly tries to repair the damage, the repair job is not as attractive or as flawless as the area was before the injury.
Think of it like dropping a glass vase. You can grab all of the pieces and glue the vase back together, but the repair job will never look as good as the original.
In an attempt to repair itself too quickly, the body sometimes produces excessive amounts of collagen. This leads to raised scars on your skin. This is referred to as hypertrophic or keloid scarring.
Another type of acne scar is atrophic or depressed scars. This happens when the damage caused by the acne leads to a loss of tissue. One of the best ways to observe the severity of acne scars is by looking at the inflammation. The more inflammation, the more severe the scarring may be.
If you have very deep acne breakouts that do not heal quickly, it is likely that you will have some form of scarring. Simple blackheads or whiteheads do not usually cause scarring, because they do not injure the dermis.
Sometimes patients have what looks like acne scarring but is actually hyperpigmentation. This is a discoloration of the skin caused by the acne, but it is not really a scar. Over the course of a few months or a couple of years, the hyperpigmentation will dissipate on its own.
Of course, just knowing why acne scars happen does very little to minimize the trauma that they cause. Thankfully, there are many procedures available that are specifically designed to treat and reverse the effects of acne scarring. The Dermatology, Laser, and Vein Center offers many of these procedures. Schedule a consultation with our office in Cincinnati to discuss your options and discover which course of action is best for you.