Acne Scars Removal - Comprehensive Guide for Today's Available Treatments

Acne Scar Removal - Can It Be Done?

About Acne

Acne is a skin disorder which is caused by plugged pores on the skin. Acne lesions arise through pilosebaceous units, which are made of sebaceous glands and hair follicles in the middle layer of skin called the dermis.

Pilosebaceous units are found all over the body except in the palms of hands and the bottoms of feet. That’s why we do not have body hair or oil glands in these places, and thus no acne.

Pilosebaceous units are the densest on the face, upper neck and the chest. The primary cause of acne is obstruction of pilosebaceous canal, which can take place due to various reasons.

The first and foremost reason for acne development is the overproduction of sebum, which clogs the pilosebaceous canal. Sebum production is affected by male hormones called androgens. That’s why any fluctuation in hormonal balance or stimulation of male hormones due to various reasons always leads to acne.

With excess sebum production, the cell lining of the follicle wall also starts to overproduce (Ductal hypercornification). These dead cells along with the extra amount of sebum plugs the canal and accumulates there.

Soon, the bacteria present on the skin surface, namely Propionibacterium acnes, invade these clogged ducts and attract white blood cells of the immune system. The infected area becomes inflamed due to the reaction between white blood cells and the bacteria.

The development of acne takes place over 2-3 weeks before it appears on the surface of the skin. It starts as a blemish in the sebaceous hair follicle. Deep within the hair follicle, two processes continually take place.

The produced sebum mixes with old, dying cells and gets excreted through the hair follicle pores. Old cells die so that new cells can be generated and skin can rejuvenate itself.

How Does Acne Develop In Our Skin

In normal circumstances, the dead cells that are shed gradually keep pace with the formation of new cells. This shedding of skin cells is different in different people. In some people, the skin sheds dead cells evenly.

In other cases the shedding of the skin becomes uneven and the dead cells accumulate in the follicles, thus effectively plugging the pore with sebum and bacteria.

Acne can be non-inflammatory or inflammatory. Non-inflammatory acne is the common form of acne called comedo. When a comedo’s pore is closed and the plug remains inside the skin, it is called a whitehead. These appear on the skin as small, whitish bumps.

When the pore is open and the plug pushes through the skin on the outer surface, it is called a blackhead. The opening of this blackhead appears dark in color not because of the accumulation of dirt, but due to the build up of pigment melanin.

Although these forms of acne are non-inflammatory, if these are not controlled, they may turn into inflammatory acne lesions which are red, swollen, and take time to heal. These are papules, pustules, nodules, cysts, maculae and scars.

Papules are red pimples or lesion. Pustules are just like papules but its center is filled with pus. Nodules are deep-seated acne which may take up to 8 weeks to heal.

Cysts are not a common type of acne but this is the most serious example of acne, which can reach up to several centimeters of diameter. Cystic acne is considered to be a severe form and needs immediate medical attention.

Acne can develop in different age groups of people. Infants to people in their 40s can suffer from acne, as it is largely linked with the hormonal imbalance. Infant acne develops because of the hormonal changes occurring in mother which pass through the placenta and affect the infant.

This acne can appear before birth or between 3 to 6 months. Baby boys are more likely to develop this acne than baby girls. Usually the infantile acne does not leave scars and gets healed naturally, but it also may develop in that person’s teen years as acne vulgaris.

There are some unusual forms of acne which develop due to different reasons other than those causing the normal acne (acne vulgaris). Acne Keloiddalis is one such form which is commonly found in people with strong, curly hair.

Interestingly, this kind of acne is caused by the hair itself which curls and penetrates the follicular wall. This leads to blockage of the follicle and obstruction of normal sebum secretion.

Because of this a fibrous tissue develops in the follicle with inflammation. This area often becomes infected and shows typical acne symptoms.

Acne Scarring

Acne is a difficult and unsightly problem. First it harms us by making our skin less than perfect, then adds insult to injury by leaving acne scars in its wake to remind us forever of our problem skin.

The problem begins within our skin as it naturally produces oil in our sebaceous gland. Acne-causing bacteria metabolize this oil and that metabolized oil is irritating to our skin.

As the skin becomes increasingly irritated by this oil our hair follicles will become plugged, thereby collecting debris. This debris then erupts down into the deeper layer of our skin, the dermis.

This debris is an intruder in the dermis, a foreign body, which doesn’t belong there. As a result our body attempts to get rid of this foreign body with an inflammatory response.

As our body struggles to remove this foreign debris with this inflammatory response, a wound in our skin is the result, and we end up with a scar. Acne scarring, like any other scarring, are the result of a wound in the skin, which then heals, leaving too much collagen behind.

Acne scars are primarily a cosmetic concern and do not worsen without treatment. However if active acne is present and no action is taken to correct it, there will be an increase in the severity and amount of acne scarring.

Example of Acne Scars

Types of Acne Scars

Ice Pick Scars

Ice pick scars are deep, narrow scars which form pits in the skin. They are among the most common.

Rolling Scars

Rolling scars create a wave-like appearance on the skin's surface due to their wide and shallow depth.

Boxcar Scars

As one might expect from their name, boxcar scars have angular, well-defined edges usually on the temples or cheeks. Their appearance is similar to chickenpox scars.

Hypertrophic / Keloid Scars

Hypertrophic scars are raised scars which stay within the boundary of the original wound and can reduce in size with the passage of time. Keloid scars, on the other hand, are overgrowths of tissue which expand beyond the original wound site. The scar is rubbery and firm and may itch. Often they form to be much larger than the original wound.

How To Prevent Scarring

The best way to prevent any acne scars from forming is to prevent more acne in the first place. Visit a dermatologist so they may evaluate your active acne and develop a course of treatment to prevent further outbreaks.

How Can Acne Scarring Be Treated?

Most of the time, those reddish or brownish acne marks that are left behind after a pimple eventually fade with no need for treatment. Picking or squeezing acne can increase the risk for scarring, though.

Depending on how severe the scars are, a doctor or dermatologist may suggest a chemical peel or microdermabrasion to help improve the appearance of scarred areas. These milder treatments can be done right in the office.

If you have serious scarring from previous bouts with acne, there are some things you can do. One form of treatment is laser resurfacing, which can be done in the doctor's or dermatologist's office.

The laser removes the damaged top layer of skin and tightens the middle layer, leaving skin smoother. This can take anywhere from a few minutes to an hour. The doctor will try to lessen any pain by first numbing the skin with local anesthesia. It usually takes between 3 and 10 days for the skin to heal completely.

Another method for treating acne scarring is dermabrasion, which uses a rotating wire brush or spinning diamond instrument to wear down the surface of the skin. As the skin heals, a new, smoother layer replaces the abraded skin. It may take a bit longer for skin to heal using dermabrasion — usually between 10 days and 3 weeks.

The newest form of treatment for acne scarring is called fractional laser therapy. This type of treatment works at a deeper level than laser resurfacing or dermabrasion, Because fractional laser therapy doesn't wound the top layer of tissue, healing time is shorter. Fractional laser therapy is quite costly, and it's not usually covered by insurance.

Sometimes doctors inject material under the scar to raise it to the level of normal skin. Finally, in some cases, a doctor may recommend surgery to remove deeply indented scars.

A person's acne will need to be under control before having any of these treatments. One thing you shouldn't do to deal with acne scars is load up your face with masks or fancy lotions — these won't help and may irritate your skin further, making the scars red and even more noticeable.

If you have a red or brownish mark on your face that you got from a bad zit, it should eventually fade, just like the scars on your knees from falling off your bike as a kid. However, it may take 12 months or longer — so your best bet is to avoid these kinds of marks by not squeezing or popping your zits, no matter how tempting it may seem.

Ways To Remove Scars

People often ask us about ways to remove acne scars. Getting rid of acne scars can be a challenge, even though there are many treatments that are supposed to do that very thing. Sorting through all the options can be confusing. We’ll tell you about the different treatments available and the pros and cons of each one.

Although there are many ways to remove acne scars, not every treatment is right for everyone. Some methods treat shallow scars while other treat deep scars. Some procedures are painful and most people would like to avoid the discomfort of those treatments. Multiple treatments may be required, and most people want to remove the scars as soon as possible. Expense can be an issue.

Lets now go over the different treatments for acne scar removal:

Dermabrasion

Dermabrasion involves removing the top layer of skin to reveal fresh, new skin underneath. The upper layer of skin is removed with a wire brush or rough diamond wheel. The wheel or bush is rotated quickly over the skin.

Dermabrasion works well for shallow acne scars. Getting rid of acne scars that are deep requires a different treatment. Many people prefer treatments other than dermabrasion.

Dermabrasion can be quite painful even though a local anesthetic is used during the procedure. It causes bleeding. It is expensive, and several treatments are often needed. The typical cost per treatment is about $1500.

Laser Treatments

Laser treatments for scars removal are another way of getting rid of acne scars. The laser moves over the affected skin and removes the top layer.

The results are similar to dermabrasion, except that it does not make the skin bleed. Skin is reddened and may appear crusty for a couple of weeks, however.

If you pick at the crusty skin, you’ll cause new scars. Laser treatments work best on shallow scars.

Laser treatments are more expensive than dermabrasion, and again multiple treatments are usually required. The procedure usually costs about $3000 per treatment.

Chemical Peels

In this way of getting rid of acne scars, a chemical solution is applied to the affected area of skin. Like dermabrasion and laser treatments, the goal is to remove the upper layer of skin. This procedure works best on shallow scars.

Chemical peels are less expensive than dermabrasion and laser treatments, but are still costly. The average cost is $750 per treatment, and multiple treatments are usually required.

Punch Techniques

Punch techniques are ways to remove acne scars that are deep. A punch tool, like the kind used to take a biopsy of the skin, is used to remove the scar. The wound must then be sutured, or a skin graft from elsewhere on the body can be fitted into the hole.

Many people prefer to avoid this treatment because it can be painful and it is very expensive (doctors usually charge about $50 per scar).

Other Ways to Remove Scars

There are other ways to remove acne scars. There are a number of over-the-counter remedies for scar removal, some more effective than others. Some are quite costly, but not as expensive as the procedures described above.

You might want to try an over-the-counter product before undergoing an expensive procedure. In addition to being more affordable, over-the-counter remedies generally do not irritate the skin the way those other procedures do. If you like, you can ask a dermatologist which product he or she recommends.