Acne Scars Types, Causes and Solution

The scars caused by enlarged or overgrown tissue are called keloids or hypertrophic scars. Both types of scars are caused by excessive amounts of collagen. Injured skin cells can respond by over producing collagen, which becomes piled up in fibrous masses. The scar is characteristically firm, smooth and irregularly shaped. Hypertrophic and keloid scars last for years, but may diminish in size over time.

Acne scars associated with loss of tissue similar to scars that result from chicken pox are more common than keloids and hypertrophic scars.

Ice pick scars usually occur on the cheek. They are usually small, with a somewhat jagged edge and steep sides like wounds from an ice pick. Ice-pick scars may be shallow or deep, may be hard or soft to the touch and too deep to correct with skin resurfacing treatments such as dermabrasion or laser resurfacing. With this type of scar, the dermatologist will do a “punch excision” and cut out the core of scar tissue with a biopsy punch needle and carefully stitch up the hole. Some physicians may do a punch graft at the same time the scar tissue is removed with the same biopsy punch needle. Then, a small graft of normal skin usually taken from behind the ear is transferred to fill in the cavity and then taped in place.

Boxcar scars are round to oval depressions that have sharp vertical edges. Unlike ice-pick scars they do not taper to a point at the base. For this type of scar, physicians use a technique called "punch elevation,” sometimes called a “punch float.” The scar tissue is elevated from the surrounding fat to level it with the surrounding tissue and taped or stitched in place.

Rolling scars occur when otherwise normal-appearing skin becomes “tethered” to the subcutaneous tissue below. This process gives the skin a rolling or undulating appearance. Conventional skin resurfacing techniques do not work on rolling scars. The fibrous bands under the skin must be broken up surgically.

Atrophic macules are usually fairly small when they occur on the face, but may be larger on the body. They are soft, often with a slightly wrinkled base, and may be bluish in appearance due to blood vessels lying just under the scar. Over time, these scars change from bluish to ivory white in color in white-skinned people, and become much less obvious.

Follicular macular atrophy is more likely to occur on the chest or back of a person with acne. These are small, white, soft lesions, often barely raised above the surface of the skin they almost look like whiteheads that never fully developed. The lesions may persist for months to years.

Acne scarring can be a minor annoyance or a lifelong concern. Prevention is best. If acne does leave its marks, however, there are many options available.

Articles on Acne Scarring:

• Acne Scars
• Remove Acne Scars