What causes Acne Scars to occur?

Most zits and pimples are usually just temporary and non-life threatening annoyances that can be dealt with using  the combination of a mild retinoid, touch of a concealer, salicylic acid and a bit of patience. So it's a bit frustrating that acne scars and marks from these healed pimples can linger for weeks, years or even decades long after the breakout has been dealt with and the painful/embarrassing memories have faded.

Fortunately, however, thanks to the advances and effort that modern science has put into developing scar remover technology, you don't have to resign to lugging around this burden for the rest of your life. There are plenty of skincare ingredients and professional dermatological procedures that can minimize the conspicuousness of acne scars, regardless of how wide, deep or old those bad boys are. So, we did some digging and unearthed some of the reasons why some of these exasperating acne scars show up at the least convenient time of our lives, as well as what you can do to treat them and minimize the probability of them reoccurring.

What Causes Body Acne Scars?

The big question here is, why do some people get acne scars and some do not, despite them also suffering repeated acne bouts? 

There are several reasons but, long story short, it all boils to your skin type, genetics and how your body's largest organ handles inflammatory acne.

Speaking of inflammation, it is usually traced back to

  • Untreated or poorly treated acne
  • Genetic predisposition and makeup
  • A habitual tendency to pick and squeeze blackheads and whiteheads using unwashed hands

Picking, popping and squeezing pimples, in particular, accounts for more than 80% of all mainstream acne scars. And these scars will often fall in one of the following categories

  • Keloid scars: They occur when your skin overproduces collagen in an attempt to heal wounds resulting from a breakout. It's not surprising then that they are usually characterized with a raised and lumpy appearance.
  • Boxcar scars: They often leave behind a broad and depressed imperfection on the skin.
  • Ice-pick scars: They are characterised with a linear and thin-looking depression.
  • Rolling scars: They occur when the skin heals with a wavy and an uneven contour after severe to moderate acne.

Why are Some People More Predisposed to Having Acne Scars or Clogged Pores?

Scarring of some people is, unfortunately, a genetic predisposition that they can do little about. They are families that tend to have a history of bad scarring and this hereditary nature of the scars is usually passed down genealogically. Keloid scarring and hyperpigmentation tend to be the biggest culprits of this kind of  genetic inheritance. Now you why keloids acne scars are mostly observed in people with darker skin tones than in fairer ones.

Hence, it goes without saying that if your immediate siblings or parents have a history of post-inflammatory hyperpigmentation or scarring, then you may want to be a little more cautious on how you handle acne bouts. It is also imperative that you should see a qualified dermatologist on how to treat acne scars that could crop up later in life.

Why Don't All Papule Acne Breakouts Scar?

There's no proven formula of knowing for sure whether or not the zit or papule on your chin will go away quietly or might linger around for years. So, why then do some blackheads scar and some barely leave any evidence after they are done tormenting you?

One of the factors behind this is the degree of inflammation. You see, for an acne scar to form, the skin often has to be inflamed significantly to the extent of drawing extra blood cells into the affected tissues. These cells, in turn, trigger an enzymatic response that involves pumping strands of collagen to the area to initiate the healing process.  At this juncture, if your collagen-producing mechanism runs smoothly, then your skin will not scar. However, sometimes a few collagen-inhibiting enzymes ( known as MMPI enzymes in dermatological circles ) will mess with the collagen production process which often leads to a scar formation.

Then there are certain types of breakouts that have a higher probability of ending up scarring your skin than others. Good examples are cystic acne and highly inflammatory pustular breakouts that tend to be almost always infected or take unbearingly long to heal. Comedonal pimples, on the other hand, especially when attended promptly with acne spot treatment remedies, are less likely to scar.

In short, avoid picking and squeezing your pimples when you have a blackhead or whitehead acne episode to avoid boosting your chances of ending up with a scar.

Beat the Acne System to Avoid Getting Scarred for Life

Just like old adage asserts – prevention is often better than cure – the ideal way to stop acne scarring is to keep your skin from breaking out in the first place. It's critical, therefore, to craft a good acne regimen if your skin has a tendency of breaking out to resolve the existing pimples whilst preventing new pimples from forming. It may sound quite simplistic or cliche' but you'd be surprised with how effective this is when it comes to minimizing one's overall risk of scarring.

Speaking of stopping acne, a good place to start is usually picking the right kind of cleansing and toning solution. Ideally, you want blemish-busting salicylic acid or benzoyl peroxide in its list of ingredients. Your acne scar removal attempts can also do with a touch of niacinamide and lactic acid too, both of which have proven to be quite effective artilleries of dealing with post-inflammatory scarring and hyperpigmentation. Additionally, normalise treating your zits with gentle but still potent acne skincare ingredients such as adapalene and retinol.

What's more, if your zits don't take a step back even after all your efforts using over-the-counter ( OTC ) skincare products, you'd want to talk to your dermatologist or physician about prescription-strength medications to get on top of things. And in such cases, retinoids, oral antibiotics, hormonal treatments or even birth control pills can come in handy. Nothing is usually off the table, not even spironolactone and accutane.

Now that we are talking about dermatologists, getting a well-timed cortisone injection at your esthetician's or skin specialists’ office is also another convenient way of flattening inflamed pimples. But, as you’d expect,  it is not without its own unique set of risks. If you, for instance, get a quick cortisone shot into an inflamed blackhead, there is always a chance of a long-standing depression or dimpling resulting from the shot.

The Basics of Treating Chin Acne Scars

So, now that you have learnt what these skin imperfections entail, the natural reaction would be; is it possible to completely get rid of acne scars? Well, with the aid of an excellent skincare routine and the valuable input of a dermatologist, the scars can disappear, become less conspicuous or fade entirely altogether. Here are some of the treatments that you can try.

1. Chemical Peels and Lymphatic Drainage 

If you have moderate or mild acne scarring, we would recommend visiting a derm or registered skincare professional for trichloroacetic ( TCA ) or glycolic peels. Glycolic peels, in particular, require no downtime to recover after what is otherwise an abrasive procedure. A series of these peels done weekly every eight to six weeks can result in visible and impressive improvement for most mild to moderate acne scarring.

That said, while peels can improve scarring in most skin tones, those with darker skins ought to proceed with utmost caution before considering adopting TCA peels due to the risk of developing post-inflammatory hyperpigmentation.

2. Fillers, Hyaluronic Acid and Retinization

Pitted acne scars, whether new or old, can be injected with composites such as hyaluronic acid fillers to smooth them out and give your complexion a chance to even itself out. Now, depending on the type and depth of the scars, there are several fillers that one can pursue including Restylane, Sculptra and Bellafill.

3. Microneedling: A Clearly Corrective Dark Spot Solution

Long-standing and deep acne scars ( often from breakout episodes from a while back ) can be dealt with using microneedling. The procedure is designed to boost the production of collagen by creating a series of tiny microscopic punctures on the scar tissue to stimulate collagen production. This, in return, gives your skin's surface a new lease of life thanks to the stimulated cell turnover.

In Closing

While acne scars can be a bit unsettling and normally take a toll on one's self-esteem, getting rid of them does not have to be an insurmountable challenge anymore.

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