Acne scarring - Types of acne scars

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There are two different types of acne scars brought about by the tissue repair mechanism based on the level of tissue damage and inflammation.

Hypertrophic types of scars are characterized by raised thickened tissue with net increase in tissue formation on the skin. Atrophic types of scars are depressed areas of skin with loss of tissue.

Skin discoloration macules are formed When the acne is mild. If it is treated in the early formative stage it may leave behind reddish blemish, which may change in color to dark brown and then to whitish. This post inflammatory pigmentation blemish fades over time and may completely disappear in most of the cases. However if the zit is severe, if there is delay in starting of treatment or if the pimple is pinched or squeezed to repair the damage to tissue collagen bands may get formed causing scars, which may persist for years.

Hypertrophic types of acne scars

This cutaneous condition is characterized by increased tissue formation and raise in level. It is due to over production of collagen and its excess deposits during the healing process. Usually these types of blemishes confine to boundaries of the wounds and appear as bumps. These blemishes are usually found on the chest and back. This characteristic differentiates the normal hypertropic scars from keloids.

Keloid scars are formed in cases of severe pustules and are found to run in families. People of African origin have been found to be predisposed for developing keloids. Keloids can expand beyond the original pustule area and keep growing. Histologically, they are fibrotic benign tumors with excessive deposition of collagen, proteoglycans, fibronectin and elastin. Treating keloids is a challenge and when surgically removed, there is 50% chances of fresh keloid forming at surgery site.

Atropic types of scars

Atropic blemishes are more common and are as the result of loss of tissue during healing. Depending upon the appearance, they are further categorized into ice pick, boxcar and rolling types.

Ice-pick acne scars

As the name denotes, they look like ice-pick wounds. Usually they are small in diameter and are deep and narrow, having steep sides. Depending upon the severity of acne, they may extend into dermis. They are usually formed on cheeks.

Acne scars types

Boxcar scars

These boxcar acne scars are very similar to those of chickenpox. They are found usually on the cheeks and forehead. They appear like deep pits with vertical sides. Wider than ice-pick scars, they are oval or round depressions. Depending upon the amount of tissue lost and collagen deposited, they may be superficial or cause severe depression.

Rolling acne scars

These acne scars give the skin a wavy appearance with undulation. They usually involve interlinking many closely formed pustules. As the pustule heals, in some instances, fibrous collagen bands form between the cutaneous tissue and the underlying subcutaneous tissue. These bands pull the epidermal layer towards the subcutaneous tissue which results in the undulating appearance of skin.

Types of treatments

There are various types of treatments available for these scars depending upon the skin and acne condition. Very effective treatments are chemical peel, dermabrasion, augmentation, subcision, filler injections, laser resurfacing, cryotherapy and surgery.

To avoid all these types of acne scars from occurring it is advised to consult and take guidance from dermatologist for treatment at the earliest stage.

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