Acne is one of most common skin disorders worldwide and affects millions of young individuals in the prime of their life. The majority of acne cases are usually mild and resolve on their own. However, some cases of acne do not resolve and get worse. In some individuals, severe acne is associated with the formation of acne scars. It is not known why some individuals get acne scars following healing and some don't.
In general, scarring tends to occur with the more severe acne. These scars are usually permanent and unattractive. The resulting acne scar sometimes is even worse looking that the acne and it is emotionally traumatic for the individuals. Acne scars are different in appearance and result because of either increased loss of tissue or increased tissue formation
Increased Tissue Formation
When scars result from increased tissue growth, this is what is known as keloids or hypertrophic scars; the skin has a mass of flesh growing in an irregular manner. This is very common in Blacks and Asians. Keloids usually result on the neck, arms and back. Keloids on the face are rare but do occur. Keloids do tend to run in families and individuals in these families should be aware of the condition. Keloids never resolve on their own and any attempt to treat them with surgery only worsens the condition.
Scars Resulting from Loss of Tissue
Sometime when acne resolves, there is a loss of tissue and this results in several types of scars such as:
Soft scars are not ugly looking but create a smooth defect in the skin. These small shallow scars may either be linear or oval in shape. Occasionally these soft scars fade with time but never completely disappear.
Ice-pick scars look like their namesake. They are the most common type of scars in acne sufferers. They may be superficial or deep but are usually small. When touched the superficial scars appear soft, whereas the deep scars have a hard feeling. The treatment of ice pick scars is difficult but the results can be pleasing.
Fibrotic scars usually occur after an episode of infectious acne; these large scars are very conspicuous and have a sharp edge with a steep incline. They are the most difficult to treat.
Atrophic macules are the soft flat spots and are quite common. They may vary in color from dark blue to black and are often surrounded by fine blood vessels. Macules are common when acne resolves and fortunately, the majority of macular scars also resolve with time.
Today there is treatment available for the majority of acne scars.