What Are The Different Types of Acne Scars?

Acne scars are visible reminders of injury and tissue repair. It occurs when the tissue suffers an injury, the white blood cells and an array of inflammatory molecules rush to the injured tissue site to help heal the damaged tissue and fight infection. This results in the formation of a fibrous scar tissue or eroded tissue. There are ‘pseudo-scars’ that would eventually disappear, these are macules which after the acne heals appears as a reddish spot and ‘post-inflammatory hyperpigmentation’, a darkening of the skin at the site of a healing acne lesion and common in African-American/blacks, Asian and Latino populations. These pseudo-scars (which are not true scars) are usually temporary lasting between 6-18 months.

There are basically two types of scars defined by tissue response to inflammation. They are
A. Scars that are caused by increased tissue formation : These scars are usually called Keloids or Hypertrophic (meaning enlargement) scars. These scars are formed due to the production of excess collagen which is a response of the skin cells to injury. This response causes the excess collagen to become piled up in fibrous masses. They are seen most frequently along the jawline, back and chest. They found primarily in African-Americans, Asian and Latino. A typical keloid or hypertrophic scar is 1 to 2 millimeters in diameter but may be 1 centimeter or larger. These scars appear firm and shiny and may persist for years, but may also diminish in size over time.

B. Scars caused by loss of tissue : These scars are similar to scars that result from chicken pox. They are more common than keloids and hypertrophic scars. They take many forms which include:
1. Ice-pick scars : Is mostly found on the cheek. They are usually small, shallow or deep, have a jagged edge and steep sides and may be hard or soft. The soft scars may be improved by stretching and are soft to touch (like the name suggests) but the hard ones are difficult to treat.

2.Depressed fibrotic scars: Ice-pick scars may evolve into depressed fibrotic scars, they are quite large, have steep sides and sharp edges. The bases of the scars are usually firm to touch.

3. Soft scars (superficial or deep): They are soft to touch, have gentle sloping rolled edges that merge with the surrounding skin, are small and may be circular or linear in shape.

4. Atrophic macules: are more common in Caucasians and are usually soft with a slightly wrinkled base. They are small when they occur on the face but may be larger when they occur elsewhere on the body. They may appear bluish or purplish due to the blood vessels that lie below the surface of the scar and may fade over time.

5. Follicular macular atrophy: Is more likely to occur on your back or chest due to an acne present there. They are small, white, soft lesions that resemble whiteheads and may persist for months to years.

Note that the best way to prevent acne scars or spots is to effectively treat and prevent your acne. It is important to get an effective acne treatment and stick to your regimen even after your acne goes away. Sticking to your regimen would take care of your old acne and prevent new ones.