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Acne scarring

Scars can be a complication of some types of acne spots bursting and damaging the skin or from picking or squeezing spots.

There are three main types of acne scar, some more noticeable than others.

  • Ice-pick scars are deep puncture holes in the surface of the skin.
  • Rolling scars are caused by bands of scar tissue under the surface of the skin, making the skin appear rucked and uneven.
  • Boxcar scars appear as craters in the skin and are round or oval in shape.

Scars can differ in pigmentation, depending on a person's skin colour and tone.

What causes acne scarring?

When the skin is damaged from a spot bursting or being picked or squeezed, the body produces extra collagen - a protein fibre normally found in the second layer of the skin - as part of the healing process. The greater the damage, the more collagen is produced. Picking and squeezing leads to further inflammation and subsequent damage, so collagen is over-produced in response and this makes scarring more prominent.

What makes scarring worse?

Some people believe that applying vitamin E creams to the skin aids healing, but some studies have suggested the reverse is true. Some independent research carried out to ascertain the effect of vitamin E applied topically to post-surgical scars and burns found no significant differences between the results in patients using vitamin E and the control groups. In some cases, those using vitamin E had experienced other resultant skin problems, including contact dermatitis.

Another common belief is that sun exposure promotes healing. In fact, the ultraviolet rays from the sun encourage pigment production, so the skin may become more discoloured. Sun exposure can also delay healing.

Treating acne scars

Special camouflage make-up is available from pharmacies to help cover-up scars, including acne scars on the face.

Cosmetic procedures are available to treat or reduce the signs of acne scars, but these are unlikely to be available on the NHS unless the person is suffering psychological distress from the acne scars.

Talk to your GP before considering cosmetic surgery. Private treatment can be expensive and it is important to understand what results may or may not be possible.

The appearance of acne scars may result in a 50% to 75% improvement after some cosmetic procedures, but everyone's circumstances and likely results will be different.

Treatments include:

Dermabrasion

This procedure involves removing the top layer of skin with a specifically designed wire brush or by the use of lasers. Skin is left looking and feeling sore for a matter of months. There should, however, be an improvement in the appearance of the skin after this time.

Laser treatment

Ablative and non-ablative laser treatment may help with mild to moderate acne scarring.

Ablative laser treatment removes a patch of skin around the scarred area.

Non-ablative laser treatment stimulates growth of new collagen to help repair skin damage.

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