Types of acne scars

Types of acne scars


Wound healing leads to formation of granulation tissue, which includes blood vessels, fibroblasts and collagen. Over time the granulation tissue transforms into a well healed scar. In a scar we see mostly collagen and only few blood vessels, fibroblast left. The first collagen laid down by fibroblasts is T-III collagen, over time it changes into type I, which is strongest type of collagen. So scars consist of mostly collagen. Prolonged chronic course of acne may result of various types of scars, however, atrophic scars are most frequent sequela of acne vulgaris.

Keloid and hypertrophic scars, when wound healing gone stray:

Hypertrophic scars are characterized by an accumulation of myofibroblasts expressing smooth muscle actin and thin, randomly organized, collagen fibres, both usually arranged in nodules. Chronic inflammation in the dermis has been explained as primary mechanism by which hypertrophic scars are formed. In keloids myofibroblasts, expressing smooth muscle actin, are usually absent, the cellularity is less marked and the collagen bundles are thicker than in hypertrophic scars.

Hypertrophic scars

These types of acne scars are very protubering and raised, excessive production of granulation tissue, genetic factors are involved. Hypertrophic scars are raised, firm, erythematous scars formed as the result of overzealous collagen synthesis coupled with limited collagen lysis during the remodeling phase of wound healing. The result is the formation of thick, hyalinized collagen bundles consisting of fibroblasts and fibrocytes. Despite the obvious tissue proliferation, they tend to stay in their own boundaries and are limited to the borders of the initial injury.

A Keloid

This type of hypertrophic scar has a genetic predisposition, more common in african-american population. Keloids tend to occur in earlobe, along the neck, the face and sometimes forearms as well. They can often produce this large masses of collagen. if you do a biopsy through this mass, you would see it’s a scar, it’s mostly pink collagen, large bundles of T-3 collagen. In a keloid scar wound healing has gone stray. Why? Because in normal wound healing it starts with collagen T-III and overtime it should mature to type I. In a keloid wound healing starts with T-III collagen and for many years it remains collagen III. Unlike a hypertrophic scar, keloids extend beyond wound margins and do not regress over time. They are also firmer than a hypertrophic scar. Keloids present as smooth, firm, irregularly shaped lesions. Keloids exhibit a prolonged, proliferative phase resulting in the appearance of thick hyalinized collagen bundles similar to those produced by hypertrophic scars, but extend beyond the margins of the inciting wound and do not regress over time. Although they can be seen in all skin types, keloids tend to appear most frequently in patients with darker skin tones and are related to an inherited metabolic alteration in collagen. Treatment of hypertrophic scars and keloids is feasible using co2 and YAG laser. Indeed they are the best scar candidate for laser scar removal

Atrophic facial scars, acne scars

Atrophic type is characterized by dermal depressions most commonly caused by collagen destruction during the course of an inflammatory skin disease such as cystic acne or varicella. Scarring after inflammatory or nodulocystic acne can manifest as atrophic, saucerized, ice pick, or boxcar scars. Treatment of these types of acne scars involves certain considerations. While ice pick and boxcar scars respond best to dermal filler augmentation or punch excision, these types of scarring, atrophic scars, usually respond well to laser resurfacing. Papular acne scars have been recently added to the classification of acne scars as 3 to 4 mm skin-colored papules which commonly misdiagnosed as acne and do not respond to any type of treatment for acne vulgaris. Papular scars show dermal fibrosis in histology.

Macules or “pseudo- scar”

See below, hyperpigmented skin and its treatment

Post-inflammatory pigmentation

See below, hyperpigmented skin and its treatment

Striae distensae

Striae, or stretch marks, are linear bands of atrophic or wrinkled skin. These horizontal bands appear whiter than the surrounding skin. Formation of stretch marks may be the result of rapid weight loss or weight gain in areas that are excessively stretched. So they are more commonly seen in breasts, abdomen, thighs and joint areas. Dermal inflammation and dilated capillaries mark the initial presentation, which results in an erythematous appearance with characteristic pink, lavender, and purple hues. Later, stretch marks appear hypopigmented and fibrotic. Pathogenesis remains unclear, although estrogen and mast cell degranulation with elastolysis may be contributing factors. The dermis seems to be looser and more flocculant. They also show an increase in glycosaminogylcan content.

Removal techniques

Initiating treatment before the scarring process is complete is the best mode for treatment of striae. Considering the fact that more than 90% of pregnant women develop stretch marks, it would be wise to consider a preventive treatment before the pregnancy ends. Combination of 20% glycolic acid and 10% ascorbic acid in two separate preparations seems to be as promising as application of 0.05 Retinoic acid and glycolic acid regimen. The result could persist one year after discontinuation of therapy. Laser is another modality to treat stretch marks. Treatment with pulsed dye laser shows significant improvement. This is associated with increase in dermal elastin and could be attributed to the observed improvement.

Even-tone your skin and treat pigmentation spots using potent anti aging serums

Types of acne scars are of paramount importance in determining appropriate treatment so diagnosis of types of acne scars before initiating treatment is critical. At-home regimen using high potency serums may result in an effective elimination of skin hyperpigmentation and discolorations, pigmentation spots and acne spots using gradual skin resurfacing.

This method even tones the skin using high potency serums. Even though impact of this evidence based skin care in comedones treatment has been associated with favorable outcomes, these scar treatment products have been bioengineered primarily for elimination of acne scars through skin resufacing and dermal repair.

This regimen for removal of hyperpigmentations and acne spots even tone your skin in less than two weeks and provides a radiant appearance to the skin. Resurfacing serum works on the surface of the skin, epidermis, as well as deep within the dermis layer. It benefits from retexturizing properties of different renewal agents such as retinol, AHAs and BHA’s for skin reconstruction.

Acne scar serum also provides the skin with the nutrients it needs the most to make up for lost nutrients while the epidermis involves with rigorous skin renewal. The result is a new skin, where skin scarring is hardly recognizable because overall smoothness of the skin overwhelms the gradually-disappearing scars. Our motto is, “we don not promise miracles, yet we do promise results”.

Skin resurfacing treatment changes the overall appearance of your skin from tone and texture to resiliency and smoothness. The skin becomes noticeably smoother and younger, while the appearance of scars diminishes. General smoothness of your skin undermines the gradually disappearing scars. Stimulation of connective tissue fibers’ synthesis in dermis layer is another target of these serums to correct hyperpigmented skin.

This kit helps to increase epidermal subeipedermal microcirculation and stimulation of collagen remodeling, which is disrupted during scar formation. Please navigate through our site to become more familiar with the choices you have to treat skin scars.