What Causes Acne Scarring Anyway?

Acne scars result from skin damage caused by healed acne wounds. The types of acne scars are as varied as the types of acne lesions. This variety arises because of the multiplicity of ways an acne lesion can form.

For example, an acne eruption may originate deep within the fatty tissue of the skin as the in the case of cysts or nodules.

Then again, the acne mark may form just beneath the epidermis as a result of pore irritation as in the case of the comedone. A non-inflamed closed comedone is a pore blocked by excess oils, keratin and/or skin cells.

Because excess bacteria and free fatty acids irritate the pore, the proceeding localized inflammatory response causes the pore to expand.

However, once the inflammation is removed, the acne lesion can begin the healing process.

The origin of the acne lesion within the skin will impact if and how an acne scar forms.

Another factor that shapes the development of an acne scar is how the lesion was treated. If an acne patient prematurely “pops” or opens and acne lesion, this could result in acne scarring.

Types of acne scars

In November of 1999, the British Journal of Dermatology published a study on the effectiveness of laser resurfacing to treat acne scars. During the investigation, the designers defined two types of acne scars, atrophic (“ice-pick”) scars and raised acne scars. Additionally, acne patients may experience a third type of acne scar– flat, pigmented marks.

Atrophic (“Ice-pick”) Acne Scars

Atrophic acne scars appear as round indented marks in the skin. Their size can range from 0.254mm to 2.540mm in diameter. The dept of an atrophic acne scar can vary between 0.254mm to 0.762mm.

According to review of acne scar pathology Greg J. Goodman published in the 2001 edition of the Australian Journal of Dermatology, the skin indentations associated with atrophic acne scars typically results from the contraction of the skin’s surface layers.

The depth and width of an atrophic acne scar is influenced by the loss of collagen, and sometimes fat loss, that results from the healed acne lesion.

Raised Acne Scars

Raised acne scars or keloid scars are less common than “ice-pick” type acne scarring.

Pigment Acne Scars

A number of acne lesions can form, or move, to the surface of the skin. Such lesions include blackheads and pustules (pus-filled acne lesion on the surface of the skin). Due the unwanted presence of such blemishes on the face, acne patients are tempted to burst or squeeze such skin imperfections prematurely.

Since these acne lesions are closer to the upper layer of the skin than deep acne lesions like cysts, pustules and blackheads generally do no leave indented acne scars.

This is because their anti-inflammatory healing process involves less collagen repair and little if any fat loss.

Nevertheless, because acne lesions like pustules and blackheads are on the surface of the skin, their repair can involve the build-up of skin scales to repair the opened wound. The build-up of skin cells concentrates the brown skin pigment melanin, which creates the circular, darker toned scars where the acne lesion once resided.

Given that the skin is designed to repair itself, not all acne lesions are doomed to result in acne scarring.

Allowing your body time to remove pore inflammation and expel cellular waste emitted by acne lesions create an optimal environment for a scar-less healing of your acne marks.

So, the next time you have an acne lesion, before you do anything crazy like pop it or squeeze it, ask yourself, “If I do this now, am I going to give myself an acne scar?” Think about it.