Acne scarring occurs when the visible remnants of acne are permanently left on the skin after the acne itself subsides. True scarring is to be distinguished from macules, or reddish spots that mark the site of prior acne.
Acne scarring is caused by a variety of factors. When acne is produced on the skin as a response to sebum, the body may attempt to target the inflammation with white blood cells. Once the inflammation has subsided, however, the tissue may have yet to be fully repaired, and as such, scar tissue will show. It is important, however, to note that marks on the skin are not necessarily scars; simple marks will usually disappear within six months.
The types of acne scarring are twofold. They are:
Hypertrophic scarring, which results in a growth of tissue. Excess collagen is produced, and in severe cases, large outgrowths may result.
Atrophic scarring, which results in a loss of tissue. This type of scarring is much more common than hypertrophic scarring. There are several types:
Atrophic macules. These are small, bluish-whitish skin colorations, and are usually less visible than other types of scarring.
Depressed fibrotic scars. These are large, depressed valleys on the surface of the skin. They are usually jagged.
Follicular macular atrophy, or perifollicular elastolysis. This consists in small , slightly raised lesions, similar in appearance to whiteheads.
Ice-pick scars. These less severe versions of depressed fibrotic scars, and with time, they can in fact develop into them.
Soft scars. These are gentle, scar-like depressions in the skin. They are usually small, and either circular or linear.
Prevention and Treatment
Some people are more prone to acne scars than others. Acne scars should be treated early, with dermatological consultation, to reduce their visibility and size later in life.
Treatment is discussed under acne scar treatment.