Acne Scars

Acne scars are permanent marks that can remain on the skin after acne has healed. Acne itself is a skin condition where sebaceous glands become clogged and inflamed, leading to various skin changes such as red pimples, blackheads, and cystic lesions. Acne scars form when inflammation penetrates deeper into the skin, damaging the tissue and disrupting its natural healing process. Although acne is most common among teenagers and young adults, it can persist into adulthood, especially due to hormonal changes such as pregnancy or menopause.

Acne scars are not just a cosmetic issue: they can also significantly impact mental well-being. Scar treatment is an essential part of comprehensive acne care, as timely and effective treatment can prevent worsening scarring and support faster skin recovery. Cystic acne, which is a particularly deep and inflammatory form of acne, is especially prone to scarring. Similarly, hormonal acne can also lead to more severe acne scars.

What Causes Acne Scars?

Acne scars develop when the inflammation and skin damage caused by acne heal unevenly. When an acne lesion is severe and penetrates deeply into the skin, it can damage the tissue and lead to the formation of scar tissue. The scarring process can take time and is influenced by several factors, including genetics, the skin’s healing capacity, and the severity of inflammation during acne.

Severe forms of acne, such as cystic acne and hormonal acne, are especially likely to cause deeper and more permanent scars. Cystic acne is a painful, deep, and widespread inflammation that can cause significant tissue damage. Hormonal fluctuations, particularly during puberty, pregnancy, or menopause, can also increase the risk of acne and scarring. For example, women may experience hormonal changes during their menstrual cycle, pregnancy, or menopause that can increase sebum production and make the skin more prone to acne.

Environmental factors and lifestyle habits can also contribute to acne scarring. Stress, poor diet, and smoking may worsen acne and slow the healing of scarred skin. Certain medications, such as corticosteroids, may increase the risk of scarring by weakening the skin’s natural healing ability. Improper skin care practices, like aggressive cleansing or squeezing pimples, can also damage the skin and promote scarring.

Acne scarring is the result of many contributing factors, and preventing it requires a comprehensive approach to acne treatment.

Types and Stages of Acne Scars

Acne scars can appear in different forms and levels of severity, depending on the intensity of the inflammation and how well the skin has been able to heal. The most common types of acne scars are atrophic and hypertrophic scars.

Atrophic scars are the most common type of acne scars and develop when the skin does not produce enough collagen to properly repair the damage. This results in visible dents or indentations in the skin. There are three main types of atrophic scars: ice pick scars, which are small and deep; boxcar scars, which are angular and shallower; and rolling scars, which are rounded and more superficial. Treating these types of scars can be challenging, but with the right methods that stimulate skin regeneration, they can gradually improve over time.

Hypertrophic scars, also known as raised scars, form when the skin produces excess collagen during the healing process. This overproduction can result in thick, red, or pale scars that are visibly elevated from the skin’s surface. Hypertrophic scars can remain noticeable for a long time and may even spread beyond the area of the original acne inflammation. Keloid scars are a specific type of hypertrophic scar; they can be large, thick, and often extend well beyond the initial site of the skin injury. Keloids are particularly challenging to treat and typically require specialized care.

Scar formation usually begins as acne starts to heal, but damaged skin does not always recover evenly. The first phase involves the acute inflammation caused by acne, which damages the skin tissue. As the inflammation subsides, the skin initiates its repair process, but the scarring phase is often long and complex. Scar formation can take months or even years, and during this period, dark or light marks may persist on the skin.

How Can Acne Scars Be Treated?

Treating acne is an essential part of preventing and reducing acne scars. Properly managed acne can help stop scarring and minimize long-term effects. However, if acne scars have already developed, they can still be improved with various treatment methods that enhance the skin’s appearance and stimulate its regeneration:

• EXION Clear RF: Reduces acne scars by delivering RF energy through microablation to the skin's surface layer, removing damaged tissue and triggering the skin’s natural regeneration process for a smoother texture.
• EXION Fractional RF: RF microneedling combines microneedles with radiofrequency energy to stimulate collagen production and improve skin texture. It helps to reduce pore size and smooth out the skin.
• Dermal Fillers: Fillers can help treat acne scars by plumping up depressions in the skin from within, making the surface appear smoother and more even immediately after the treatment.
• PRP & PRP with Hyaluronic Acid: PRP therapy uses the patient’s own blood plasma, rich in growth factors, to stimulate skin renewal, boost collagen production and improve firmness. When combined with hyaluronic acid, the treatment also delivers intense hydration, enhances elasticity and texture, smooths out scars and gives the skin a healthier, more refined appearance.
• Mesotherapy & Biorevitalization: These treatments deliver rejuvenating, brightening, and deeply hydrating active ingredients including pure hyaluronic acid, directly into the skin. They stimulate cell renewal, activate the skin’s natural regeneration process, improve texture and elasticity, and gradually smooth out acne scars over time.
• Botox: Botox treatment can significantly soften the appearance of post-acne scars located in facial expression-active areas, such as the forehead, between the eyebrows, or on the chin. By relaxing the surrounding muscles, Botox reduces skin tension, helping to make atrophic or hypertrophic scars less noticeable.
• Laser Treatments: Laser therapy targets deeper skin layers to improve scar appearance, reduce visibility, and promote smoother skin.
• Chemical Peels: Chemical peels use blends of acids and enzymes to exfoliate the skin’s surface and stimulate collagen production, helping to renew skin texture. This is an auxiliary method, effective for post-acne pigmentation.
• AHA and BHA Products: Skincare products containing alpha hydroxy acids (AHA) and beta hydroxy acids (BHA) help exfoliate the skin, lighten dark spots, and reduce uneven skin texture. These products work well for post-acne pigmentation and are recommended as part of a home care routine.