Acne occurs when the follicle becomes inflamed and ruptures, resulting in the formation of an abscess in the surrounding area. This skin injury initiates a series of biochemical and immunoinflammatory reactions, which ultimately lead to the restructuring of extracellular matrices. Nodular and cystic acne are particularly prone to causing scarring.
Atrophic scars (or depressed scars) develop when an imbalance in biochemical processes causes more inhibition than formation of extracellular matrix metalloproteinases (MMPs), leading to a net loss of collagen. Atrophic scars are twice as common as hypertrophic scars and keloids.
Hypertrophic and Keloid scars develop when excess collagen deposits in the skin.
Hypertrophic scars are typically raised, firm, with thick bundles of hyalinized collagen lodged within the original site of the inflammation (or pimple).
Keloids form as small reddish-purple lumps proliferating well beyond the confines of the original injury.
Preventing acne is the first step in avoiding post-acne scars. The next best step is to reduce the duration and severity of inflamed acne as much as possible. Once pimples appear, seek treatment early to avoid aggravating the condition further as it can cause more scarring. As a stop-gap measure for emergencies, your doctor may inject steroids into severely inflamed pimples, which rapidly reduce swelling, limit blood flow feeding scar tissue and inhibit keratin proliferation.
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Acids can exfoliate keratin and trigger new collagen production. Chemical Peels such as 50% TCA peels initiate keratocoagulation and can give significant results for both shallow boxcar and deep icepick scars. While pyruvic acid is known to be effective for moderate scars.
HA fillers can augment indented scar tissue and restore volume to the face where collagen fibres have degenerated with inflammatory damage. These are most effective for deep pitted scars which may not respond well to ablative fractional laser treatment alone.
It is best to seek the advice of an experienced aesthetic doctor to decide on the right acne scar treatment for your skin. At VIDASKIN, we have a diagnostic VISA analysis machine for assessing your skin and a myriad of options to select from when it comes to treating acne scars.