Kinds of acne scars – and how to heal them

acne scar healing

About 15% of people have post-acne scars after treating acne. Wondering what kind of scars you have, and how you should treat them? You’re in the right place! 

Brown or pink scars generally don’t change the texture of the skin. Then there’s what’s called “real acne scars,” which DO change the texture of the skin. Real scars look like small holes or depressions in the skin.

Treatment of brown spots is usually pretty easy. You can start with over-the-counter whitening creams containing kojic acid or arbutin. For more resistant brown spots, it’s possible to add prescription-grade whitening cream with hydroquinone, superficial peels or intense pulse light treatments — for any of those, you’ll need to visit your dermatologist.
Pink post-acne spots are caused by the enlargement of microscopic capillaries — they usually fade two to three months after your acne is controlled. If you wanna fade them faster, a couple of IPL (Intense pulsed light) or laser treatments will do the job.

Real acne scars are the hardest to treat. But there’s hope — a new technology shows promise. This technology, called microneedle radiofrequency, uses extra sharp gold-plated needles to heat the deep part of the skin. This heat promotes a natural healing process of the skin that builds new collagen and decreases the depth of the scars.
There are five main types of real acne scars: Hypertrophic acne scars (Elevated scars confined within the margins of an original pimple) and keloid acne scars (Elevated scars larger in size than the original pimple and commonly found on the chest, back, shoulders and ears. These scars are very persistent) are two types. 

Both hypertrophic scars and keloids have thicker, more abundant collagen that’s stretched and aligned in the same plane as the epidermis. Both have an incidence 5-to-15 times higher in African Americans and 3-to-5 times higher in Asians (Compared with Caucasians). It’s estimated they affect both the African American and Hispanic populations between 4.5% and 16%.
Another kind of real scar is called an icepick scar. These are smaller in diameter (1-2 mm) and deep with tracks to the dermis or subcutaneous tissue possible. Although the surface opening is smaller and steep-sided, there may be a wide base that could later evolve into depressed or boxcar scars. Icepick scars are commonly seen on cheeks. Depressed or boxcar scars are shallow (0.5 mm) or deep (0.5 mm) and often 1.5 to 4 mm in diameter. They have sharply-defined edges with steep, almost vertical walls. Shallow scar treatment can happen with resurfacing or possibly punch elevation, whereas deep scar treatment is often done by punch excision, elevation or other modality. Last, there are soft rolling scars. These can be circular or linear, are often greater than 4 mm in diameter and have gently sloped edges that merge with normal-appearing skin. Treatment is commonly by subcision.

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