Acne Scarring

What Is Acne Scarring?

Acne scarring is a very common skin condition; often developing as a complication of acne, most commonly affecting those with cystic acne or inflamed/infected blemishes. Around 80% of people between the ages of 11 and 30 will experience acne (though many people also experience acne before or after these ages), and one out of five of those people will develop scars, which can appear in various forms.

Symptoms

The symptoms of acne scarring include:

Post Inflammatory Hyperpigmentation (PIH) – dark spots or discolouration left on the skin after a blemish heals, resulting from an overproduction of melanin during the skin’s healing process.
Atrophic scars – The most common type of acne scars that appear as indentations or depression in the skin as tissue has been lost
- Ice Pick Scars – small, deep pits that resemble punctures from a sharp object
- Rolling Scars – broad depression with sloping edges, giving the skin a wave-like appearance
- Boxcar Scars – round or oval depression with sharp, defined edges, often appearing on lower cheeks and jaw
Hypertrophic scars – Raised scars that remain within the boundary of the original acne lesion. Some people may also experience keloid scars, that are raised, firm scar tissue that grows beyond the original site of the blemish. They are more common in individuals with darker skin tones and can be itchy or painful.
Skin texture changes – Uneven and rough skin texture caused by the combination of vafrious types of scars and pigmentation.
Post Inflammatory Erythema – Red or pink marks that are remnants of inflammation in the skin and usually indicate the skin is still delicate and vulnerable despite the surface having healed from the blemish.

Causes

Causes of Acne:

Any type of acne or blemish can lead to scarring, but it’s more common when the spot is very inflamed and large, like a pustule, nodule or cyst. This deep inflammation can destroy skin tissue and lead to scarring as the skin tries to heal.
Scarring is also more common when you pick or squeeze spots, so it’s important to avoid deepening any inflammation during a breakout by leaving them alone- however tempting it is to try and reduce the appearance of a head on a spot!
A family history of acne scarring can increase the likelihood that an individual will develop scars. Genetics can influence how your skin responds to acne and heals after inflammation.
Using the wrong type or inadequate skincare products can further inflammation in the skin, increasing the chances of scarring. Also, not protecting the skin effectively with sunscreen can worsen symptoms such as PIH.
Hormonal fluctuations, particularly during puberty, pregnancy, or conditions like PCOS, can increase oil production in the skin, leading to more severe acne and a higher risk of scarring.
People with certain skin types may be more prone to scarring. For instance, lighter skin tones are more likely to experience PIE, whilst darker skin tones are more prone to hypertrophic scarring and PIH.
External factors, such as diet, stress, and environmental factors (such as pollution/humidity) can aggravate acne symptoms can impair the body’s natural healing process, leading to more or longer lasting inflammation, and therefore a higher chance of scarring.