Do you know what are Types Of Acne Scars And How To Treat Them? Dr. Dhananjay Chavan answers some of your questions about different types of acne scarring, how to prevent acne scars, how to treat acne scars, etc.
00:32 - How Acne Scar Is Formed?
03:09 - Grades of Acne Scar
04:26 - How to Examine Your Acne Scar?
06:23 - Types of Acne Scar & Its Treatment
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Let us discuss the different types of acne scars. Depressed or pitted acne scars are the most common. 90% of people have atrophic mixed scars only. Less collagen in the skin leads to depressed or atrophic scars that look like small pits. Depressed scars are a result of inflammatory acne, which generally sits on collagen-rich scar tissue, which prevents the skin from repairing the indentation. This is why there is an appearance of a shallow dent on the skin.
There are 3 main types of atrophic or depressed scars - rolling scars, icepick scars & boxcar scars. The first type is rolling scars. These are broad depressions that are saucer-like that may is 4-6 m long. When your superficial skin, fibrous tissue, or fibrous bond attaches to the deep tissue or subcutaneous layers, it causes puckering which causes the skin to get pulled inwards.
These are called rolling scars. They often have a rough texture & have an “M” shape but have smooth edges. There are several treatments like light or lasers or energy-based devices like fractional CO2, erbium laser, microneedle radiofrequency (MNRF), dermaroller, dermapen, PRP, skin needling & surgical subcision.
Boxcar scars are opposite to rolling scars. These are round, square, oval but with steep, sharp & vertical edges. They are very much like chickenpox scars. They are quite deep with broad bases. The surface of the scars is pigmented, textured, very rough & are visible even from a distance.
Treatment for boxcar scars include surgically removing them - this is called punch excision or punch elevation or subcision. Smaller scars respond to light, laser or energy-based devices. Mainly, fractional CO2 laser, erbium laser, or MNRF are used. Next, are icepick scars. These may appear small but are a little more severe as they are deep & narrow. They may be bigger than 2m, appear narrow but go to the deeper layers of the skin. They have very sharp edges. These don’t respond much to treatment either. They look like a large, empty pore on the skin & are very difficult to cover up because they quite evidently look like holes on your skin.
Treatments like punch excision, TCA (Trichloroacetic acid) cross, or fractional lasers are quite effective. Fat grafting or dermal fillers are often used to treat atrophic scars in combination with other treatments. These help in making the scar shallow & make the scar more responsive to treatment. So this was the treatment of depressed or atrophic scars.
Raised acne scars are the opposite of depressed scars. They are formed when the body produces excess collagen during the healing process. There are two types, keloid scars & hypertrophic scars. They are the result of inflammatory acne, as well. Instead of healthy skin living on the surface, there is an excess amount of scar tissue on the upper surface of your skin which causes a bumpy, uneven figure.
The thick, wide, raised scars that are formed on the skin during the healing process are called hypertrophic scars. These are generally small bumps & can be red, pink or skin color. They are smaller than keloids, they heal faster than keloid scars & eventually fade.
Usually, keloid scars are bigger than hypertrophic scars. They can form over a larger area than the original injury site. These keep increasing with time & are mostly pink or purple. It is quite difficult to treat them. Treatments like surgery, lasers, steroid injections & silicone sheets are used to treat them. Cryotherapy can be used to treat small keloid or hypertrophic scars. However severe, deep, pigmented the scar is or whichever type the scar is, their appearance can definitely be reduced & we can get good results with treatment.