Freelance Writing Jobs | Today's Articles | Sign In

Articles
Writers

How Does Acne Scars Form?

Cause of Scarring in Pimples

Nov 26, 2009 Hanish Babu

Acne scars are formed due to delayed, improper treatment or non-treatment of inflammatory acne.

Acne scars are the result of negligence of the pimple eruptions or ignorance about proper treatment of the blemishes. Improper self- or OTC treatments add to the problem. Acne scars are potentially preventable if acne is treated in the initial stages itself. In fact, the aim of treatment of acne is not to affect any cure (which is practically impossible given the fact that acne is hormone- and lifestyle-dependent), but to prevent side effects like acne scars and other acne blemishes.

How Does Acne Develop?

To understand the causes and development of acne scars, one should learn the basis of acne formation.

  • The androgen hormones stimulate the sebaceous glands to produce more sebum within the hair follicles. The hormones also act on the keratin, the protein found in the superficial skin cells and the lining of the hair ducts and the altered keratin is deposited in the hair and sebaceous gland ducts, resulting in the blockage of the hair follicle opening. This in turn results in retention of the oily sebum within the hair and sebaceous ducts.
  • When the pore of the hair follicle is fully blocked, this is known as "closed comedones" or "whiteheads" and when it is open, "open comedones" or "blackheads." This is the type 1 or mild type of acne. As this type of acne does not cause any inflammatory reactions within the dermis, the chances of scar formation are minimal, though not impossible, with this type of acne.
  • In certain teens, the resident bacteria inside the sebaceous and hair ducts, known as the Propionibacterium acnes, induces an inflammatory reaction after interacting with the sebum. As a result, skin colored or red bumps, known as papules (grade 2 moderate acne) or pus filled blisters, known as pustules (grade 3 severe acne) form on the skin surface. These types of acne, if treated early and properly, may abort and heal the blemishes without scars. Otherwise these pimples heal with superficial scars.
  • Further inflammation results in the release of enzymes and other inflammatory cytokines into the sebaceous duct and hair follicle. The debris from this severe inflammatory reaction forms deep-seated nodules and cysts, which may rupture into the dermis resulting in widespread damage to the dermal structures. This is the very severe type of grade 4 acne. In these types of acne the chances of deep scar formation is a foregone complication, with or without treatment.

How Does Acne Scars Form?

Acne scars are formed when the inflamed acne bumps heal. After any injury, including the inflammatory reaction in acne, the skin heals itself through regeneration of new collagen and elastic fibers within the dermal layer. If the basal layer of the epidermis is completely destroyed, it is not possible to regenerate the superficial layer of the skin and give it the natural appearance. The newly formed collage fibers form a fibrous covering over the damaged skin, known as the scar tissue.

Some acne sufferers can cause deep scars due to incessant picking at the acne bumps or blemishes. This could result in ungainly and deep pigmented scars even following the non-inflammatory grade 1 mild acne eruptions.

Types of Acne Scars

Types of acne scars formed depend upon the depth, extent and severity of the inflammatory reaction and how fast the inflammation was controlled. The deepest acne pits and scars are formed, as expected, following the most severe nodulo-cystic acne. In some predisposed individuals, even the comedonal acne has been found to cause ice-pick scars.

When there is a loss dermal support due to damage of tissue, the resultant scars are of the thin, shiny, atrophic variety and when the healing takes place with increased tissue regeneration and deposition of fibrous tissue, the resultant scars are of the thick, soft or firm hypertrophic type of acne scars.

In addition to the roles of the hormones, sebum, bacteria and the inflammatory reaction, a hereditary predisposition is also thought to play a role in acne scar formation.

Acne Scar Causes: Related Article.

Sources:

  • Diane T, Gollnick H et al. New insights into the management of acne: An update from the Global Alliance to Improve Outcomes in Acne Group. J Am Acad Dermatol, 2009;60:S1-50.
  • Simpson NB & Cunliffe WJ. Disorders of the Sebaceous Glands in Rook’s Textbook of Dermatology. 2004; 7: 43.1-43.75.

Disclaimer

The information given in this article is for educational purposes only so that patients are aware of the options available. No diagnosis should be made or treatment undertaken without first consulting your doctor. If you do so, Dr.Hanish Babu, MD or Suite101 will not be responsible for any consequences. The images provided are for illustration purposes only.

The copyright of the article How Does Acne Scars Form? in General Medicine is owned by Hanish Babu. Permission to republish How Does Acne Scars Form? in print or online must be granted by the author in writing.
How Acne Scars Form., Dr.Hanish Babu, MD How Acne Scars Form.
Acne Pitted Scars., Dr.Hanish Babu Acne Pitted Scars.
 
What do you think about this article?
NOTE: Because you are not a Suite101 member, your comment will be moderated before it is viewable.
post your comment
What is 4+6?
;