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An Acne Scar Primer
By Acne Guru | September 8, 2010
Before we get too carried away with the ways of removing acne scars, we should know a bit more about them!
Even with the most careful skin care, acne scars can still happen.
Acne scars come in different types. Generally, acne scars can be divided into two categories: those caused by a loss of tissue (atrophic), and those caused by an excess of tissue (hypertrophic). Within these categories, acne scars fall into one of four types: ice pick, boxcar, rolling and keloid scars.
Ice Pick Scars
- Appearance: Ice pick scars are deep, very narrow scars that extend into the dermis (the second layer of your skin). The skin looks as if it has been pierced by an ice pick or sharp instrument. Ice pick scars seem to make a small, deep “hole” in the skin. Sometimes they even have the appearance of a large open pore.
- Development: Deep rooted infection making its way to the surface cause ice pick scars. Skin tissue is destroyed, leaving a long column-like scar.
- Common treatments: Ice pick scars respond best to various punch surgery techniques.
Boxcar Scars
- Appearance: Boxcar scars consist of roundish low spots, with steep sides. Boxcar scars are wider than ice pick scars, but both are a deeper scar and cause the skin to look pitted.
- Development: When a breakout destroys collagen, tissue is lost. In the area where the tissue was lost, the skin no longer has the necessary support. This creates a depression. Boxcar scars may be superficial to severe, depending on the amount of tissue lost.
- Common treatments: Treatments for these scars include dermal fillers, laser resurfacing, and punch excision or elevation.
Rolling Scars
- Appearance: Rolling scars have that name because they can look almost like waves rolling across the skin.
- Development: Rolling scars arise when fibrous bands of tissue develop between the skin and the subcutaneous tissue below. These bands pull the epidermis, binding it to deeper structures of the skin. The tension from being attached to lower structures, pulls on the skin and the pulling creates a “rolling” effect on the outer skin.
- Common treatments: These scars respond best to a subcision surgery.
Hypertrophic or Keloid Scars
- Appearance: As you recall, hypertrophic is a way of saying “too much tissue”. Thus they look like a firm, raised mass. Very often, these scars are actually larger than the wound that caused them. Hypertrophic scars caused by acne are most often found on the torso, especially in men.
- Development: These scars are not caused by A LOSS of tissue, like with a boxcar or ice pick scar. Quite the opposite, they are caused by an overabundance of collagen.
- Common treatments: Cortisone (steroid) ointments, tapes, or injections are used to smooth and reduce these scars. Interferon injections are also used to soften scar tissue.
There you go, now you know. “And knowing is half the battle”!
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