Acne scars

белези от акне

The most unpleasant outcome of the activity of an acne in severe stages is the appearance of permanent scars. I will not go into detail which types of acne and which is their mechanism of skin damage. I have written in detail on these topics in the blog. The scars are most often the result of the presence of inflammatory lesions (papules, pustules, cysts) or the manipulation of them by the patient.

Types of acne scars

Ice-Pick. They are called this way because they resemble the holes left on the ice by an ice picker (pickle). As this complex association suggests, the scars are deep, narrow, and speckled. This type of scar is punctate and is the deepest compared to the others. This makes them extremely difficult for therapy, which must certainly be combined.

Rolling. They are formed by the merging of several dotted scars with irregular, sloping edges.

Boxcar. Extensive crater-shaped scars with beveled, well-defined edges.

The photo is from the website of Acne Support at the British Association of Dermatologists

Atrophic. They can appear on the face and body. Those located on the shoulders, back and décolleté are extensive and most often a consequence of acne conglobata. The fresh scars are pink / red, and the older ones are white, thin as parchment, wrinkled in places, with transparent capillaries from the underlying tissues. Sweat and sebaceous glands are not seen at the site of older acne scars. They are terminally destroyed by the inflammatory process.

Hypertrophic scars and keloids. Hypertrophic nodes are also called fibrous nodules, which are preceded by deep inflammatory nodules in severe acne and are most commonly seen on the shoulders, back and décolleté. Their size can reach 1-2 cm and more and are raised above the skin surface. Keloids are the most terrifying variant of the scars that most often form on the sternum. The unpleasant point with them is that in patients prone to the formation of keloids, they can also form in milder forms of acne (papules, pustules). They are thick, hard, spread beyond the initial location of inflammation. Their surface can be wrinkled, wrinkled. They are usually pink in color. And now I want to write something in capital letters, because it is the most common diagnostic error, and consequently therapeutic: HYPERTROPHIC SCARS ARE NOT A FORM OF KELOID. THESE ARE COMPLETELY DIFFERENT CHARACTERISTICS, WHICH MUST BE TREATED IN A FUNDAMENTALLY DIFFERENT WAY.

The photo is from the website of Acne Support at the British Association of Dermatologists

Calcifications. One of the late manifestations of chronic inflammation in acne can result in the formation of calcifications, including the formation of osteomas (bone tissue).

Linear scars in combination with a draining sinus. Imagine inflammatory tunnels that form in chronic inflammation with pus-containing structures. At one stage of inflammation, this purulent contents drain to the surface, forming sinuses.


Unfortunately, a combination of these scars can occur in a patient, which is a huge therapeutic challenge. You will be able to read about the healing approach in a separate article in the blog.

My advice would be directed first to people with active acne: do not wait for it to pass, look for a good dermatologist who will help you prevent the appearance of scars. To patients with pre-existing ones: scars are a terminal result of chronic inflammation, do not waste time in self-treatment, seek competent help.

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