Why do Acne Scars Appear?

Before discussing acne scars and their treatment, it’s important to point out that acne red marks that may mirror scars are not actually scars because no permanent change has occurred. In other words they are not real scarring and disappear in time, nonetheless while they are visible they can cause uneasiness.

Flat, red or reddish spots that appear at the final stage of most inflamed acne lesions are called Macules or “pseudo-scars”. After an inflamed acne lesion flattens, a macule may remain in the lesion’s site for up to 6 more months. When a macule finally disappears, no trace of it will remain, unlike a scar.

Post-inflammatory pigmentation is darkening or discoloration of the skin at the site of a healed or healing inflamed acne lesion. The lesion’s color can range from light brown to black. Lesions may become darker if exposed to sunlight (UV rays). It occurs more frequently in darker-skinned people, but is sometimes seen in people with white skin. Early treatment with a natural skin care cream minimizes the development of post-inflammatory pigmentation and also eliminates existing marks. If untreated, post-inflammatory pigmentation can even persist for up to 18 months, specially with excessive sun exposure.

Acne Related Scars

Acne scars appear after inflammation or improper healing of some spots. While for some people scarring seems to depend on genetic factors or skin color, precautions can be taken to avoid scars along with treatments, which significantly reduce a scarred skin’s appearance.

In the simplest terms, scars appear at the site of damage and are the visible reminders of wound and tissue repair. In the case of acne, the injury is originated by the body’s inflammatory reaction to sebum, bacteria, and dead cells in the plugged sebaceous follicle. There are two types of true scars:

(1) Depressed areas such as pitted acne scarring or ice-pick scars, and

(2) Raised thickened tissue such as keloids.

When tissue suffers a lesion, the body rushes in its ‘repair kit’ to the wound site. The skin activitates all its immune and repair systems, where elements such as leukocytes, inflammatory molecules, and regenerative elements have the task of healing tissue and controlling infection. However, when their mission is done they may leave a somewhat messy repair patch in the form of fibrous scar tissue, or eroded tissue. It’s not always that way.

White blood cells and inflammatory molecules may stay at the site of an active acne lesion for days or even weeks. This can result in an acne scar in people who easily scar. The occurrence and incidence of scarring is still not well understood, however. There is considerable variation in scarring between one person and another, meaning that some people are more susceptible to scarring than others (ex. genetic factors or skin color). Scarring usually is a consequence of severe inflammatory nodular cystic acne that occurs deep in the skin. But, scarring may also appear from more superficial inflamed lesions.

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- Angelique Jodein