What is acne scarring?

As if acne on its own isn’t bad enough, it can leave scars on your skin after the acne itself has cleared up. Up to 67% of people who experience acne report having acne scars or skin discolouration. But let’s take a step back and review a bit about what acne scars are and how they develop.

A scar is a mark or uneven looking skin that remains on your skin after a wound heals. It forms when your body repairs and replaces damaged skin. Scar tissue is made up of collagen fibres – the same protein found in normal skin, but it builds up in a way that can change the appearance and function of this area of skin.

How and why do acne scars form?

Acne scars can form when the healing process is altered by the inflammation and damage associated with acne. This can cause an imbalance of the proteins that break down and rebuild skin tissue, leading to scar formation.

Not everyone who has acne will get acne scars, and it’s not always clear who will end up developing acne scarring. Some factors that may increase the risk for acne scarring include a family history of acne scars, the type and severity of acne (scarring is more common in the more inflammatory nodular or cystic types of acne), how long inflammatory acne lasts, and picking or squeezing pimples or acne spots.

The best thing you can do to help minimise or avoid acne scarring is to seek effective treatment for your acne as early as possible, and of course, avoid popping, squeezing, and picking at your acne!

Types of acne scars

First, acne scars are divided into atrophic scars and hypertrophic scars. Put simply, scars can form as depressions or pits in your skin when there is too little collagen, or as raised scars when there is too much collagen. Redness may accompany either type of scar.

Atrophic or pitted scars are the most common type of acne scars. They are divided into three subtypes: boxcar scars, icepick scars, and rolling scars. These names might sound a bit weird, but they actually help describe what each type of scar looks like as well as their shape and depth. Hypertrophic or raised scars are firm lumps and bumps on the surface of your skin. These scars are called keloid scars when they grow beyond the edges of the original acne scars.

Acne can also leave marks on your skin that look like dark acne scars or red acne scars. This is technically not considered scarring and is called post-inflammatory pigmentation. This is just a fancy way of saying that after acne clears, it can leave spots or discoloured areas of skin. This discolouration can appear as darker brown spots (called hyperpigmentation), lighter white spots (called hypopigmentation), or even as reddish spots (erythema). The risk of discolouration is higher in people with darker skin. These marks usually improve over time but may take months to completely resolve.

Post-acne management

If you have acne scars that are causing you concern, it’s important to talk to a healthcare professional (dermatologist or pharmacist) about acne scar treatment options. There’s no single best treatment for acne scars, because there are a number of different treatments that work in different ways, with some being more suitable for certain types of scars and certain types of skin.

If you’re looking for products to help with scarring or discolouration after your acne clears, consider products that contain ingredients such as retinol, salicylic acid, and alpha-hydroxy acids. Products that contain silicon may also help improve the appearance of acne scars.

Some people find that natural remedies such as aloe vera, olive oil, vitamin C, sunflower oil, apple cider vinegar, honey, coconut oil, or lemon juice can help improve the appearance of acne scars or discoloured or uneven areas of skin.

The most important thing to remember before starting any acne scar treatment is that you will need to have your acne under control. If you are still experiencing acne breakouts, your skin is inflamed – which can reduce the effectiveness of scar treatments – and you are at risk of developing new acne scars.