Acne Scar & Stretch Marks


About 15% of people are left with post-acne scars after they active acne is reduced.  Wondering what kind of scars, you have, and how you should treat them? 
You’re in the right place! 

There are two main categories of post acne marks. The first category includes flat smooth brown or pink spots that DO NOT change the texture of the skin. Then there’s what’s called “real acne scars,” which DO change the texture of the skin. These real acne scars look like pits (icepick scars), valley-like depressions in the skin (rolling or boxed scars) or elevated hard to the touch bumps. (hypertrophic and keloid scars). 

Why do you get acne scars? 

While a pimple is healing, your skin is producing new collagen fibers to replace the damaged tissue. If this process is defective, these new collagen fibers will pull down A scar may appear as a little pit in the skin’s surface, or a shiny, slightly raised surface. If you pick at a pimple too much, or if an acne pimple is so inflamed that your skin’s collagen is destroyed, and not enough collagen is produced to rebuild the skin, you end up with a depressed (aka atrophic) scar. On the other hand, if the healing response gets a little too enthusiastic, it may result in a raised (aka hypertrophic) scar.

How to treat flat brown acne marks? 

Treatment of post acne brown flat spots is usually pretty easy.  Your first step should be to control your active acne with an effective anti-acne treatment protocol. Do not pick or pop your pimples! This commonly contributes to acne scars. The second step - use an oil-free sunscreen. Excessive sun exposure and visits and avoid the sun or tanning salons will make you post-acne dark spots darker.  The third step – look for a high-quality dark spot corrector for acne-prone skin. Dark spots corrector are not alike. The best Dark spot corrector will contain Hydroquinone. The newest ones add to hydroquinone retinoids and plant-based complexes that help fade the post acne spots faster, with less skin irritation. 
For more resistant brown spots, it’s possible to add superficial peels or intense pulse light treatments — for any of those; you’ll need to visit your dermatologist.

How to treat flat pink and red acne marks? 

The enlargement of microscopic capillaries causes pink or red post-acne spots. They usually fade two to three months after your acne is controlled. If you want to fade them faster, a couple of IPL (Intense pulsed light) or laser treatments will do the job.

What the five main types of real acne scars? 

There are five distinct types of real acne scars. Icepick scars, rolling scars, boxed scars, and hypertrophic acne scars and keloid acne scars. 

What are icepick acne scars? 

Another kind of “real acne scar” is called an icepick scar. These are smaller in diameter (1-2 mm) deep with tracks to the dermis or subcutaneous tissue possible. Although the surface opening is smaller and steep-sided, there may be a wide base that could later evolve into depressed or boxcar scars. Icepick scars are commonly seen on cheeks.

What are boxcar (boxed) acne scars? 

“Boxcar scars” are shallow (0.5 mm) or deep (0.5 mm) and often 1.5 to 4 mm in diameter. They have sharply-defined edges with steep, almost vertical walls. Shallow scar treatment can happen with resurfacing or possibly punch elevation, whereas deep scar treatment is often done by punch excision, elevation or another modality. 

diiferent types of acne scars

What are rolling acne scars? 

Last, there are soft “rolling acne scars”. These can be circular or linear, are often greater than 4 mm in diameter and have gently sloped edges that merge with normal-appearing skin. Treatment is commonly by subcision.

What are hypertrophic acne scars and keloid acne scars? 

Hypertrophic acne scars (Elevated scars confined within the margins of an original pimple) and keloid acne scars (Elevated scars larger in size than the original pimple and commonly found on the chest, back, shoulders and ears. Both hypertrophic scars and keloids have thicker, more abundant collagen that’s stretched and aligned in the same plane as the epidermis. Both have an incidence of 5-to-15 times higher in African Americans and 3-to-5 times higher in Asians (Compared with Caucasians). It’s estimated they affect both the African American and Hispanic populations between 4.5% and 16%.


What exactly is a stretch mark?

A stretch mark is a type of scar that develops when our skin stretches or shrinks quickly. The abrupt change causes the collagen and elastin, which support our skin, to rupture. As the skin heals, stretch marks may appear.

Not everyone develops these narrow bands on their skin. Fluctuating hormone levels seem to play a role. You may also have a higher risk if people in your family get stretch marks.

If you develop stretch marks, you’re most likely to do so during these times:

  • Growth spurts that happen in puberty
  • Pregnancy
  • Rapid weight loss or gain
  • Weight training when you have rapid muscle growth

Applying a corticosteroid to your skin for a long time can also cause stretch marks. If you have Cushing’s disease or Marfan syndrome, you may see stretch marks.

When stretch marks first appear, they tend to be red, purple, pink, reddish-brown, or dark brown, depending on your skin color. Early stretch marks may feel slightly raised and can be itchy.

In time, the color fades and the narrow bands sink beneath your skin. If you run your finger over a mature stretch mark, you often feel a slight depression.


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