Acne Scarring can be a terribly embarrassing facial deformity that feels unavoidable. Most people accept acne scarring as an unsightly side effect to a condition that seems inevitable. However, having acne, and its resulting scarring, doesn’t have to be something you need to get used to.

Why Do I Have Scarring?

Acne scars, like any scars on the body, are a result of damage to the skin. The extent of the damage is what determines whether a scar will result or not. Wounds to the most outer layer of the skin, the epidermis, usually heal without a scar forming. If the wound or damage reaches down into the dermis, the layer of skin below the epidermis, then it is likely a scar will develop while the skin is healing. When the dermis is damaged, new collagen fibers are grown to repair the damage. This is necessary as collagen is what makes the skin strong and flexible. Unfortunately, the new skin rarely grows back exactly like it was prior to becoming damaged. This is how a scar results. Raised scars result when too much collagen is produced during the healing process, leading to a mass of tissue on the surface of the skin at the site of the repair.

What Causes Acne Scarring?

Milder and non-infected forms of acne rarely cause any scarring. Most of the scars due to acne result from papules, pustules, nodules or cysts. How these different spots differ is due to the amount of inflammation and their size. Papules and pustules are both referred to as pimples, but the difference is that papules do not contain pus and pustules do. Pustules often grow larger than papules and usually have a white head due to the pus and oil found within it. Nodules and cysts are the much more serious forms of papules and pustules, as they are larger and form much deeper in the skin.

All four of these types of acne are infected, which means the follicles in the skin have become blocked by oil, dead skin cells and dirt and then had bacteria attack them. As the infection by the bacteria progresses, the skin will produce pus, so a papule will progress to a pustule if not dealt with. As the follicle becomes filled with the debris, it will swell until it breaks, or ruptures. The follicle can rupture near the surface of the skin or lower down. Ruptures at the skin surface are usually minor and will often heal without causing a scar. It is the ruptures that occur deeper in the skin that are often behind acne scarring.

When the follicles rupture in the dermis, the material within the blocked follicle is emptied into surrounding tissues. This in turn infects those healthy skin cells, which is how nodules and cysts develop. Nodules feel like a hard, painful lump deep in the skin. Cysts feel like fluid filled sacs, which are also painful, and can grow to be centimeters in diameter. The fact that nodules and cysts damage healthy tissue surrounding them means that scarring is highly likely. Trying to pick or pop these forms of acne should be avoided as it can make the acne worse by spreading the infection and cause greater damage and scars.

How Do I Know if I Have Acne Scarring?

If you aren’t afflicted with severe acne, it might be hard to distinguish the marks on your face. Acne scarring has very distinctive features, which can often be confused for old chicken pox scarring! Scars due to acne are usually depressed scars, or said to be crater-like. These scars develop due to a loss of healthy tissue in a region. The amount of inflammation and the length of time for the breakout to heal are the two main causes of acne scarring. Nodules and cysts damage deep into the dermis and take a much longer time to heal, thus the likelihood of scars is much increased versus milder surface damage by other forms of acne.