Acne and Acne Scarring
Understanding Acne
Acne is a common skin condition that occurs when hair follicles become clogged with oil, dead skin cells, and bacteria. Increased oil production in hair follicles occurs at puberty due to androgen (hormone) production. Skin cells cannot be shed normally from the follicle, which then blocks leading to the formation of blackheads (open plugged pores) and whiteheads (closed plugged pores). P. acnes (bacteria) colonises the follicle and breaks down the oil into substances that cause inflammation, resulting in inflammatory lesions like papules (small red lumps) pustules or pimples (similar to papules containing pus), nodules (large solid tender lumps under the skin) and cystic lesions (painful pus-filled lumps under the skin). Acne can appear on the face, chest, upper back, and shoulders.
The impacts of acne can be both physical and emotional. The presence of acne lesions can cause inflammation, redness, and swelling, leading to discomfort and pain. Moreover, acne can have significant psychological effects, including reduced self-esteem, social anxiety, and depression. Even after acne clears, it may leave behind scars that can further affect an individual's confidence and well-being.
Acne scarring occurs because of rupture of deep inflammatory acne lesions in the dermis of the skin. There are different types of acne scars, including atrophic scars (depressed or pitted scars) and hypertrophic scars (raised scars). These scars can be a lasting reminder of the acne and can be challenging to treat effectively.
It's crucial to recognise the type of acne that is likely, if untreated, to result in scarring. Prevention of scarring is key.
Acne & Acne Scarring Treatment
Fortunately, several treatments can help to reduce the severity of acne and to reduce existing acne scars.
Topical treatments: Benzoyl peroxide, topical retinoids and topical antibiotics are available to help control acne by unclogging pores, increasing skin turnover and killing bacteria.
Oral medications: In more severe cases, oral medications such as antibiotics, hormonal therapy, or isotretinoin (commonly known as Oratane) may be prescribed to target acne-causing bacteria, regulate hormonal imbalances, or reduce oil production.
Chemical peels: Chemical peels involve applying a chemical solution to the skin, which exfoliates the top layer and stimulates new skin growth. This process can improve the appearance of acne and acne scars by promoting cell turnover and collagen production.
Microneedling: Microneedling involves using tiny needles to create controlled micro-injuries in the skin, stimulating collagen production in the underlying tissue and promoting skin rejuvenation. This treatment can help reduce the appearance of acne scars and improve overall skin texture.
Dermal fillers: Dermal fillers containing substances like hyaluronic acid can be injected into depressed acne scars to restore volume and create a smoother skin surface.
Surgical procedures: In some cases, minor surgical procedures such as punch excision may be advised. Punch excision is a method of treating acne scarring in which a punch tool (regularly used for biopsy of skin cancer) is utilised to remove scar tissue. The wound is closed with a stitch. This scar revision treatment is ideal for deep ice pick scars. Subcision is another minor surgical procedure in which a bevel-edged needle is inserted into the skin under the scar to release the fibres that pull the scar into the underlying tissues, allowing the skin to rise.
What else do I need to know?
Acne is a medical condition that can be treated. It's essential to consult with a medical practitioner to examine your skin, grade the severity of your acne and recommend appropriate treatments to help reduce the impact of acne and acne scarring on your skin.
