What Are Acne Scars?

To understand acne scars, we first need to understand a little about acne.

What is Acne?

Acne is a skin condition that occurs when pores become clogged with oil, impurities and dead skin cells. This can result in a variety of spot types: blackheads, whiteheads, papules, pustules, nodules and cysts.

According to figures released by the NHS, around 95 per cent of people aged from 11 to 30 will suffer from acne at some point. Although it usually disappears when an individual reaches their mid-20s, it can continue into later life—around three per cent of people aged 35 and over have acne.

A tendency to acne can be hereditary, and it’s also known to be triggered by hormonal changes in women, such as pregnancy or menstruation. It most commonly develops on the face, and nearly all sufferers will have it here. However, over half of people with acne develop it on their back, while around 15 per cent will also get acne on their chest.

Does All Acne Cause Scarring?

The short answer is no. Only one in five acne sufferers is left with scarring from the condition.

The long answer is that your chance of developing scarring depends on a few factors:

· your tendency to scarring, which is partially hereditary

· the extent and severity of your acne

· your (ill-advised!) attempts to squeeze or pick at your spots, which can damage the skin

· the type of spots that you develop.

While acne scars can be caused by any of these spots, they most commonly occur when the more severe types (nodules and cysts) burst and damage nearby skin. Nodules are large hard lumps that build up beneath the surface of the skin, sometimes causing pain, while cysts are large pus-filled lumps that look rather like boils. Cysts carry the greatest risk of causing permanent scarring.

Types of Acne Scarring

There are four main types of acne scarring: ice pick, rolling, box car and keloid scars.

· Rolling scars affect thicker areas of the skin, such as the jaw and lower cheeks. They’re caused by bands of scar tissue that form under the skin. This gives the scar edges a sloped appearance and makes the skin’s surface look ‘rolling’ and uneven.

· Boxcar scars also appear on the lower cheek and jaw area. They’re round or oval depressions that can penetrate deep into the skin, causing sharp edges.

· Ice pick scars are small but deeply indented, puncture-like scars. The name comes from the fact that the scar shape is similar to an ice-pick (i.e., the hole caused by the acne blemish is wide at the top and narrows the deeper it goes in to skin). This type of scar tends to occur on areas of the skin that is thinnest, such as the forehead or cheeks.

· Keloid scars sit above the surface of the skin and are the result of collagen overgrowth. These large thick scars tend to be rubbery and usually populate the back and shoulders, chest or jaw line.

Can Microneedling Help with Acne Scars?

If you have indented acne scars, microneedling can be very effective. However, it’s not recommended for raised scarring. That’s because this scarring is built from layers of collagen sent to heal the damage to the skin, and microneedling promotes collagen production—microneedling is also known as Collagen Induction Therapy.

However, collagen production is just what’s required when your acne scars are deep, punctures or indented lines and marks. Microneedling promotes the production of both not just collagen, the skin’s scaffolding protein, but also elastin, the protein that gives your skin its ability to stretch and then return to shape.

Production of these proteins is stimulated by running the microneedling device over the skin. The device is equipped with fine needles (around 0.5mm –1mm long) that cause tiny punctures in the skin’s surface. This kickstart’s the skin’s healing process, which includes collagen and elastin production.

About Microneedling Treatment

Is Microneedling Suitable for Me?

If your acne scars are indented or flat, then yes. However, microneedling isn’t suitable for you if:

· you are pregnant or immunosuppressed

· you are taking anticoagulants (blood-thinning medications)

· you suffer from eczema or psoriasis

If you also have rosacea, seek advice from a health professional first.

How Should I Prepare for a Microneedling Session?

Ensure you stay well-hydrated in the days before a microneedling treatment, as this will help to reduce any after-effects. Avoid anything that might irritate your skin. The practitioner will prepare your skin on the day by applying a numbing cream first, making the treatment more comfortable.

What Are the After-Effects of Microneedling?

Your skin may be a little inflamed or even bruised after your microneedling treatment, but this should only last a few days at most. During this time, you should avoid direct sunlight and strenuous exercise to give your skin time to heal.

When Will I See Results from My Microneedling Treatment?

Microneedling treatments are usually given every four to six weeks. You will need a few treatments to see significant results, and you may be advised to have several treatments to get the maximum benefit from this therapy. But seeing your scars begin to fade and a new, smoother layer of skin emerge will be worth the wait.

Further reading

· https://www.nhs.uk/conditions/acne/

· https://www.nhs.uk/conditions/acne/complications/

· https://my.clevelandclinic.org/health/diseases/21222-acne-scars

· https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4509584/

· https://journals.lww.com/idoj/Fulltext/2016/07040/Microneedling__Advances_and_widening_horizons.2.aspx