Following a skin trauma such as an acne outbreak, the skin heals. This natural and beneficial process can, however, result in various types of more or less permanent marks.
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The various types of acne scars/marks.
Summary
Published September 2, 2022,
updated on August 2, 2024,
by
Maylis, Chemical Engineer
—
7 min read
Acne marks.
Unlike scars, acne marks can spontaneously disappear after a few weeks or even months. Depending on the "colour" they take on and the underlying biological mechanism that causes their formation, they are classified into two categories:
The pigmented (brown) spots: These are flat brown to black spots, depending on the skin colour, that occur following a skin lesion or inflammation. This post-inflammatory hyperpigmentation is due to an excessive production of melanin, a pigment present in the skin whose main function is to protect skin cells from UV rays. Indeed, during inflammation, pro-inflammatory cytokines will stimulate the activity of melanocytes, cells that produce melanin. This type of mark is more common in mixed to dark phototypes.
To mitigate them, it is recommended to apply daily care products containing the following active ingredients: azelaic acid, arbutin acid, niacinamide, vitamin C, chemical exfoliants (AHA, BHA and PHA), retinoids. If this is not effective, certain procedures can be performed by a dermatologist: chemical peels, laser treatment, prescription of hydroquinone or the use of pulsed light.
Erythematous spots (red) : These pink to red coloured marks are caused by the dilation of superficial skin vessels and are more visible on fair skin:they are also referred to as post-inflammatory erythematous marks .
To diminish their appearance or even completely erase them, it is essential to keep the skin hydrated with the application of products containing moisturising ingredients (aloe vera, glycerine, hyaluronic acid, polyglutamic acid...).
It is also necessary to repair the damaged skin barrier with treatments containing ceramides, niacinamide, fatty acids, etc... and use treatments with anti-inflammatory active ingredients (vitamin C, azelaic acid...). Furthermore, rely on products containing soothing and healing ingredients (Centella asiatica, panthenol...).
Acne scars.
We refer to scars when the mark remains visible 1 year after the healing of the lesion. Thus, depending on the severity of the acne, acne scars are traces that can permanently mark the skin. They can be more or less numerous and more or less deep. Everything depends on the damage to the layers of the skin. We distinguish two types of acne pimple scars:
The atrophic scars that have a sunken appearance in the skin, the size and depth of which vary. This is the most common form of scarring after severe acne. They can present in three different forms: "ice pick" or "V" shaped which are narrow and deep, "U" or "crater" shaped which are rather wide, shallow, with sharp or rounded edges, and "boxcar" which are wide and deep. This type of scar appears when a wound does not heal properly and the connective tissue that forms is insufficient. Depending on the severity, it is sometimes impossible to completely remove them, but they can be reduced. There are several options depending on the depth and age of the marks (cosmetic medicine or surgical intervention): TCA dermatological peeling, infrared light, microdermabrasion, injection of hyaluronic acid or fat, microneedling, laser treatment, skin ablation, skin grafting, fractional radiofrequency.
The hypertrophic scars that are slightly swollen, showing a kind of skin tissue outgrowth. They are also known as keloid scars. They are due to the formation of a second layer that has come to cover the scar tissues during the healing phase of the acne spot (excess collagen). In aesthetic medicine, there are various treatments that can reduce or remove the hypertrophic scar: intralesional corticosteroid injection, skin ablation, radiotherapy, laser treatment (CO2 laser, Erbium laser), pressotherapy, dermatological peeling.
Sources:
BAD-CASINTAHAN F. & al. Frequency and characteristics of acne-related post-inflammatory hyperpigmentation. The Journal of Dermatology (2016).
HAMZAVI I. H. & co. The role of sunscreen in melasma and post-inflammatory hyperpigmentation. Indian Journal of Dermatology (2020).
MADAN R. Post-inflammatory hyperpigmentation: A review of treatment strategies. Journal of Drugs in Dermatology (2020).
SANGHA A. M. Managing post-inflammatory hyperpigmentation in patients with acne.Journal of Clinical and Aesthetic Dermatology (2021).
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