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"Old-looking" skin can sometimes have less to do with aging than with a defect that makes the skin look prematurely old. One such skin problem—and a fairly common one—is acne scars.
Acne is one of most common skin conditions in the world. Nearly 80 percent of people aged 11 to 30 years have acne, most often on the face, chest and back. However, acne is not restricted to any age group; adults in their 20s, 30s and even into their 40s can get acne. Most cases of acne responds to treatment and clears up without leaving scars. Healed acne does leave scars in some people, however, and it is not easy to predict who will have scars after acne and who will not. Severe, inflamed, cystic acne always leaves scars after healing, but in some people even superficially inflamed acne can result in scarring.
Whether acne scarring is deep or superficial, extensive or scattered, the esthetic result can be less than desirable and even disturbing. Acne scars can give the skin an "old" look. Scars may also contribute to an appearance of age as the skin loses its elasticity over the years.
A number of treatments are available to remove or improve acne scars. The type and depth of scars influences the choice of treatment to a large degree. Here are some basic facts about acne scars:
Acne scars result from two types of tissue response to the inflammation of acne: (1) increased tissue formation, and (2) loss of tissue.
Increased Tissue Formation
Scars caused by increased tissue formation are caused by a build up of collagen in the skin. These are called hypertrophic and keloid scars. Keloid resulting from acne is shown in this photo:
Keloids tend to "run in the family"—that is, there is a genetic predisposition to form keloids after tissue injury. African-Americans often have a predisposition to keloid formation. Some families also tend to form hypertrophic or thickened scars.
 
Scars Resulting from Loss of Tissue
Acne scars resulting from loss of tissue are more common than scars resulting from increased tissue formation. There are several types:
Ice-pick scars get their name from their appearance. They may be superficial or deep, are usually small in diameter and have steep sides like an ice-pick wound. They may be hard or soft to the touch; the soft scars are usually more superficial and the hard scars deeper. The base of hard scars under the skin may be wider than the scar at the surface of the skin.
Depressed fibrotic scars are usually large scars that have sharp margins and steep sides. They are similar in appearance to deep chicken pox scars.
Superficial and deep soft scars are variable in size, and have sloping edges that merge with normal skin.
Atrophic macules are soft, flat scars that often have a bluish or violet color on white skin due to underlying blood vessels. Macules tend to fade over time and become less obvious. |
