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Acne & Acne Scarring

Acne is a common skin condition that we often associate with adolescence and puberty due to hormonal changes, but people of all ages can be affected by this disorder. For some, a temporary breakout may occur while others may experience chronic cases that can be painful to the touch, impact appearance, and cause scarring that could be permanent. Booking a consultation with Dr. Greenberg can help diagnose the severity of your acne and develop an effective treatment strategy to reduce or eliminate the effects of this common skin disorder and prevent the scarring that can be part of this condition

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Acne Breakouts: Why They Occur

Breakouts can occur for a variety of reasons. Hormonal changes are the most common reason for acne but additional factors like stress, diet, prescription medications, and even genetics can all lead to sporadic or chronic acne breakouts with an increased risk of scarring in the areas of the skin where the acne has occurred.

How Acne Develops

Acne is what happens when hair follicles are clogged with oil, dead skin cells, and bacteria, resulting in inflammation that causes pimples, blackheads, whiteheads, and in severe acne cases, cysts or nodules that can be painful.

Clogged Pores

The process starts when the pores of the skin become obstructed with a naturally-occurring oil called sebum. This oil is the product of sebaceous glands for moisturizing the skin and hair to keep them smooth and healthy, but when an excess of oil gets caught inside the pore along with an abundance of dead skin cells, this can trigger the start of an acne breakout and lead to an increase in the growth of bacteria.

Inflammation of the Affected Area

The emergence of pimples and other types of lesions on the skin are your body’s immune system reacting to the presence of bacteria in the clogged pore, causing inflammation to occur.

Types of Acne

The different forms of lesions that grow from clogged pores and the inflammation that results may include pimples, blackheads, or whiteheads. Some patients may experience cysts and nodules which are located deeper in the skin and may be more painful and tougher to eliminate without proper treatment. Dr. Greenberg can diagnose the depth and severity of the lesions you are presenting and develop the best treatment plan for alleviating the condition.

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Acne Scars and Effective Treatment Options

Scarring is not uncommon for patients who are experiencing all types of acne. When the lesions that grow from clogged pores penetrate deep into the lower layers of the skin, the surrounding tissue can become affected and your body’s natural healing processes work to repair the damaged tissue. An essential component of this healing process is collagen. This protein is tasked with building strength and maintaining elasticity of the skin and when collagen production is triggered, the results may lead to scarring of the skin tissue. The two most common types of acne scars are atrophic scars and keloid scars. Understanding how each type can occur is vital for developing the scar treatment plan that is best for your particular type of scarring.

Atrophic Acne Scars

Atrophic scars can occur when there is too little collagen produced during the healing process, resulting in deep indentations in the skin. This happens because tissue has been lost causing small gaps to form beneath the skin’s surface. There are three different types of atrophic scars:

Boxcar Scars

Boxcar scars are named that because the shape of the scarring is square and boxy. These scars are found primarily around the lower cheeks and jawline and their depth can vary. Most boxcar scars are caused by moderate to severe acne cases and the most effective treatment options may include microneedling to stimulate the production of collagen, laser resurfacing to remove the top layers of skin and stimulate new skin cell growth, and dermal fillers which can be applied to fill in the deep gaps of scarring that exist in the skin. In some cases, chemical peels can also be an effective type of treatment for addressing boxcar scars.

Ice Pick Scars

Ice pick scars are recognizable by their narrow appearance and greater penetration into the skin’s surface. As a result, treatment for acne scars that Dr. Greenberg categorizes as ice pick scarring can be more challenging to treat because they typically penetrate so deep into the lower layers of the skin.

These types of acne scars are the result of severe acne and look like small, deep wounds in the skin. The best methods of treatment to improve the appearance of acne scars such as these are punch excision or grafting techniques that remove the scar through surgical intervention and repair the wound, laser resurfacing, or microneedling to refresh the skin’s appearance. These last two treatment options may require multiple treatments to achieve your desired results and Dr. Greenberg will advise you on the best treatment option to address your ice pick scars.

Rolling Scars

The last of the most common atrophic scars, rolling scars appear as wide and shallow giving the surface of your skin a wave-like or rolling appearance. This is caused by long strands of scar tissue that have formed beneath the surface of the skin. The best and most effective treatment options are subcision which is a surgical procedure that is performed to dislodge the fibrous strands of scar tissue that are giving the surface of the skin its uneven appearance, as well as microneedling or non ablative laser rejuvenation. These options can revitalize the skin’s surface by triggering the production of collagen and increasing skin cell regeneration.

Keloid Scars

Keloid scars (or hypertrophic scars) can occur when too much collagen formation takes place during the healing process creating raised scars that spread out further than the circumference of the initial acne lesion that emerged. These types of scars are the result of an overactive immune response and may be more common in patients with darker skin. They appear as firm, raised growth on the skin that may be red or purple in color. Most keloid scarring occurs along the jawline of the face and certain areas of the body including the chest, shoulders, and back. Patients have a variety of treatment options available for addressing keloid scarring including topical ointments, laser therapies, surgical intervention, and steroid injections that are designed to lower inflammation and reduce the size and height of the scar. In some cases, cryotherapy can also be an effective treatment alternative.

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Best Methods to Prevent Acne and Avoid Scarring 

While there is no guarantee that you can live a completely acne-free life, there are steps you can take to prevent acne from growing in the first place and avoiding the different types of acne scars that can result from the healing process. The following are some effective options for prevention and keeping clear skin all year round:

Early Acne Treatment Intervention

The longer you wait to address your acne issues, the greater the risk of developing acne and the acne scars that often come with it.

Adopt a Non-Comedogenic Skincare Regimen

These types of products reduce the risks of clogging your pores and triggering the inflammation that leads to all types of lesions on the skin.

Leave Your Pimples Alone

Sure, we all get the urge to pick at whiteheads and pop pimples in the hopes of helping the skin heal faster, but all that’s really doing is triggering further inflammation and increasing your risk of developing scars.

Use a High SPF Sunscreen

Protecting the skin from UV rays is the best way to support faster healing processes and avoiding further damage to the skin.

Book Your Consultation Today

If you are dissatisfied with the appearance of your skin due to acne lesions or scarring that has occurred, give Dr. Greenberg a call and book your consultation for a full diagnosis of your skin’s condition. She will help you restore the lush, natural appearance of your skin through a treatment regimen tailored specifically for your skin’s health and condition.

Don’t wait, book today. You’ll be glad you did!

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Acne & Acne Scarring

Acne Breakouts: Why They Occur