- A pimple is an inflammatory lesion that occurs when a hair follicle becomes filled with dirt, oil and dead skin cells, and infected with acne-causing bacteria. A scar is the visible remainder of injury to healthy tissue. As the body's defense systems rush to repair the pimple, scar tissue is left at the site. Generally, there are three types of acne scars: superficial scars (which are small and soft), icepick scars (which are depressions in the skin that get wider as they deepen) and hypertrophic scars (which are elevated over the surface of the skin, but flatten over time).
- When healthy tissue suffers injury in the form of an inflammatory lesion, or pimple, red and white blood cells and inflammatory molecules rush to the site to remove the bacteria and heal the lesion. The blood cells and molecules stay at the site for days, and sometimes even weeks, repairing the damage by refilling it with collagen and leaving scar tissue behind as they fight the bacteria. However, the refilling and repairing process rarely yields a smooth result, accounting for the presence of scars. Acne scars such as icepick scars occur due to loss of tissue. This type of scarring tends to occur when the individual picks at his/her skin, thereby aggravating the area around the pimple and leading to deep grooves in the skin similar to chickenpox scars. Finally, sometimes hyperpigmentation can be mistaken for an acne scar. However, this is just a natural skin reaction known as post-inflammatory hyperpigmentation. As the pimple heals, the skin in that area becomes slightly darker, but then this pigmentation subsides as time goes by.
- A variety of treatments to remove acne scars are available. Laser removal treatments work best for superficial scars and hypertrophic scars. Some of the most effective laser treatments are fractional laser removal and laser resurfacing. Done in a dermatologist's office, these laser treatments remove the damaged outer layer of the skin to reveal healthy, smooth skin underneath. Icepick and depressed scars are much harder to treat, especially if they are very deep. These scars cannot be treated with laser resurfacing. Instead, the dermatologist uses a treatment called a "punch technique," which is removal of the scar and insertion of a skin graft to fill in the depression. Almost all of these treatments are costly and some are not covered by insurance. If you suffer from unsightly acne scars, make sure to consult with a dermatologist to determine which type of treatment is best for you.
