What is acne scars?

Acne scars are additional permanent Textural or Pigmented skin marks from severe or inflamed acne lesions. When acne deeply invades the skin and destroys the surrounding tissue, the body will start to heal this injury by producing collagen. If this process produces too little or too much collagen, scarring can result.

These scars take on different forms: some are atrophic scars (depressed scars such as ice-pick scars, box-car scars, or rolling scars, depending on the mode of scarring); some are hypertrophic or keloids (thick and raised); and post-inflammatory hyperpigmentation, which is not a true form of scarring but is regarded as dark spots that remain from healed acne.

Scarring occurs mostly on the face but can also occur on the back, chest, and shoulders. The severity of these scars often depends on the type of acne, duration of the acne, genetic predisposition to scarring, and whether the acne was picked or squeezed.

In rare instances, they are difficult to treat. However, several dermatological procedures, such as laser therapy, microneedling, chemical peel, and fillers, can improve their appearance significantly.

What are the types of acne scars

They are essentially grouped into two main types of scars: atrophic (depressed) scars and hypertrophic (raised) scars, with several subtypes under each:

1. Atrophic Scars (Depressed Scars)

These are the most well-known acne scarring types and are caused by tissue loss.
Ice Pick Scars: Scars appear as deep, narrow and pitted marks due to puncture, and they are very difficult to treat.
Boxcars: Broad, rectangular-shaped depressions with sharp edges, usually found in the cheeks and temples.
Rolling Scars: Wavy or undulating scars, which have sloping edges, thus creating a rolling or uneven look to the skin.

2. Hypertrophic and Keloid Scars (Raised Scars)

Those scars that develop when the body lays down too much collagen while healing.
Hypertrophic Scars: Raised, firm scars, developing well within the limits of the original acne lesion. Tend to develop mostly on the chest, back and shoulders.
Keloid Scars: More severe than hypertrophic scars, keloids extend beyond the confines of the original wound and may continue to grow over time. Keloids are often itchy or painful, but they can be more common in people of darker skin tones.

3. Post-Inflammatory Hyperpigmentation (PIH)

PIH is actually not a scar: It describes the dark or discolored spots left after acne heals. These are more common in darker-skinned individuals and may fade with the passage of time.

Common Causes of Acnes

Acne is said to manifest due to a combination of different factors that act to block and/or become inflamed in the skin. The major causes of acne are given below.

Excess Sebum Production: These overactive sebaceous or oil glands produce too much sebum. When blocked, acne may result especially during the period of puberty when the hormones are rising.
Plugging of Hair Follicles: The dead skin cells and oil can accumulate inside the hair follicle to form a plug. When this happens, blackheads, whiteheads, or pimples are created.
Cutibacterium acnes: It is a natural skin bacterium whose rapid reproduction in blocked pores would begin acute inflammation and pus lesions.
Hormonal Changes: Events in life that alter hormones, specifically androgens, are also a cause for acne. These fluctuations are seen during puberty, menstruation, pregnancy, or due to conditions such as polycystic ovary syndrome (PCOS).
Diet: Some studies suggested that high glycemic foods, dairy products, and sugary diets can worsen acne to some people.
Psychosocial Stress: It does not cause acne per se, but under significant stress, already existing breakouts worsen due to hormone fluctuations, resulting in increased oil production in the sebaceous glands.
Certain Medications: Corticosteroids, lithium, and some birth control pills may trigger acne or worsen it.
Cosmetic Products: Using oil-based and comedogenic makeup and skincare products will clog the pores and cause acne.
Genetics: A family history of acne is said to raise the likelihood of someone suffering from it genomically.

Top Natural Remedies for Fading Acne Scars Fast

Here are some of the best natural remedies to help acne scars fade faster, especially when used regularly and in conjunction with a mild skin-care regimen.

1. Aloe Vera

Benefits: It is anti-inflammatory, promotes healing, and lightens hyperpigmentation.
How to Use: Apply pure aloe vera gel from the plant or a trusted product onto scars every day.

2. Lemon Juice (With Caution)

Benefits: It has a natural bleaching effect; may lighten dark scars.
How to Use: Apply diluted lemon juice (with water or honey) to scar for 10-15 minutes, then rinse.
Note: It can cause irritation or photosensitivity, so always patch test and wear sunscreen.

3. Honey

Benefits: Natural moisturizer and antibacterial; promotes healing and the reduction of scars.
How to Use: Apply a thin layer of raw honey as a mask, leaving it on for 20 minutes before rinsing.

4. Cucumber

Organizing these benefits: Hydrating and relieving with fading redness and light pigmentation.
How to Use: Daily place slices or juice of cucumber on the skin.

5. Apple Cider Vinegar

Gently exfoliates and helps remove dark spots.
How to use: Mix with water in a concentration of 1:3 and soak a cotton ball into this solution. Apply to the affected area, wait for a few minutes, and rinse.

6. Rosehip Seed Oil

Rich in vitamin A and fatty acids, helps regenerate skin and improves texture.
How to use: Rub a few drops into scars daily.

7. Turmeric

Anti-inflammatory and antioxidant properties are associated with lightening scars.
Method: Mix turmeric with honey or yogurt into a paste and apply to scars for 10-15 minutes. Rinse off.
How to use: Dilute with a carrier oil (e.g., coconut or jojoba) and apply to affected areas.

When to See a dermatologist?

Acne should be seen by a dermatologist when it is chronic, painful, or when scarring or emotional distress occurs. Unsuccessful treatments can go on for weeks before seeking medical care, especially for severe forms of acne-such as cystic and nodular acne-which can cause damage to the skin over a long time.

A dermatologist can also assist with dark spots or different changes in the skin’s texture due to hormonal turbulence, medications, or any illnesses affecting the body systems.

Further, should the acne scarring begin to form, a dermatologist can provide in-depth treatments using chemical or laser therapy and prescribed medications to enhance the skin’s appearance and prevent further scarring. Early intervention could get better results with less permanent damage to the skin.

Conclusion

Self-esteem and quality of life can be greatly influenced by acne as well as its resulting scars. It’s very important to treat acne early and appropriately to prevent permanent damage to skin.

Natural remedies may give some minor improvement, but in most cases of chronic or severe acne or scarring, they require professional treatment. I, Dr. Jagdeep Rao, a specialist in dermatology and aesthetic medicine based in Jaipur, would highly recommend visiting a well-trained dermatologist for a personalized treatment module. Clear, healthy skin is possible for all under correct guidance with modern dermatological techniques.