Why do Acne Scars Appear?

Before addressing acne scars and their treatment, it's pertinent to point out that reddish acne marks that resemble scars are not actually scars because no permanent change has occurred. In other words they are not real scarring and disappear in time, however, while they are visible they can cause embarrassment. Flat, red or reddish spots that appear at the final stage of most inflamed acne lesions are called Macules or "pseudo-scars". After an inflamed acne lesion flattens, a macule may remain to "mark the spot" for up to 6 more months. When a macule eventually fades, no trace of it will remain, unlike a scar. After the inflammation of an acne lesion has passed, skin pigmentation can become dark or discolorated. The lesion's color varies from light brown to black. Under sunlight exposure (UV rays), lesions may become darker. It occurs more commonly in darker-skinned people, but can be occasionally seen in people with fair skin. Early application of a natural skin care product attenuates the occurrence of post-inflammatory pigmentation and also eliminates older marks. If untreated, post-inflammatory pigmentation can even persist for up to 18 months, specially with excessive sunlight exposure. Acne scars appear after inflammation or improper healing of some spots. While for some people scarring seems to depend on genetic factors or skin color, precautions can be taken to avoid scars along with treatments, which significantly reduce a scarred skin's appearance. In the simplest terms, scars form at the site of damage and are the visible reminders of wound and tissue repair. In the case of acne, the lesion is caused by the body's inflammatory reaction to sebum, microbes, and dead cells in the plugged sebaceous follicle. There are two types of true scars: (1) Depressed areas, commonly associated with pitted acne scarring or ice-pick scars, and (2) Raised thickened tissue such as keloids. When tissue suffers a lesion, the body sends in its 'repair kit' to the wound site. The skin activitates all its defensive and repair systems, where elements such as leukocytes, inflammatory molecules, and reconstructive elements have the task of healing tissue and fighting infection. However, when their mission is done they can leave a somewhat messy repair patch in the form of fibrous scar tissue, or eroded tissue. But sometimes it's different. White blood cells and inflammatory molecules may remain at the site of an active acne lesion for days or even weeks. In people who are susceptible to scarring the result may be an acne scar. The occurrence and incidence of scarring is still not well understood, however. There is considerable variation in scarring between one person and another, indicating that some people are more susceptible to scarring than others (ex. genetic factors or skin color). Scarring usually results from severe inflammatory nodular cystic acne that occurs deep in the skin. But, scarring may also appear from more superficial inflamed lesions.