Our body repairs any injury through production of collagen. Collagen is a protein that gives the skin its rigidity and strength and is produced by skin cells called fibroblasts. The collagen plays a major role in patching up any damage to skin. When there is an overproduction of collagen, the excess of it becomes piled up in firm masses, resulting in a characteristic scar.
Acne scars are caused by the body’s response — and sometimes, overresponse — to injury caused by inflammatory acne lesions. Most often, scarring results from severe nodular acne that occurs deep in the skin. But, scarring also may arise from more superficial inflamed lesions. Studies have shown that likelihood of scarring is associated with the duration of inflammatory response shown by any individual, which in turn determined by the genetic makeup. Longer the duration of inflammation shown by the individual, greater are the chances of formation of scars.
The term scarring technically refers to a process in which new collagen is laid down to heal an injury. Some people endure their acne scars all their lives with little change in them. They’re notoriously difficult to treat and impossible to completely eradicate. A single, optimal technique for scar treatment hasn’t been developed. That is why, scarring is considered one of the most dreaded complication of acne.
Types of scars:
Some acne scars appear as holes, pits, or craters in the skin. Called atrophic scars or crateriform scars, these depressed, cavity-like, inward-directed scars are associated with a lack of tissue. This occurs when the inflammation from healed acne causes destruction to the skin (similar to scars that often result from chickenpox). The scar tissue contracts and binds the skin down. Atrophic scars may be further divided in
- Ice-pick scars – these are deep, narrow, pitted scars.
- Rolling scars – broad depressions with sloping edge.
- Boxcar scars – broad depressions with with sharply defined edges.
- Depressed fibrotic scars- These scars are usually quite large, with sharp edges and steep sides.
These scars bulge outward like lumps.
A keloid is a scar whose size goes far beyond what would be expected from what seems to be a minor injury. It’s kind of an “over-scarring.”