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Acne is a common problem of the oil glands of the skin present at the base of the hair follicles. Commonly seen during puberty, acne is not a dangerous disorder or permanent, but can result in scarring.

Development of acne

In teens, acne is the result of hormonal changes associated with puberty. The regions commonly affected include the face, shoulder, neck, chest, and the upper back. Acne is formed when the oil glands under the skin secrete excess oil, which, along with the dead skin cells clog the pores of your skin. Bacteria are trapped inside and multiply leading to redness and swelling. This is the beginning of acne.

Acne and scarring

Depending on the severity, acne can be classified into different forms:

  • Mild acne: commonly seen as whiteheads or blackheads
  • Moderate acne: white-centred red pimples called pustules and inflamed red pimples called papules
  • Severe acne: painful cysts filled with pus, commonly referred to as nodules

The scars left behind by mild and moderate acne are not usually permanent, and heal with time. However, the scars of severe acne can become permanent, requiring the immediate attention of your dermatologist. Scars can be of the following forms:

  • Having a gradual depression (rolling scars)
  • Deep and narrow (ice pick)
  • Depression with a sharp border (boxcar)
  • Thickened and inflamed (hypertrophic or colloidal)
  • Dark pigmentation (not true scarring; slowly heals without treatment)
  • Pink or red regions (not true scarring; slowly heals without treatment)


The method used to treat an acne problem varies depending on the type of scar.

Some of the treatment procedures that your doctor may choose include:

  • Soft tissue fillers:injecting collagen/fat under the skin to stretch out or fill in the skin; thereby lightening the scars
  • Chemical peels:peeling away the top skin layer using a chemical
  • TCA cross:applying a concentrated acid onto scars such as ice pick, rolling and box scars to stimulate new collagen formation, and reduce the depth of depressed scar. Multiple treatments are required.
  • Subscision:uses a sterile needle to break the fibrotic tissue under depressed scars. The release of the fibrous strands helps stimulate collagen deposit in the area and improve the appearance of the scar.
  • Laser beam:destroying the outer most skin layer especially the edge of a box scar
  • Skin surgery (punch excision):removing individual small scars through a minor surgical procedure
  • The link below is a discussion between 2 very experienced cosmetic dermatologists about acne scarring and their preferred treatment.

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