What is Acne? Acne vulgaris or cystic acne is a very common skin disease affecting many young and middle-aged individuals. Acne vulgaris lesions include papules, pustules, nodules and comedones (black heads and white heads). Severe acne lesions are usually inflammatory however, acne also has noninflammatory presentations. Increased incidents of acne are often seen on areas of the body where there are numerous sebaceous glands: the face, the upper chest and the upper back. Acne can be seen in adults as well as teenagers however, there is often a peak in the number of acne incidents during the adolescent years due to the hormones that are constantly changing during the process of puberty.
What causes Acne? Acne blemishes do not happen over night. The process of acne lesion formation starts two to three weeks before the lesion becomes visible on the skin's surface. Acne begins in the pilosebaceous unit, which is the skin structure consisting of the hair follicle and sebaceous (or sweat) gland. Sex hormones (Androgens) send a signal to the sebaceous gland to start the secretion process of Sebum. Sebum is a natural oil that aids in maintaining the skins moisture and elasticity. Sebum, rich in essential lipids, also provides an excellent breeding ground for the acne causing bacteria, Propionibacterium acnes or (P. Acnes). As our skin continually rebuilds itself, new skin cells are pushed to the surface and the old cells die and are sloughed off. However, when there is an interruption in the normal skin rejuvenation process, the dead skin cells and natural oils may build up on the skins surface. If this process continues the pores become plugged. The anaerobic environment of the hair follicle that is plugged with a comedone provides a thriving breeding ground for bacteria (P.Acnes). The visible acne lesions seen on the surface of the skin is a result of excess oil and dead sin cells that have clogged the pore of the hair follicle. Underneath the comodone, the bacteria continues to grow, thus resulting in increased swelling and inflammation.
What is Acne Scaring? The term "scarring" refers to a process where the skin's cells can not repair the damaged parts of the skin, leading to permanent texture changes in the skin. There are 3 types of acne scarring: ice pick scarring, atrophic scarring, and hypertrophic scarring.
Treatment for Acne Scars. In the past, acne scarring has been considered to be permanent. But, with the latest research and newly developed technology noteable improvement can be seen even in some of the most severe cases of acne scaring. A combination treatment may be required to achieve the desired results. Treatment of acne scarring is usually considered an elective cosmetic procedure and in most cases will not be covered by your insurance. It is important that the acne is under control and the skin clear before you consider treating the scared areas. Otherwise, new scars form and the procedures are wasted. The most effective treatments for acne scarring are surgical, not medical. Acne scars show little improvement with the application of topical creams. Treatment options available for acne scaring include: Dermabrasion, Dermsanding, Acne Laser Treatment, Subcision, Punch Excision and Grafting, Dermal Fillers, Chemical Peels, and rarely Steroid Injections.