The vast majority of adolescents (up to 90%) suffer from some form of acne. Up to 20% of adults continue to suffer from the aggravating outbreaks of acne. Most of acne lesions occur on areas that have a large amount of pilosebaceous glands, mostly the face, chest and back. Although many have small lesions that come and go relatively fast, some end up with scars and pits that follow them for life. There are options for those who already have scarring that is bothersome, but treatment of active acne thereby preventing the scars is hands down the best option. For those who are not aware, there is viable treatment options for adolescent and adult acne that are not nearly as toxic as the options once were. Med club by Dr Jenn.
Acne has multiple different ways that it occurs. Sebum (the oily secretion on your face and back) can contribute to acne in two ways. The first is through increased production. If you have oily skin, you have probably fought acne at some time in your life. If there is a change in the consistency of the sebum from a bad diet or hormones can also cause acne outbreaks. A change in your androgen activity can be a culprit of acne. The actual name comes from the proliferation of a bacteria called Priopionibacterium acnes (P. Acnes), which is the final culprit.
There are two different scar types that may occur from acne. The most common 3 to 1 is atrophic scars. This is a scar that leaves a pit or rolling of the skin where the fibrotic scar tissue is flatter than the surrounding skin. Sometimes this type of scar is actually tethered to the dermis through the dense fibrotic scar tissue. The underlying issue with this type of scar is a lack of collagen in the area of injury. The other type of scarring is a hypertrophic, or keloid scars. This type of scar is characterized by firm pink or grey tissue that rise above the level of the original skin surface. This type of scar is from too much deposition of collagen with an innate decrease in collagenase activity.
When tissue gets injured, the three stages of wound healing begins. The first stage that happens is classified as the inflammation stage. The first step your body takes is vasoconstriction (your blood vessels close as much as they can) to minimize blood loss. Soon after, your vessels vasodilate (increase blood flow) and flood the area with multiple different cells that have specific jobs in beginning the body for healing. This is the period of time when the area looks erythematous (red) from the inflammation and vasodilation. The more intense the inflammation is and the longer this first phase continues leads to a worse scar after healing is complete. This is why acne prevention and treatment is the best way to avoid scarring.
The next phase is the formation of granulation tissue. During this phase, the area is reacting to the cytokines (messages) they activated cells in the area release. One of the main players in this phase is stimulation of fibroblast which creates collagen. During this phase the majority of collagen that is being laid down is type 1 collagen, with a smaller amount of type 3 collage. The natural composition of our skin has the majority of the collagen as type 3 collagen. So during the later part of this phase the collagen composition switches to be more similar to our uninjured skin.
The final phase is matrix remodeling. This is the phase enzymes are released to breakdown the collagen and other components of the area. There is a fine balance between these lytic enzymes and the enzyme inhibitors which is where the scar formation begins. If there is a perfect balance then the area injured looks identical to the surround tissue, but if too much activity occurs on the enzyme side, atrophic scars are formed. If not enough enzyme is activated, then hypertrophic scars are formed.
Once a scar is formed, very few things can help its’ appearance. One of the most powerful tool we have is microneedling. This process entails making thousands of microinjuries after a topical numbing agent is put on the face, leading to increased collagen formation. This process is not an instantly seen effect, it rebuilds the tissue volume from the inside out and is completely natural. After a series of microneedling treatments, the scar is minimized or completely gone. The addition of topical platelet rich plasma (PRP) to this microneedling technique adds to a stronger reaction from your body to create a larger volume of collagen. Both methods are an excellent way of fighting a scar.
This treatment of acne scars is also a great method for any scar on your body. It is one of the only viable treatments available and has been proven over and over.