Scarring is the result of deep injury to the skin. In response to injury, special cells called fibroblasts secrete collagen to repair the damage. Many factors influence the extent of repair and the final appearance of the scar. Location, size, and depth of the injury are important as some areas of the body have a predisposition for excessive scarring. Susceptible areas include the ears, upper chest, outer arms, and back. Healing is a complex process that generally occurs over one year's time. Prevention of wound infections and maintaining an overall state of good health and nutrition are important to the healing process.
Some individuals actually have a genetic predisposition for excessive scarring. Scars that are enlarged with a "heaped up" appearance are called keloids. Keloids result from fibroblast overactivity. It is unclear why some people produce keloids and others do not. Scars that are elevated above the surface but are confined within wound boundaries are called hypertrophic.
Acne scarring consists of depressions in the skin. It requires more aggressive approaches and cannot be cured by creams and superficial treatments. Dermabrasion, laser, surgical excision, subcision and collagen are effective when combined and used in the appropriate situations. Acid peels and microdermabrasion do lessen the appearance of fine scars: however, they do not address deep skin scarring. Make sure your physician discusses realistic outcomes. Acne scarring is difficult but not impossible to treat.
Skin discoloration from acne does notrepresent scarring. This type of discoloration represents resolving deep inflammation. Topical bleaching agents are helpful initially. Discoloration usually resolves within six months once the acne is controlled. The first step is to address the acne. Acne is controlled with daily use of medications and conservative skin care. (See Acne).
Over the years, many different treatments have been recommended for scar improvement. Historically, one of the most popular remedies involves the application of topical vitamin E. At this time, there is no scientific evidence to support that topical vitamin E is beneficial. In fact, people may actually develop a contact dermatitis from this type of treatment.
Scar treatments vary and some are more successful that others. Many physicians will inject scars with cortisone in an attempt to decrease the fibroblast overactivity. Multiple injections are usually necessary for improvement. Surgical excision of the scar is another means to remove the overgrown skin. Unfortunately, this also creates a scar that may be even worse than the original