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Types of Acne Scars You Should Know

illustration of women and types of acne

At some point in your life, you start to experience breakouts which eventually leads to acne over time. No doubt you’ll feel overwhelmed about this and experience emotional distress because it’s something that’s out of your control and affects your appearance.

Often appearing at the most inconvenient times, like before dates, parties, or work presentations, acne can be hard to remove within a short time. When the hair follicles or pores on your skin get clogged by oil and dead skin cells, they form comedones. Once bacteria start to grow on them, you’ll notice some inflammation and red bumps on your skin.

You see, acne is a skin condition that is most common among teenagers, although young working adults may experience it too. If you’re one of the few who has suffered acne for years and is looking to treat it, you’ve come to the right place. In this article, let’s understand how acne develops along with how the scars are formed.

How does acne develop?

Acne typically appears on your face, forehead, chest, upper back, and shoulders as these areas of the skin have the most sebaceous glands, which are connected to hair follicles. When the follicles are bulging, they produce whiteheads. If the plug is open to the surface and exposed to external pollutants such as bacteria, oil, and dirt, it becomes a blackhead.

Meanwhile, pimples develop when your pores become inflamed or infected with bacteria, causing them to appear as raised red spots with a white centre. Should there be blockages and inflammation deep inside your skin’s hair follicles, it can cause cyst-like lumps to develop beneath your skin’s surface.

Additionally, certain things may trigger or worsen your acne such as hormonal changes, medications, diet, and stress. On top of that, if you often touch your face with your hands, you may want to cut down on that habit as your hands aren’t exactly clean from dirt or bacteria.

Types of acne

Call it a pimple, blemish, bump, or breakout if you like, but there are many types of acne and knowing the difference can be highly beneficial when you’re looking for the right treatment method. In general, there are six types of acne:

  • Whiteheads – These closed comedones happen when your pores are clogged all the way through, creating a little white bump on the skin. This type of acne can’t be removed or fixed by squeezing them, so don’t pop them on your own or you’ll end up with acne scars.
  • Blackheads – Unlike whiteheads, blackheads appear black on your skin’s surface. These are open comedones because the head of the pore remains open. Blackheads can be removed by squeezing but they can also cause acne scars to form.
  • Papules – These small red bumps form when oil or excess skin cells block your pore and mix with the bacteria on your skin. When the contents of this blocked pore spill out, the bacteria escape into the surrounding skin tissue, creating an inflamed lesion with no pus.
  • Pustules – Similar to papules but contain pus, pustules are small, bulging bumps with a white centre and red, inflamed skin surrounding them. They form when a blocked pore gets infected or caused by hormonal changes in the body.
  • Nodules – This type of acne typically appear as red bumps deep under the skin’s surface. It’s usually a result of the bacteria causing a painful infection deep within the pore.
  • Cysts – This is the most severe form of acne as a result of an infection deep within the skin. They often appear as large, red, inflamed, painful and filled with pus. Softer than nodules due to pus, bursting them can infect the surrounding skin.


How acne scars form?

If you’ve tackled acne and won the battle, you may feel that it’s over. However, it’s never truly over until it’s over because the blemishes that you’ve battled can leave their mark on your skin long after the breakout has subsided.

You see, acne scars occur when there’s an overproduction or underproduction of collagen at a specific spot when a wound is healing. The scar often develops within the dermis, where the acne or skin inflammation is.

When you have cystic acne, there’s a higher chance of having deep acne scars – especially if you pick on them before they’re ready. Also, constantly touching or squeezing your pimple spots can damage small veins, glands, and tissues surrounding the spots, causing acne scarring to occur.

Types of acne scars

Depending on the severity of your acne, the scars can range in appearance from shallow, mottled depressions to deep, narrow depressions. Acne scars are usually skin-coloured but can appear darker or lighter. Here’s a look at the different types of acne scars:

Atrophic scars

Commonly caused by severe cystic acne, atrophic scars are flat, shallow depressions that heal beneath the skin’s top layer. There are three types of atrophic scars:

  • Boxcar scars typically appear as broad, box-like depressions with sharp, defined edges on areas like the lower cheeks and jaw, where the skin is relatively thick. They’re caused by widespread acne, chickenpox, or varicella, a virus causing red, itchy rash with blisters.
  • Ice-pick scars are smaller with narrow indentations that point into the skin’s surface. They’re commonly formed on the cheeks. This type of acne scars can be tough to treat and often require persistent, aggressive treatment.
  • Rolling scars are different from the previous two types of scars. They have different depths with sloping edges that make the skin appear uneven.


Hypertrophic and keloid scars

Unlike atrophic scars, hypertrophic and keloid scars form as raised lumps of scar tissue where the acne once was. This occurs due to the build-up of scar tissue from previous acne spots. Also, hypertrophic scars are usually the same size as the acne that caused them while keloid scars create a scar larger than the acne.

These types of scars are more common on areas such as the jawline, chest, back, and shoulders. Also, those with darker skin tone are more likely to develop these types of scarring.

Post-inflammatory hyperpigmentation

As the name suggests, post-inflammatory hyperpigmentation isn’t a scar but simply a darker or discoloured patch of skin that will fade over time with a good sun protection regimen. Hyperpigmentation occurs when the skin is damaged by severe acne or if you pick on your acne. Regardless, your skin will return to its natural colour over time.

Now that you’ve learned about the types of acne and acne scars, it’s important that you seek the right treatment for your acne to effectively treat future acne scars. Avoid picking on your acne or the scars so that it doesn’t worsen over time.

If you have severe acne, it’s best to seek for medical advice from our doctors at Eeva Medical Clinic to understand your skin condition and find the best acne treatment in Singapore for your skin.

Eeva Medical Aesthetic Clinic