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Acne Scars


What is acne?

Acne is a common skin condition affecting the hair follicle and sebaceous gland, in which there is expansion and blockage of the follicle resulting in inflammation.

What you need to know

Acne affects both males and females of all races and ethnicities. It is more common in adolescent young adults with the majority (~85%) of 16 to 18 year olds affected. However, it can sometimes occur in children and adults of all ages.  

Acne is due to a combination of factors as follows (list is not exhaustive)

  • Familial tendency
  • Hormones
  • Acne bacteria
  • Distension and occlusion of hair follicles
Acne is usually confined to the face, but it may involve the neck, chest and back. It is characterised by the following
  • Comedones (blackheads and whiteheads)
  • Inflamed papules and pustules
  • In severe acne – nodules and cysts
  • Post-inflammatory pigment and scars
  • Severe social and psychological effects
Severity of acne is broadly classified into mild, moderate and severe acne. The severity will normally guide the treatment recommendations.

This will depend on the severity of the acne. Treatment options include e.g. topical creams (retinoids), oral medications (antibiotics, isotretinoin) and procedures (Agnes, lasers), etc.

Acne Scars

What are acne scars?

Acne scars form as a result of the normal healing process of inflammatory acne lesions e.g. nodules and cysts. Fibrosis occurs with new collagen laid down to heal a full-thickness injury. It affects roughly 30% of those with moderate to severe acne vulgaris. To reduce the chances of scarring due to acne, seek treatment for your acne early.

What you need to know

Post inflammatory colour changes are seen after inflammatory acne lesions have recently healed.  Post inflammatory erythema are pink and purple flat patches. Post inflammatory pigmentation are brown marks that occur in mainly darker-skin individuals. Post inflammatory hypopigmentation are white marks on the skin.

1. Ice-pick scars – these are deep, narrow and pitted scars
2. Rolling scars – broad depressions with slopping edge
3. Boxcar scars – broad depressions with sharply defined edges
4. Atrophic scars – flat, thin scars or depressed scars
5. Hypertrophic or keloid scars – lumpy scars