I remember a time when when I would be constantly waiting for that huge volcano of pus on my forehead to erupt. I picked it, then it turned into my “third eye” (or that’s what my sister called it…), then scabbed for weeks until finally, just a dark spot remained. Years later, the evidence of my acne misgivings still shows.
I once thought the scars were the price I have to pay for my inability to stop picking, just like my mom said. But as it turns out, there are ways to treat the worst of acne scars. Once you understand a little more about your “craters,” you might find the ideal solution for them.
Why does my acne still show?
I had severe acne in my teens, and the occasional beast would rear its ugly head throughout my 20s. But I haven’t had a severe breakout in years. I always thought my skin would magically turn smooth once I stopped breaking out, but let’s just say I’m still waiting. The evidence of my past pizza-face self is almost as telling as the actual zits. Ugh!
Acne scars are particularly long-lasting because the skin on your face is super sensitive, and acne causes a lot of inflammation. The more sensitive your skin, the more likely it is to scar after an injury (which is even more likely if you were a chronic picker, breaking the skin).
However, even if you never picked a zit, some breakouts are enough to cause a scar. The body has a strong response to acne bacteria, leading to intense inflammation. When your skin is inflamed for a long time, scarring is bound to occur.
Ice pick? Boxcar? What kind of scar do I have?
You might see your acne scars as a mishmash of marks that resemble the zits they once were, but dermatologists have been able to categorize acne scars into four groups. Even though most people have more than one type of acne scar, knowing which ones you have is helpful when determining which treatment will get rid of them.
• Ice pick. “Ice pick” scarring is characterized by a bunch of small pits on the skin that give your face the appearance of being dug out with a tiny ice pick.
• Boxcar. Scars that are angular with sharp vertical edges are called “boxcar” scars, and are most common on the cheeks and temples. They can be deep or shallow pits on the skin.
• Rolling. If your acne causes severe damage under your skin, you may have “rolling” scars, which are wide and shallow and give the skin a “wavy” appearance.
• Hypertrophic. Cystic acne or other serious acne lesions can often result in hypertrophic scars, which are raised and lumpy because of all the scar tissue underneath. They are more common on back and chest, but may also occur on the face and neck.
Erasing the evidence
Once you know which type of scar you have, it might be easier to figure out what kind of treatment will work to erase them. Of course, always consult with your dermatologist. The skin doc is the best person to “diagnose” your scars and explain the best treatments for them.
• Topical. There are over-the-counter and prescription ointments, gels and creams that might help for minor scarring. Vitamin E and aloe vera are both known for their healing abilities, but corticosteroids are also commonly recommended.
• Procedures. There are a number of procedures dermatologists offer that can reduce the appearance of scars, or fill them in altogether. Laser resurfacing, skin grafting, microdermabrasion and “punch” techniques can make a huge difference. Punch techniques essentially punch out the scar then sew up the skin, which leaves a smaller scar that is easier to heal. There are also incisions that are best for rolling acne scars, allowing the skin to lift out of the scar’s depression.
• Injections. Dermal fillers and steroids are commonly used to get rid of scars, too. A dermal filler takes a substance like hyaluronic acid, collagen or your own fat and injects it into the site, lifting the depressed region. Steroid treatments are better for hypertrophic scars – injected into the site, they help the scar tissue shrink or flatten.
It’s important to note that not all acne scars can be magically erased, even with the most advanced technology. But remember, our little imperfections are what make us unique! If that acne scar on your forehead has become a part of who you are, by all means, leave it be!