Beauty 101

Types of Acne Scars and How to Treat Them

Dr Ingky Dermatologist
Types of Acne Scars and How to Treat Them

Types of Acne Scar

Acne scars fall into two main categories: those caused by a loss or excess of tissue, and those caused by skin discoloration. Within these categories, there are five main types of acne scars: ice pick, boxcar, rolling, keloid scars and hyperpigmentation.

Acne scars can be difficult to treat, and always require professional help if you want to see real improvement. However, over-the-counter products can help you treat the scar but it’s going to take some time to see the improvement. Your options depend on the type of scarring you have. Most people have more than one type of scarring on their skin, so you might need a few different treatments to see the best results. Before we learn more about the treatment, here's a look at the different varieties of acne scars:

Ice Pick Scars

Ice pick scars are deep, very narrow scars that extend into the dermis. The skin looks as if it has been pierced by an ice pick or sharp instrument. Ice pick scars seem to make a small, thin, deep hole into the skin. Some may look like a large, open pore. 

Boxcar Scars

Boxcar scars are round or oval depressions with steep vertical sides. Wider than ice pick scars, boxcar scars give the skin an uneven, pitted appearance. 

Rolling Scars

This type of scarring causes rolling or wave-like depressions across otherwise normal-looking skin. Rolling scars differ from boxcar scars in that they aren't sharply defined. The skin itself looks uneven and craggy. 

Hypertrophic and Keloid Scars

Hypertrophic scars are firm, raised scars that grow above the surface of the skin. Hypertrophic scars caused by acne are most often found on the torso, especially in men, but they can happen anywhere on the body. Hypertrophic scars are more common after a deep wound or trauma.

Keloids are a more severe type of raised scar. Keloid scars are caused by overgrowth of granulation tissue at the side of the healed wound, which is then slowly replaced by collagen. This type of scar can appear as firm, rubbery lesion or shiny, fibrous nodules.

Hyperpigmentation Scars

Post-Inflammatory Hyperpigmentation (PIH)

PIH is the overproduction of melanin in the skin triggered by the skin’s natural response to inflammation. PIH scar can become worse from sun exposure. PIH is usually flat and it is darker than the surrounding skin. Discoloration can range from light to deep brown or even black.

Post-Inflammatory Erythema (PIE)

PIE is damaged or dilated capillaries (blood vessels) caused by inflammation and trauma. Over exfoliation, sunburns, inflamed acne and are all causes. Dryness and dehydration will also contribute which is unfortunate since many acne treatments are often drying. PIE can vary from pink, red to deep purple.

How to Treat Them: What to Know About Combining Niacinamide, Retinol and Vitamin C

Vitamin C + Retinol

Retinol usually work best in an acidic environment. This means if you use vitamin C, which is usually low pH and acidic, prior to using retinol, retinol will work very effectively. Both help with exfoliation and to improve overall skin texture. Studies have shown that using a product with 5% vitamin C increased elastic fibers and showed a more uniform distribution of collagens. This works nicely with retinol because it also stimulates collagen production. Together, one can expect to see a smoother, brighter and even skin texture.    

Vitamin C + Niacinamide

Niacinamide is a base and vitamin C is an acid. So, in the world of chemistry, an acid and a base should neutralize in solution and cancel each other, but not always. The reality is that niacinamide is extremely stable and it takes a lot of energy for it to react with anything. This means it won’t react with vitamin C, so there is no risk of neutralization and you can use niacinamide and vitamin C together without any problem. Each of these ingredients on their own can help address dark spots and uneven skin tone, and when used together, they will still work just as effectively and sometimes even better. 

Niacinamide + Retinol  

Using niacinamide and retinol together in one product or combined as part of your skin care routine has several benefits. A study in 2008 examined the combination of niacinamide and retinol and has found that niacinamide lessens the irritation and dryness caused by retinol. Additionally, a 2017 study found that a retinol cream with moisturizing ingredients, including niacinamide, caused less irritation than a formula with just retinol.

This suggests that if you use a product that also contains niacinamide, which can protect your skin barrier, and you may be able to benefit from retinol but with fewer side effects. Studies have also found that formulas containing both niacinamide and retinol can be beneficial for your skin.

The bottom line..

As we can see here, niacinamide and vitamin C is good in treating acne scars that caused by discoloration. Meanwhile, retinol is good in treating acne scars caused by loss or excess of tissues. People that struggle with acne scars usually have more than one type of scar. Therefore, the combination of these 3 miracle ingredients could be exactly what you need in treating acne scars.

If you want to know more, we are here to help you! SkynFyx is a platform that provides personal care education that is completely free. SkynFyx is run by our skin doctors and you can chat with us without ever leaving your home.

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