Atrophic acne scars occur as depressed and well-defined lesions. They are usually caused by collagen destruction during the course of an inflammatory condition such as cystic acne.
These scars often have a sunken and pitted appearance. Scar formation is a necessary process for the healing of skin tissue after an injury. However, abnormal or disrupted collagen production can cause impaired restoration of the skin surface and textural irregularities. Various factors determine how the skin will scar, including depth and size of the wound, heredity, ethnicity and age.
Although scars are harmless, they are more susceptible to environmental factors such as sun damage.
Atrophic scars can be easily identified by their depressed and pitted appearance in the surface of the skin.
Atrophic acne scars are typically caused by inflammation. They result from damage to the underlying tissues beneath the scar. As the skin undergoes the natural healing process and repairs itself, scar tissue is formed.
Choose gentle cleansers for the skin, preferably in liquid form. These cleansers will gently remove dirt, excess oil, bacteria and cosmetics without irritating the skin.
Avoid soaps, especially bar soaps, as they can cause dryness. Avoid scrubbing the skin too hard when bathing to prevent irritating the scar tissue. After washing, gently pat the skin dry with a towel.
Moisturizers can restore and maintain the skin’s natural moisture levels. When completely healed, gently massaging the scar with a moisturizer may be helpful to minimize dryness and irritation. Look for moisturizers specially designed for sensitive skin that are free of fragrance, dye or other allergens that may irritate the skin.
The best way to prevent atrophic scarring is early treatment of inflammatory skin conditions.
For example, in the case of acne, early and effective treatment can reduce the severity and progression of the inflammation, thereby limiting the potential for scars to form.
Skin camouflaging cosmetics can cover up the appearance of scars.
A doctor may prescribe a topical cream containing tretinoin or other retinoids (forms of vitamin A) that encourage collagen production and improve the appearance of fine and small scars.
Atrophic acne scars usually respond well to laser therapy. Facial atrophic scars can be safely and effectively resurfaced through laser treatments, such as high-energy pulsed or scanned carbon dioxide (CO2) or erbium-yttrium-aluminum-garnet (Er:YAG). These lasers use a high-energy beam of light to resurface the skin by destroying the damaged outer layers (epidermis and superficial dermis) and stimulating the production of collagen and new skin cells.
Non-ablatative therapies such as pulsed dye lasers can be helpful. Procedures such as chemical peels, dermabrasion, subcision, and soft tissue fillers (collagen and hyaluronic acid fillers) are also used to treat atrophic scars.