Acne scars: Who gets and causes

Who gets acne scars?

Some people are more likely to see scars when their acne clears. The risk increases when a person:

  • Has inflammatory (swollen, reddish, and painful) acne, such as acne cysts and nodules. This type of acne tends to penetrate deep into the skin, which damages the skin. 
  • Delays or does not treat inflammatory acne. The longer a person has inflammatory acne, the greater the risk of scarring.
  • Picks, squeezes, or pops acne. This increases inflammation, which increases the risk of scarring. 
  • Has a blood relative who developed acne scars. Genes play a large role.

Although we know what increases a person’s risk of developing acne scars, it is not possible to predict who will develop acne scars. Even people who have all the risk factors may not scar. 

It is, however, possible to prevent acne scars with effective acne treatment. 

Waiting to treat acne until it becomes severe can lead to extensive scarring.

What causes acne scars?

When acne breakouts penetrate the skin deeply, they damage the skin and the tissue beneath it. As the acne clears, the body tries to repair this damage. 

During the healing process, the body produces collagen — a substance that gives the skin support. If the body produces too little or too much collagen, you will see a scar. 

The type of scar depends on how much collagen your body makes.

Depressed acne scars: If the body produces too little collagen, depressions or pits form as the skin heals.

Raised acne scars: Sometimes the body produces too much collagen as it tries to heal the skin and underlying tissue. When this happens, a person develops a raised acne scar. This type of acne scar is more common in people who have skin of color like African Americans, Hispanics, and Asians. 

Even when we do our best to prevent acne scars, some people scar. There are many treatment options, which can significantly diminish depressed and raised acne scars.

You can find out about the many treatments by going to Acne scars: Treatment and outcome.

Learn more:

References:

Jacob CI et al. “Acne scarring: A classification system and review of treatment options.” J Am Acad Dermatol 2001;45:109-17.

Riveria AE. “Acne scarring: A review and current treatment modalities.” J Am Acad Dermatol 2008;59:659-76.

Thiboutot, D et al. “New insights into the management of acne: An update from the Global Alliance to Improve Outcomes in Acne Group.” J Am Acad Dermatol 2009;60:5(sup. 1) S1-S50.