How To Prevent Acne From Scarring

To prevent the formation of acne scars, one must take precautionary measures because once these scars form, it can be difficult to treat or manage them. These preventive measures ensure that the skin is not irritated, stressed, or infected, contributing to the acne leaving scars behind after they are healed. 

Even though acne is not a life-threatening condition, it can harm a person's appearance and, if left untreated, can cause scars. At the top of the list of precautions to take when you have active acne is to get it treated as soon as possible while avoiding picking at or popping your acne, as these cause significant distress to the skin where the acne occurred, thus, increasing the risk for scarring.

Let's delve further to know its causes, strategies for preventing scarring, and effective scar treatment options.

Understanding acne

The sebaceous glands are tiny glands in the skin that secrete sebum, a lubricant, into hair follicles to lubricate the skin and hair. Acne is medically known as Acne Vulgaris, a condition that affects these glands resulting in either non-inflammatory or inflammatory lesions.¹ 

Sebum is a wax-like and oily secretion produced by sebaceous glands which shields the skin's surface from drying. Changes in sebum secretion and the rate of sebum excretion are correlated with the severity of acne.²

Open comedones (blackheads) and closed comedones (whiteheads) are two categories of comedones that are non-inflammatory. The inflammatory type of acne ranges from papules, pustules, nodules, or cysts, which cause scarring of varying degrees if no precautions are taken.^1,3 We will discuss how to recognize them going forward in this article.

Common causes of acne

Common causes are environmental, genetic, psychological, and sometimes lifestyle induced.^3,4

• Environmental pollution: Exposure to chemicals and air pollutants in the workplace or around the home⁵
• Social media: Consuming poor quality or inaccurate information on social media regarding how to take care of your skin⁴
• Age: Acne is predominant and more common in adolescence. Incidence increases in teenagers and reduces as they get older
• Hormones: Pregnancy, depression, and stress can disrupt hormone levels⁶
• Gender: Acne affects more males than females during adolescence and more females than males post-adolescence
• Economic level: Those with acne were more often residing in metropolitan regions with a higher socioeconomic class²
• Heredity: With more family members having a history of acne, the likelihood of developing acne is greater⁶
• Temperature and humidity: While warmer weather boosts moisture and oil production, cold weather may cause moisture levels to drop, worsening inflammation
• Sun exposure: UltraViolet B rays from the sun increase sebum production
• Menstrual cycle: The menstrual phase in a woman’s menstrual cycle causes moderate to mild acne
• Diet: Intake of sweets, milk, and daily consumption of dark chocolate
• Cosmetics: Incorrect use or method of application of cosmetics and skincare products as well as certain ingredients in cosmetics, such as mineral oils
• Electronic products: According to research, prolonged exposure to the short-wavelength visible light emitted by smartphones and tablets may promote the growth of Staphylococcus aureus bacteria⁴
• Quality of sleep: Staying up late or getting less than 8 hours of sleep daily can result in losing water in the skin, weakening the skin’s barrier function
• Skin type: Oily and combination skin types tend to be more acne-prone than normal and dry skin types
• Medication: Some medications have acne as a side effect

Signs and symptoms 

Acne occurs predominantly on the face, back, chest, and sometimes the ears. Your acne symptoms will differ depending on the underlying reason and severity of your condition. As was mentioned in the previous section, whiteheads are closed clogged pores, while blackheads are open clogged pores. Papules are tiny, red, and uncomfortable bumps, and pustules, commonly known as pimples, have pus at their tips. Smaller, painful, pus-filled lumps beneath the skin represent cystic acne and are more likely to scar than other types of acne due to being deep within the skin, while nodules are solid, big, painful lumps beneath the skin.

What causes acne scarring?

Having acne itself does not guarantee that you will have acne scars. When there is bacterial buildup leading to inflammation of acne, chances are that the acne will scar.

There are two primary types of acne scars: those that grow when tissue is lost, leaving an indentation in the skin's surface, or those that are elevated on the skin's surface, which in fact, indicates that your skin may be functioning too effectively.⁷

The different types of indented or atrophic scars:

• Ice pick scar is a large hole in the skin which narrows to a point as it gets into the skin and is one of the hardest scars to heal
• Rolling scars appear uneven and wavy due to the sloping corners of the indentations.
• Boxcar scars are indents with sharper edges

Elevated scars, also known as keloid or hypertrophic scars, are formed because excess collagen is produced to aid the healing of the skin, resulting in elevated scarring. They can be itchy, tender, or painful.

How to prevent acne from scarring?

There are medications and natural remedies that you can use on your acne to prevent it from scarring and also to treat or manage already-formed acne scars. 

Medications

Medications for acne are either applied on the skin or taken orally. The type of medication to be used is determined by the kind of acne and your skin type; your dermatologist may prescribe one or more. 

Commonly prescribed drugs include:

• Benzoyl peroxide 
• Azelaic acid 
• Salicylic acid 
• Retinoids 
• Alpha hydroxy acids 
• Lactic acids 
• Antibiotics 

There are prescribed depending on age and if pregnant or lactating.^1,6,7,8 Care should be taken while using antibiotics because the body may develop resistance to the antibiotics, reducing or stopping their potency.⁹

Natural remedies

Tea tree essential oil, ayurvedic ingredients, barberry extract, gluconolactone, probiotic treatments, fish oil, green tea, basil oil, copaiba oil, minerals, resveratrol, rose water, seaweed, taurine bromamine, dietary changes, and acupuncture are examples of natural remedies to prevent acne scars. Other natural remedies include lemongrass, lemon, neem, oak bark, onion, orange peel, calendula, chamomile, coriander, cucumber, garlic, geranium Patchouli, pea, petitgrain, pine, rosemary, stinging nettle, turmeric, witch hazel, and pomegranate rind extract.^1,9,10

Avoid touching, popping, or peeling your scar. Skincare products containing niacinamide and vitamin C have been shown to boost collagen production. Using sunscreen helps to reduce the effect of sun rays, while products containing hyaluronic acid soothe inflammation.

Complications of acne scars

One in five people with acne will develop acne scars. The appearance and texture of acne scars can worsen over time by getting darker, thicker,  bigger (in hypertrophic scars), or deeper (in atrophic scars). Strict adherence to the treatment and aftercare procedure stipulated by your doctor is essential for a successful treatment and to prevent relapse.¹¹

If left for long, acne scars will take longer to heal, while some scars are tough to heal, even with treatment due to genetic factors. The elimination of all acne scars is not a 100% guarantee. However, most treatments shrink acne scars and make them less noticeable.

Ways to treat acne scars

The method for treating acne scarring entails a thorough physical examination and a conversation about your goals, concerns, and tolerance level for various treatment choices. Erythema (red skin) and the kind, extent, and location of scarring are considered.¹² 

Your dermatologist will know the best treatment for your acne scars. 

Your dermatologist may prescribe one or more medications listed in the previous section or perform cosmetic procedures to resurface the skin through chemical peels, dermabrasion, and microdermabrasion laser resurfacing to stimulate new production after using heat to destroy the scarred collagen.^12,13

They may also remove acne scars by injecting steroids into the scar to soften and flatten them, cutting into the skin to remove the scar, injecting dermal fillers to lift indented skin, micro-needling, and freezing off the scar tissue using nitrogen.^12,13

Summary

The occurrence of acne is caused by several factors and is not solely based on personal hygiene. Environmental pollutants and irritants, genetics, cosmetics, age, gender, and medications are some of these factors. To prevent the formation of acne scars, you should treat your acne early enough. It is important to  apply your topical treatment with freshly washed hands to avoid introducing bacteria over the area that will cause inflammation. If your acne still scars after taking preventive measures, see your dermatologist for the best treatment option.