• Fri. Jun 14th, 2024

Causes, Types, and Treatments of Acne and Acne Scarring


Jul 4, 2023

What Causes Acne Breakouts?

1. Hormones

When androgens rise in both boys and girls during puberty, the sebaceous glands under the skin enlarge and produce more sebum or oil. Too much sebum damages the pore’s cellular walls and allows bacteria to grow. Hormonal changes during menstruation, pregnancy, and the use of oral contraceptives can all affect sebum production and cause acne to develop or recur.

2. Heredity

There is major evidence for a genetic influence on acne. The condition does run in families, and if both of your parents had acne, you’re likely to develop it, too. 

3. Oil-based beauty products

Makeup, moisturizing creams, lotions, and hair products that contain pore-clogging sulfates, mineral oil, coconut and cocoa butter, and silicones can encourage the blocking of your skin’s pores. Look for non-comedogenic, oil-free, and unscented cosmetics, toiletries, and sunscreens. Harsh chemicals in laundry detergent can also irritate sensitive skin.

4. Stress and Anxiety

Psychological and emotional stress directly affect the levels of hormones such as cortisol and adrenaline, making acne worse. These stress hormones stimulate your oil glands to make testosterone that increases oil production and clogs pores.

5. Pimple popping

When you try to burst a pimple, it’s easy to push the bacterial infection further down and spread it underneath your skin. This just causes more blocking, swelling, and redness, multiplying your pimples. It also makes scarring more likely.

6. Diet

Although for a long time we thought that eating greasy foods and chocolate caused acne, recent research finds a direct link between a high glycemic/high dairy diet and acne. A study published in the Journal of the Academy of Nutrition and Dietetics found an association between acne and diets high in dairy products, sweets, rice, bread, potatoes, and pasta.

How To Treat Acne?

1.Establish a Consistent Skincare Routine:

Developing a regular skincare routine is essential for treating acne. Follow these steps:

  • a. Gentle Cleansing: Use a mild, non-comedogenic cleanser to remove dirt, excess oil, and impurities from your skin. Avoid harsh scrubbing, as it can irritate the skin and worsen acne.
  • b. Exfoliation: Incorporate exfoliation into your routine to remove dead skin cells and unclog pores. Look for products containing salicylic acid or glycolic acid, which help to gently exfoliate the skin.
  • c. Moisturize: Use a lightweight, oil-free, non-comedogenic moisturizer to keep your skin hydrated without clogging pores. Even acne-prone skin needs moisture to maintain a healthy barrier.
  • d. Sun Protection: Apply a broad-spectrum sunscreen with an SPF of 30 or higher to protect your skin from harmful UV rays. Look for oil-free or non-comedogenic options.

2.Over-the-Counter Treatments:

Several over-the-counter acne treatments can help manage mild to moderate acne. Look for products containing the following ingredients:

  • a. Benzoyl Peroxide: This ingredient kills acne-causing bacteria and helps to unclog pores. Start with a low concentration (2.5% or 5%) and gradually increase if needed.
  • b. Salicylic Acid: Salicylic acid helps exfoliate the skin, unclog pores, and reduce inflammation. It is particularly effective for treating blackheads and whiteheads.
  • c. Sulfur: Sulfur has antibacterial and anti-inflammatory properties that can help reduce acne lesions.

3.Prescription Medications:

If over-the-counter treatments are not effective, consult a dermatologist who may prescribe medications tailored to your specific needs. These may include:

  • a. Topical Retinoids: Prescription-strength retinoids, such as tretinoin or adapalene, help unclog pores, reduce inflammation, and promote skin cell turnover.
  • b. Antibiotics: Oral or topical antibiotics can be prescribed to reduce acne-causing bacteria and inflammation.
  • c. Hormonal Treatments: For hormonal acne, hormonal therapies such as oral contraceptives or anti-androgen medications may be recommended to balance hormone levels and reduce breakouts.
  • d. Isotretinoin: Isotretinoin, also known as Accutane, is a powerful oral medication prescribed for severe acne. It effectively reduces oil production, prevents clogged pores, and can provide long-term improvement.

4.Professional Treatments:

In-office procedures performed by dermatologists can complement acne treatment and help improve skin condition. These may include:

  • a. Chemical Peels: Chemical peels involve applying a solution to the skin to exfoliate and improve acne-related issues.
  • b. Microdermabrasion: This procedure uses a device to gently exfoliate the outer layer of the skin, promoting new skin cell growth and reducing acne symptoms.
  • c. Laser or Light Therapy: These treatments target acne-causing bacteria or reduce inflammation to improve acne symptoms.

5.Healthy Lifestyle Habits:

In addition to skincare and medical interventions, adopting healthy lifestyle habits can support acne treatment:

  • a. Balanced Diet: Follow a well-balanced diet rich in fruits, vegetables, whole grains, and lean proteins. Limit
  • processed foods, sugary snacks, and high-glycemic foods, which may exacerbate acne.
  • b. Stress Management: Practice stress-reduction techniques, such as mindfulness, yoga, or meditation, as stress can contribute to acne flare-ups.
  • c. Regular Exercise: Engage in regular physical activity to improve blood circulation and promote healthy skin.
  • d. Adequate Sleep: Get sufficient sleep to allow your body to repair and rejuvenate the skin.

What causes acne scars?

When acne forms on your skin, your body’s natural healing processes kick in just like they would for an injury or illness. The problem is that’s not always a perfect system. Acne forms when your skin pores get clogged with too much oil and dead skin cells. Sometimes, it appears close to the surface of the skin – which means it will probably heal after a short time with minimal scarring. When acne is rooted farther down in the skin, though, it takes longer to heal. Because this runs deeper and destroys more of your skin tissue, it often leaves scars.

After a breakout, your body will try to heal itself by replacing the lost skin tissue that has been destroyed. Scarring occurs when the body produces either too much or too little of this tissue. When the body creates too much tissue, the acne lesion becomes a raised scar – known as a hypertrophic scar (or, in severe cases, a keloid). On the other hand, a lack of tissue results in skin depressions – known as atrophic scars.

Those dark marks you sometimes get after a bad outbreak are a different type of scar. Technically, they’re not scars at all, just changes in pigmentation (a technical term for skin color). When a lesion gets popped or opened up some other way, the skin has to close back together and cover up the depression. Your body is usually pretty good at healing itself, but after a particularly deep trauma – like a pit from a popped acne lesion – the body doesn’t always cover up seamlessly. Often, the skin that closes over the wound changes color, texture, or tone. In other cases, the broken blood vessels from a popped lesion leave a mark on your skin. These are what we usually call “dark marks” or hyperpigmentation.

Even if you don’t pop your acne, you may still see dark red or brown marks appear on your skin from especially deep or inflamed cases. Don’t panic, though: if you held back from popping that pimple, these marks will usually fade within a few months.

Pictures of Different Types of Acne Scars

Not all acne scars look the same. They can take various forms. For example:

  • Rolling Scars

According to Schweiger Dermatology, this is the most common type of acne scar. They’re shallow, wide, and have sloping edges. These scars tend to get more noticeable with age. 

  • Red Spots

These are flat, red (or brownish) spots that form in the spot of a previous acne lesion. They usually fade without leaving a permanent mark. 

  • Dark Spots

Sometimes, healed acne leaves a temporary dark spot on the skin, known as post-inflammatory hyperpigmentation.

  • Boxcar Scars and Ice-Pick Scars

Acne scars caused by a loss of tissue are called depressed fibrotic scars (sometimes called boxcar scars) and ice-pick scars. They tend to appear sunken and look like pits in the skin, though ice-pick scars are deeper than boxcar scars.

  • Hypertrophic Scars and Keloids

Some types of acne leave scars that appear as enlarged, raised growths of tissue. These acne scars are caused by too much scar tissue. Hypertrophic scars and keloids look similar, but the latter are more raised than the former.

How to Prevent Acne Scars?

The best prevention for acne scarring is to optimize acne treatment with a good skin-care routine, a healthy diet, and an appropriate treatment regimen.

You should treat acne with over-the-counter creams or facial washes containing active acne-fighting ingredients such as salicylic acid or benzoyl peroxide.

Regular use of a topical retinoid like tretinoin (Retin-A), adapalene (Differin), or tazarotene (Tazorac) has been shown to both prevent and reduce the appearance of acne scars, and these are commonly prescribed by a dermatologist as part of an acne skin-care regimen.

Don’t pick at your acne, and avoid using any skin-care products that are abrasive, like scrubs and loofahs or washcloths.


Treating acne requires a comprehensive approach that combines a consistent skincare routine, over-the-counter treatments, prescription medications when necessary, professional interventions, and healthy lifestyle habits. Each individual’s acne treatment plan may vary, so it’s important to consult with a dermatologist to determine the most suitable options for your specific needs. With patience, persistence, and the right combination of treatments, you can effectively manage acne and achieve clearer, healthier skin.

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