Acne Scars And Holes
Acne Scars And Holes

Acne Scars And Holes

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The unsightly appearance of acne lesions or pimples isn’t the only potential problem with the disease, unfortunately. In some cases, it’s possible for acne to leave permanent scars.

Some conditions may appear to be scars that are not. Macules and other bumps can occur even after acne is treated. Redness may persist for up to a year. But these aren’t true scars. They’re not permanent.

True scars are a permanent change to skin tissue produced by the healing process itself, chiefly creating fibrous tissue. As white blood cells attack bacteria they can produce changes in underlying skin cells in the surrounding area. This is one way scars become permanent.

They may also not be limited to areas under the surface.

So-called icepick scars are small pinholes that form in the surface of the skin. They look as if the skin has been poked with an icepick, hence the name. They’re typically too deep to be treated with simple dermabrasion or even laser resurfacing.

Boxcar scars are similar, except they tend to be flatter on the bottom, rather than narrowing to a point like icepick scars. Since they’re often shallower they can sometimes be treated with resurfacing techniques.

Keloid scars are firm and grow beyond the site of the injury. They’re characterized by an excess production of collagen. They often result in a shiny pink or red scar.

Prevention is the best option, of course. But when that’s not possible, there are a number of standard treatments.


Dermabrasion is used to treat a wide range of skin conditions, including mild to moderate acne scarring. A local anesthetic is given and the professional uses a high speed brush to remove layers of skin. The skin then naturally regenerates, minus the scar in many cases. When it’s not entirely removed, it’s often less obvious.

A variation on the technique is known as microdermabrasion. Instead of a high speed brush, aluminum oxide crystals are moved rapidly through a type of vacuum hose. They carry away skin cells on their way to being collected. It’s less invasive or traumatic to the skin, but the results may, therefore, be less.


Laser treatment can be effective for some patients. Used well, they can change the contour and size of scars. CO2 lasers are often used to remove some tissue. Sometimes a single treatment is enough, but redness can persist for several weeks afterward. Lasers work in these types of treatment, essentially, by burning.


A technique called ‘punching’ can be used to remove some icepick scars. The scar is excised down to subcutaneous fat and the resulting hole repaired. The repair may be done with sutures or a small skin graft.

Subcisions may be performed. These involve actually lifting the scar tissue away from unscarred skin. Results are mixed, but the technique can be effective.


Keloids don’t respond well to these mechanical techniques, since altering the skin often just provokes the formation of more keloids. Sometimes a topical retinoid is applied. In other cases steroid-type drugs are injected directly into the skin around the scar. They’re difficult to treat by any means and results vary widely from person to person.

Whatever treatment method you seek, it’s important to consult a professional for proper diagnosis. That’s the best way to find out about all the available alternatives, and their potential risks and benefits.
Acne scars can have a serious effect on a person’s self-confidence. The scars can make a person reclusive, avoid social contacts with people and also result in reduced self-esteem. However, acne scars need not be a lifelong burden. Today, there are several removal options that allow a person to regain self-confidence and self-esteem. At the same time, it is important to remember that the acne scar removal options may not eliminate the scarring completely, but they may help to minimize it.

Some of the different acne scar removal options are as follows:

Dermabrasion is the most popular technique of removing acne scars due to its effectiveness. The method uses a high speed brush to remove the superficial layer of the skin, so that the scarring is minimized. This treatment has a downtime of several days to allow the skin to heal.

Micro-dermabrasion is similar to dermabrasion, but is not as intensive. Instead of using a high speed brush, the dermatologist sprays the scars with minute crystals to remove the scars. The person invariably requires several treatments before the desired result is achieved, but it does not require any downtime.

Chemical peels are recommended for people with moderate acne scarring and hyper-pigmentation present around lesions that have healed. The peel is applied by a licensed doctor, spa esthetician or nurse on the out layer of the skin to give a smoother and even look. The peel may cause redness and peeling of the skin for a few days after the application of the chemical peel.

Retinoic acid is apt for scars that cannot be treated with other treatments. Retinoic acid in the form of cream is applied on the scars and gradually the scars begin to diminish. This treatment is highly effective for keloid scars.

Lasers are slowly becoming popular among people having acne scars. The laser removes the superficial layer of the skin to reduce scarring and it helps to reduce the redness present around lesions. There are a variety of lasers that dermatologists can use depend on the type of scarring a person has. Typically, a person requires more than one treatment and there could be a downtime of several days based on the type of laser used.

Fillers such as collagen or hyaluronic acid are used on some kinds of acne scars. Usually, when depressed scarring is present, fillers are used. However, this is not a permanent option of acne scar removal, as fillers ultimately get absorbed by the skin and repeat injections are needed every few months to keep the scars from becoming visible again. However, the benefit of this treatment is that the person does not have to spend any time waiting for the healing to complete.

Skin grafting is a procedure that involves taking normal skin is surgically implanting it on the scarred area of the skin. This treatment method is used primarily when a hole forms in the skin due to other treatment options, such as punch excision or dermabrasion. In punch excision, each individual scar is removed by cutting it out and the resultant hole is then filled with the help of a skin graft.

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