Different Types of Acne

Scars from acne can seem like double punishment — first you had to deal with the pimples, now you have marks as a reminder.

It helps to understand the different kinds of acne so you can figure out what to do about different types of scarring: Acne lesions or pimples happen when the hair follicles (or "pores") on the skin become plugged with oil and dead skin cells. A plugged follicle is the perfect place for bacteria to grow and create the red bumps and pus-filled red bumps known as pimples.

Acne comes in different forms:

• mild acne, which refers to the whiteheads or blackheads that most of us get at various times
• moderate acne, which includes red inflamed pimples called papules and red pimples with white centers called pustules
• severe acne, which causes nodules — painful, pus-filled cysts or lumps — to appear under the skin

Most serious scarring is caused by the more severe forms of acne, with nodules more likely to leave permanent scars than other types of acne.

The best approach is to get treatment for acne soon after it appears to prevent further severe acne and more scarring. If you have nodules, see your doctor or dermatologist for treatment.

Treating Acne Scars

Most of the time, those reddish or brownish acne marks that are left behind after a pimple eventually fade with no need for treatment. Picking or squeezing acne can increase the risk for scarring, though.

Acne scars take two forms:

1. scars with a gradual dip or depression (sometimes called "rolling" scars)
2. scars that are deep and narrow

A person's acne needs to be under control before scars can be treated.

Mild vs. Severe Scarring

Treatments depend on how severe the scars are. In some cases, a doctor or dermatologist may suggest a chemical peel or microdermabrasion to help improve the appearance of scarred areas. These milder treatments can be done right in the office.

If you have serious scarring from previous bouts with acne, there are several things you can do:

• Laser resurfacing. This procedure can be done in the doctor's or dermatologist's office. The laser removes the damaged top layer of skin and tightens the middle layer, leaving skin smoother. It can take anywhere from a few minutes to an hour. The doctor will try to lessen any pain by first numbing the skin with local anesthesia. It usually takes between 3 and 10 days for the skin to heal completely.
• Dermabrasion. This treatment uses a rotating wire brush or spinning diamond instrument to wear down the surface of the skin. As the skin heals, a new, smoother layer replaces the abraded skin. It may take a bit longer for skin to heal using dermabrasion — usually between 10 days and 3 weeks.
• Fractional laser therapy. This type of treatment works at a deeper level than laser resurfacing or dermabrasion, Because fractional laser therapy doesn't wound the top layer of tissue, healing time is shorter. Someone who has had this type of treatment may just look a bit sunburned for a couple of days.

For "rolling" scars, doctors sometimes inject material under the scar to raise it to the level of normal skin. Finally, in some cases, a doctor may recommend surgery to remove deeply indented scars.

One thing you shouldn't do to deal with acne scars is load up your face with masks or fancy lotions — these won't help and may irritate your skin further, making the scars red and even more noticeable.

If you have a red or brownish mark on your face that you got from a bad zit, it should eventually fade. However, it may take 12 months or longer. Talk to your doctor if you're upset about acne marks; he or she may have advice on what you can do.

Reviewed by: Patrice Hyde, MD
Date reviewed: March 2013