How does Acne Inflammation Cause Scars?

M.C. Huguelet

Acne inflammation occurs when blocked hair follicles which have been infected by bacteria rupture, causing swelling, irritation, and redness on the surface of the skin. This rupture causes damage to the skin tissue which surrounds the affected follicle, and scarring is a result of the body’s attempt to repair this damaged tissue. These scars can be raised or sunken. There are several dermatological treatments which can diminish the appearance of scars caused by acne inflammation.

Acne inflammation damages skin tissue around follicles, which can cause scars.
Acne inflammation damages skin tissue around follicles, which can cause scars.

An acne breakout begins when a hair follicle becomes blocked by dead skin. Bacteria and oil which are trapped beneath this dead skin then cause the follicle to become infected, and eventually to rupture. If the follicle ruptures near the skin’s surface, as is the case with blackheads and whiteheads, swelling and irritation are usually minimal. When the follicle rupture occurs deep beneath the skin’s surface, however, the infection is released into the surrounding tissue, causing it to become damaged. The immune system dispatches white blood cells to fight the infection, causing the area to become inflamed, red, and often painful.

Acne can leave behind scars and marks.
Acne can leave behind scars and marks.

Scarring which is caused by acne inflammation is actually a result of the body’s attempt to repair the tissue that was damaged by a follicle rupture. Rebuilding the damaged tissue requires collagen, or the protein which gives skin its strength and elasticity. Often, however, the body produces an improper amount of collagen at the repair site. Too much collagen results in raised patches of skin, also known as keloid scarring. Conversely, a shortage of collagen at the repair site can cause sunken areas on the skin’s surface, also known as atrophic scars.

There are a number of dermatological treatments which can reduce the appearance of scarring caused by acne inflammation. Minor scarring can often be greatly improved with microdermabrasion or a chemical peel, both which slough away the outer layer of skin to reveal the smoother skin beneath it. Those with severe acne scarring might consider dermabrasion or laser therapy. While these treatments can significantly smooth the skin’s surface, it should be noted that they are more aggressive than those used for minor scarring, and generally require a healing time of between one and three weeks.

Preventing acne inflammation is perhaps the most effective way to avoid scars. Acne sufferers who are worried about scarring should consult a dermatologist. In many cases, a routine of topical or oral medication can keep acne in check, in turn greatly reducing the occurrence of scars.

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Discussion Comments


@Scrbblchick -- Never heard of that! One of those strange but true instances, I guess.

My brother used to put warm, damp cloths on his face, followed by cold, damp cloths, in an attempt to get the swelling down. He had some real problems with it. His final recourse was to take antibiotics, and they helped. He also got out in the sun a fair bit, and that also seemed to help some.

He's got some scarring, but I guess that's inevitable, considering how much really bad acne he had. At least the antibiotics helped.


My husband had severe acne and has some scarring. He wears a beard, so it's not as obvious as it is on some people.

I know he's told me he's woken himself up at night picking at a particularly itchy pimple or cyst. He said he would wake up with his hands on his face, working at a pimple. A couple of times, he said the pain from the pimple popping was what woke him up.

So telling an acne sufferer not to pick at their pimples works OK as long as the person is awake. But when they go to sleep, all bets are off.

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