When acne becomes inflamed, white blood cells gather around hair follicles to clear away blockages and bacteria, but also damage the skin tissue.
After white blood cells clear away dead tissue, the skin begins to repair itself, and the cells release chemical signals that stimulate skin cells to rebuild. Blood vessels grow and deliver oxygen, while fibroblast cells produce collagen protein to repair damaged tissue. When collagen fills the wound, scar tissue begins to form, which is usually red in color. Over time, the scar tissue matures, blood vessels gradually fade, and the color starts to lighten.
Here we discuss pigment treatment methods before addressing scar indentation issues. After scar tissue matures, the skin may return to its normal color, but if not, alternative methods should be considered. If the scar is darker than surrounding skin, it means there is pigment deposition, and whitening methods can be used for treatment. Generally, stronger whitening medications such as hydroquinone are used. In addition, glycolic peels (such as Jessner’s Peel containing salicylic acid) can be done every two to four weeks to increase skin metabolism.
On the other hand, if the scar is lighter than the surrounding skin, it means that melanocytes have been damaged and the new fibrous tissue lacks pigmentation. This situation is difficult to treat because there is no effective method to restore melanocytes. In a few cases, tissue excision or skin grafting can be used for improvement.
If the scar is red, it indicates that the tissue is healing, and the increased blood vessels during the wound repair process cause the scar to turn red. The red phase can last for several months to several years. To improve it quickly, laser treatment (such as the 585-595nm wavelength) or color light can be used to reduce the growth of blood vessels.