Acne Scar is the most problematic issue.
Acne scar is the sequel of acne eruption that is infected and inadequately treated with antibiotic medication or acne surgical evacuation of blemishes. All eruption scar on the face are caused by acne. However, not all acne eruption causes acne scaring. Very mild and shallow acne that are not infected by bacteria may not end up with acne scaring. Commonly incriminated bacteria are Propionibacterium acnes.
Acne scaring affect almost every other teenager, especially the male. The equatorial climate is also more prone to sebum production which eventually gets blocked, oxidized at the surface causing the black heads. Cold weather decrease the sebum gland activity and thus decreased the likelihood of severe acne.
Acne Scar is more difficult to treat than an acne.
The acne prone skin are in general more oily and thicker. The male hormone androgens such as testosterone that increase drastically during puberty is another major cause of acne eruption.
Some blame the spicy food, other blame the fried food that increase chances of acne. Still other think chocolate may be incriminated. Simple sugar only provoke androgen release is a secondary indirect cause.
Acne scaring causes various degree of severity. Some are deep, other are shallow. Some acne clear up faster other much later.
Acne Scar begings its scarring process deep inside the dermis.
The deeper it is the more severe is the scaring. During infection, the bacteria multiply inside the sebaceous gland, the size of the gland distend and finally burst. When burst the content together with the bacteria can reach all the way into the sub-cutaneous layer. Here, the various types of white blood cells, also called the soldier, will attack and kills the bacteria. When this WBC rupture, it release the various cytokines which tries to wall off the infection from spreading. In so doing, it causes the formation of granulation, hardening, and the repair process start. The repair causes fibrous tissues formation which links the dermis to the deep sub-cutaneous layer. When this fibrous tissues mature, it contract pulling down the outer skin into the dermis and sub-cutaneous layer bring about depression.
In cystic acne/ acne vulgaris the resultant acne scar is severe.
If this fibrous tissues is prevented from developing, usually by administration of anti-inflammatory injections, using a mild steroid, the scaring can be prevented. However, time is the essence, until and unless it is administered early in the course of eruption, it may not be effective.
This is especially essential if the density of the acne are very closely packed together causing the coalescing of them into a huge eruption. This severe acne is called acne vulgaris.