Inflammatory acne is no picnic. It causes painful irritation, as well as cosmetic issues such as post-inflammatory hyperpigmentation and keloidal or hypertrophic scarring. Here’s a quick rundown of what causes these issues and what you can do to mitigate and prevent them.
What is Hyperpigmentation?
Post-inflammatory hyperpigmentation (usually just called hyperpigmentation) refers to the red or dark spots that remain on the skin after acne heals. These spots develop when the inflammation from acne causes skin cells to produce more melanin (the pigment that gives skin its color), which makes the skin appear darker, or redder (depending on your skin-tone) in the affected areas. Hyperpigmentation can last for months or even years in some cases.
What are Keloidal and Hypertrophic Scars?
Both keloidal and hypertrophic scars are raised scars that may occur after a bout of inflammatory acne. While keloidal and hypertrophic scars are similar, there are a few key differences:
- Hypertrophic Scars – These scars form when the body produces too much collagen during the healing process after a bout of acne. Hypertrophic scars tend to recede over time (typically within a year or two), flattening out and becoming paler in color. They also do not become larger than the original acne inflammation, staying constrained to the boundaries of the acne legions from which they form.
- Keloidal Scars – These scars are like Hypertrophic scars, but more severe and much more common in darker skin. Keloid scars form when an acne breakout does not heal properly, allowing the infection to break through the top of the skin. Your body fights this by sending up an excess of collagen to seal off the wound, which results in collagen fibers forming beyond the boundaries of the original legion, which is why keloidal scars are often larger in size than the original injury.
Healing and Prevention
When it comes to preventing hyperpigmentation and keloidal or hypertrophic scarring, the best thing you can do during an acne breakout is leave your acne alone. Picking at acne is the No.1 culprit when it comes to hyperpigmentation.