Leaving the Physical and Psychological Battle Scars of Acne Behind

By Suzanne J. Friedler, M.D. F.A.A.D

Adolescence is a stressful time. Along with the excitement of having one’s body’s transform and one’s experience broaden comes the dismay of hormonal volatility and, for most of us, the scourge of acne. For the lucky ones, acne is limited to a few unsightly blemishes. For others though, acne storms across the face, chest and upper back as if intent on destroying not only our appearance but our self-esteem. Those who suffer the worst ongoing outbreaks of acne during the teen years are sometimes left with unattractive reminders of the dermatological onslaught: acne scars. These scars, the physical evidence of teenage humiliation, can be improved or removed with a few simple treatments.

What causes acne and acne scars?

Acne is an inflammation of the hair follicles and oil glands, typically occurring after puberty when male hormones (androgens) increase in both genders, causing sebaceous glands to make more sebum — the oily substance that mixes dead skin cells and bacteria to plug hair follicles. Sebum is also food for the bacteria Propionibacterium acnes. All of these factors combined lead to acne. When the whiteheads, blackheads, nodules and cysts colloquially known as “pimples” become inflamed or do not heal properly, acne scars can occur. Hereditary factors make some people more prone to acne scarring. Because hormones affect acne outbreaks, pregnancy, some forms of birth control, and certain medications may also cause acne outbreaks to wax or wane.

While most prevalent in teenagers, acne can affect people of any age. About 50 million people in the United States suffer from the condition, including 85 percent of adolescents and 10 percent of adult women. Even infants sometimes suffer from acne. Acne can be exacerbated by the following, increasing the likelihood of acne scarring:

• Stress
• Diets containing high glycemic index “sugary foods” and dairy
• Oil-based cosmetics & creams
• Hormonal fluctuations (such as premenstrual changes)
• Certain medications, such as steroids, lithium, and quinine
• Picking, squeezing or scratching the affected skin

Whatever the cause of acne, my focus is on treating the condition itself and restoring acne-scarred skin to its natural beauty.

The Link Between Stress and Acne

Though for many years doctors suspected, and patients validated, an apparent correlation between stress and worsened outbreaks of acne lesions, it wasn’t until a Stanford University study was published in 2003 that there was hard evidence of the connection. This study found that college students had acne flare-ups during exams, that is, during periods when students reported higher than average stress levels.

Researchers concluded that there was indeed a correlation between acne severity and increased stress. Though scientists still don’t know the precise mechanism that makes acne worse under stress, they have determined that cells that product sebum have receptors for stress hormones — a significant clue. So far, while dermatologists don’t believe that stress causes acne, they do believe it can worsen it.

Ironically, there appears to be a twofold connection between stress and acne. Not only can stress provoke acne flare-ups, the scars acne leaves behind can promote stress reactions in adults, making them self-conscious or insecure in social situations, when being photographed, or even when just looking in the mirror.

Tips for treating acne scars

This is where dermatological solutions can be a godsend, particularly because over-the counter products often fail to help, or even make the situation worse. For adults who have been living with diminished self-confidence because of their acne scars, a constant visible reminder of their past adolescent angst, many new medical or surgical procedures are available to improve the surface of the skin, including:

• Lasers to treat and erase scars and smooth out irregular skin texture
• Chemical Peels to improve any remaining acne as well as enhance skin brightness
• Subscision to release scarring bands that anchor down the skin
• Microneedling to stimulate new collagen and smooth skin texture
• Dermabrasion or microdermabrasion to “sand down” scars
• Injections of fillers around the scars to smooth the surface & improve skin texture
• Transfer of fat from another part of the body to fill in areas of volume loss
• Surgical excision of scars that are resistant to other treatments

In a few short visits, patients who have felt trapped in faces and bodies marred by embarrassing traces of the hardships of growing up, can be freed to appear as they now are -– self-assured adults who have left puberty far behind.

Suzanne J. Friedler, M.D. F.A.A.D., is a board-certified fellow of the American Academy of Dermatology, with expertise in many areas of medical and cosmetic dermatology. She has been with Advanced Dermatology PC since 2002.

Advanced Dermatology P.C. and the Center for Laser and Cosmetic Surgery (New York & New Jersey) is one of the leading dermatology centers in the nation, offering highly experienced physicians in the fields of cosmetic and laser dermatology as well as plastic surgery and state-of-the-art medical technologies. www.advanceddermatologypc.com.