Acne Scars are formed when an acne breakout penetrates the skin deeply enough to damages the tissues beneath it. As such, not every acne breakout leaves a scar.
Atrophic scars are commonly found on the face. Atrophic scars are formed after acne breakouts and chickenpox. They are formed when not enough collagen is produced while the wound is still healing. The three types of atrophic scars are as follows:
These typically are wide, U-shaped and have sharp edges. Boxcar scars can be shallow or deep. The shallower scars respond better to skin resurfacing treatments, of which there are several.
These are very narrow V-shaped scars that go deep into the skin. They can look like small round or oval holes, like a hole left in ice after using an ice pick. These are by far the most difficult scars to treat because they extend far under the surface of the skin.
These are wide depressions with round edges and an irregular, rolling appearance as its name suggests.
Hypertrophic scars protrude above the surface of the skin and are caused by excessive collagen production during the healing process.
Active acne is an inflammatory skin condition that affects many teenagers and adults. It appears on the face, chest, neck and even the back. If left untreated, it can damage the skin permanently, resulting in acne scars.
There are several types of acne. These include:
Blackheads are easily visible as black “dots” on the surface of the skin. Blackheads are full of dead skin cell mixed with oil. They are black because of oxygenation, and also because of the reflection of light from clogged hair follicles. If the blackheads are deeply embedded into the skin, extraction may be necessary to remove them effectively. Extraction can be unpleasant.
Cystic acne are very visible on the skin surface, and very ugly. They are full of pus, are usually big, and look like boils or abscesses. These can cause severe scarring or post-inflammatory hyperpigmentation if forced open. This is one sign that a patient is suffering from severe acne.
By definition, these are large and hardened pimples. They are inflamed acne that is hard to the touch and are often tender. Treatment is needed to avoid permanent scar formation.
These are small little bumps on the skin, usually pinkish or reddish. If patients have a lot of papules, it is a sign of moderate to severe acne.
These are usually larger than papules and are red with white or yellow pus on top. It is not recommended to remove the pus if it's not “ripe” because pustules can lead to scarring or cause post-inflammatory hyperpigmentation.
Whiteheads ‘lie-low’ under the skin surface (the epidermis) and will at times require extraction to remove. Whiteheads are closed at the surface because they prevent a clogged follicle from being opened.
As we age, changes like these will occur:
- Skin becomes rougher to the touch.
- Pigments form.
- Skin tone is not even, fine lines and wrinkles appear.
- The loss of the elastic tissue (elastin) in the skin with ageing causes the skin to hang loosely; creating a saggy appearance.
- Skin becomes more transparent, “see-through”. This is caused by thinning of the epidermis (topmost surface layer of the skin).
Dull skin tone is a result of excessive dead skin cells that build up on the surface of the skin as the typical skin cycle is 21-60 days long. Skin tends to lose its natural luminosity caused by dehydration, damaged cells or slower cell turnover, all of which can happen even in the young. This can make your face feel not smooth or lumpy and bumpy, and can also give the skin a dull, lacklustre look.
Freckles are tiny brown spots on the surface of your skin, usually in sun-exposed areas. Freckles are harmless and benign. They form because of the overproduction of melanin. Melanin gives skin and hair it's colour (pigmentation). Simply put, freckle are a result of ultraviolet (UV) radiation stimulation.
Generally, there are two types of freckles:
Ephelides are the most common type which most people think of as freckles.
Solar lentigines are dark, brown patches of skin that develop through adulthood. These include freckles, age spots and sunspots.
When skin is injured, fibrous tissue (scar tissue) forms over the wound to repair and cover the open wound. Sometimes extra scar tissue grows, forming smooth, hard and ugly growths called keloid scars.
Unfortunately, keloids can be much larger than the original wound. Common areas where keloids grow are the chest, shoulders, earlobes, and cheeks. Having said this, keloids can grow on any part of the body.
Although keloids aren’t harmful, they are unsightly.
Melasma is a very common skin problem. This condition causes dark brown, discoloured patches on your skin.
It’s also called chloasma, or the “mask of pregnancy,” when it occurs in pregnancy. Melasma causes patches of discolouration. These patches are much darker than your usual skin tone. It typically occurs on the cheeks of the face and is fairly symmetrical.
Melasma usually appears on the cheeks, forehead, nose bridge and chin. Melasma is sometimes found on the neck and forearms. Melasma is not harmful but is aesthetically unpleasant.
MOLES, WARTS,& SKIN TAGS
Moles are growths on the skin that are usually brown or black. Moles can be found anywhere on the body.
The majority of moles appear in early childhood and during the first 25 years of life. It is quite normal to have between 10-40 moles by the time one reaches adulthood.
As the years go by, moles usually change slowly, sometimes becoming raised and/or changing colour. Occasionally, hairs grow in the mole. Some moles may not change over time, while others may slowly disappear over the years.
Moles occur when cells in the skin grow in a cluster instead of being spread throughout the skin. These specialised cells are called melanocytes, and they make the pigment (melanin) that gives skin its natural colour and tone. Moles may turn darker after UV exposure, during the teenage years, and through pregnancy.
Warts are raised lumps and bumps on your skin caused by the human papillomavirus (HPV). Although warts generally aren’t dangerous and are not cancerous, they are not pleasing to the eye, potentially embarrassing, and even contagious. They can also be painful and bleed if traumatised.
Skin tags are painless, benign growths on the skin. They’re attached to the skin by a small, thin stalk called a peduncle. Skin tags are commonly found in both genders, especially after the age of 50. They can appear just about anywhere on the body, though they’re most commonly found in places where your skin folds and creases such as the axillae, groin, thighs, eyelids and neck.
Everyone has a natural oil in their skin. Beneath each pore is a sebaceous gland that produces natural oils called sebum. This helps keep skin hydrated, supple and healthy. Sometimes the sebaceous glands overproduce oil. This results in oily skin.
You know you have oily skin if your skin constantly looks shiny (not the bright and glowy kind), and you use up several blotting sheets in a day. Oily skin can even feel greasy 1-2 hours after cleansing.
Breakouts are therefore more likely to occur because the sebum mixes with dead skin cells and gets clogged in the pores. The causes of oily skin include genetic, environmental, and lifestyle factors. While one can’t eradicate oily skin, you can take concrete steps to make the skin far less oily. The key to this is to first identify one or more of these seven underlying causes.
Each pore contains a hair follicle and a sebaceous (oil) gland that makes sebum.
Regardless of skin type, whether it’s oily, normal, or dry, can appear to have large, open pores. This gives skin a dull appearance, especially if they’re clogged with dirt and dust, germs, sebum, or dead skin cells.
Causes of big open pores include:
- Overproduction of sebum
- Reduced elasticity around pores due to loss of elastin and collagen
- Thick and coarse hair follicles
- Reduction of collagen production in the skin as a consequence of ageing
- UV damage or overexposure to sunlight
Pigmentations are brown spots or patches on the skin caused by the excessive deposition of the pigment melanin, which is produced by specialized cells called melanocytes.
There are numerous types of pigmentation, the common ones being melasma, sunspots, and post-inflammatory hyperpigmentation.
Melasma is strongly believed to be caused by hormonal changes and may sometimes develop during pregnancy. Hyperpigmentation can appear on any part of the body, but they appear most often on the abdomen and face.
Also called liver spots or solar lentigines, sunspots are common. They’re related to excess sun exposure over time. Generally, they appear as spots on areas exposed to the sun, like the hands and face.
This is a direct result of injury or inflammation to the skin. A very common cause of this type of pigmentation is acne vulgaris.
There are essentially four subtypes of rosacea. Each rosacea subtype has its own set of symptoms and signs. It is quite possible to have more than one subtype of rosacea at any one time.
Rosacea’s pathognomonic symptom is tiny, red, pus-filled papules on the skin that appear during flare-ups. Typically, rosacea appears on the skin of the nose, cheeks, and forehead.
In rosacea, flare-ups often are cyclical. This means that you will experience symptoms and signs for weeks or months at a time, after which the symptoms will resolve, and then return later.
There are four subtypes of rosacea:
Erythematotelangiectatic rosacea (ETR), is classically associated with facial redness, flushing, and visible blood vessels and capillaries
Papulopustular rosacea is associated with acne-like breakouts and often affects middle-aged women. It less often affects men.
Rhinophyma is a rare form associated with thickening of the skin on your nose resulting in a coarse-looking nose. It affects men more often and is also often accompanied by yet another subtype of rosacea.
Ocular rosacea and its symptoms are centred on the eye area.
Seborrheic or solar keratosis is another type of skin growth. They can be unsightly, look wart but the growths aren’t harmful. However, sometimes, seborrheic keratosis can be difficult to distinguish from malignant melanoma, a sinister type of skin cancer. Growths often start as small, rough surface areas. And then over time, they develop into thick plaques, wart-like surfaces. They’re often described as having a “stuck-on” appearance; locally called “Lao ren pan”. Less commonly, they appear waxy and have slightly elevated surfaces.
Sun, skin disorders, ageing and even heredity can all contribute to skin irregularities on the face and elsewhere on the body. These include textural irregularities like wrinkles and acne scars, pigmentation changes like freckles, sunspots or visible blood vessels. In addition, the skin may lose tone, feel less firm and lose the healthy glow that is evident in younger skin.
Solar lentigo is caused by prolonged exposure to UV rays from the sun. This lesion is more common in people over the age of 40, but younger people are not exempt. It occurs when UV radiation causes pigmented cells called melanocytes in the skin to proliferate. It is no surprise then that solar lentigo appears on sun-exposed areas of the body, like the face, hands, shoulders, neck and arms. These spots may become bigger over time. Solar lentigines are sometimes referred to as liver spots or age spots.
The real concern that a lot of us have is that some types of wrinkling are associated with old age. As we age, the skin atrophies and gets thinner when collagen and elastin production slows down gradually. UV damage and exposure to environmental contaminants and pollutants only aggravate it. Wrinkles and fine lines can also be caused by dehydration or allergies on the face in any age group. Industrial pollution, poor nutrition, genetics, cigarette smoking, and certain medications can also contribute to the premature formation of wrinkles.
A xanthelasma is a soft, yellowish, fatty deposit that forms under your skin. While they are generally harmless to the skin nor painful, these small growths may cause the upper eyelid to droop partly because of the weight.
These lesions may remain the same size or grow very slowly over time. It can sometimes join together or coalesce to form bigger unsightly lumps. Individuals with xanthelasma may tend to have abnormally high lipid levels in the blood known as dyslipidaemia. It is, therefore, best to have the blood checked for raised cholesterol levels.