Atrophic acne scars have lost collagen from the healing response and are the most common type of acne scar (account for approximately 75% of all acne scars). They may be further classified as ice-pick scars, boxcar scars, and rolling scars. Ice-pick scars are narrow (less than 2 mm across), deep scars that extend into the dermis. Boxcar scars are round or ovoid indented scars with sharp borders and vary in size from 1.5–4 mm across. Rolling scars are wider than icepick and boxcar scars (4–5 mm across) and have a wave-like pattern of depth in the skin.
What is a pimple in the first place? A pimple is a small comedone, pustule or papule that forms a skin lesion; the more technical term is acne vulgaris. There are numerous causes, but regardless of the cause, pimples develop when the sebaceous glands (oil glands) get clogged and infected from bacteria. This is why pimples swell up and become red, pus-filled lesions on the surface, and just under the surface, of the skin. (2)
The earliest pathologic change is the formation of a plug (a microcomedone), which is driven primarily by excessive growth, reproduction, and accumulation of skin cells in the hair follicle. In normal skin, the skin cells that have died come up to the surface and exit the pore of the hair follicle. However, increased production of oily sebum in those with acne causes the dead skin cells to stick together. The accumulation of dead skin cell debris and oily sebum blocks the pore of the hair follicle, thus forming the microcomedone. This is further exacerbated by the biofilm created by C. acnes within the hair follicle. If the microcomedone is superficial within the hair follicle, the skin pigment melanin is exposed to air, resulting in its oxidation and dark appearance (known as a blackhead or open comedo). In contrast, if the microcomedone occurs deep within the hair follicle, this causes the formation of a whitehead (known as a closed comedo).
If one of you is a night owl and the other an early riser, bedtime can become a source of conflict. It’s hard for a light sleeper to be jostled by their partner coming to bed four hours after them. Talk to your partner about negotiating some compromises. If you’re finding it difficult to agree on a bedtime, negotiate with your partner. Don’t come to bed before or after a certain time, giving the early bird a chance to fully fall asleep before the other comes in. Consider giving the night owl an eye mask to allow them to stay in bed while their partner gets up to start the day.
Shower twice a day. Take a shower or bath in the morning and at night. Alternatively, take a shower in the morning and then again after physical activity, like exercise, or sweating. Wash your entire body with a mild cleanser and use shampoos that limit oil production in your hair. Be sure to always shower after exercising to remove the dead skin cells your body has sloughed off through sweating.
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How to Handle It: Pair two of the best-known acne-fighting ingredients, salicylic acid and benzoyl peroxide, in the week leading up to your period. (If you're feeling bloated, now's the time to do it.) The combo can help prevent hormonal acne from happening in the first place. Zeichner suggests following a salicylic acid wash, like fan-favorite Neutrogena Oil-Free Acne Wash Pink Grapefruit Facial Cleanser ($7), with a benzoyl peroxide spot treatment, such as Murad Acne Spot Fast Fix ($22). If you're still seeing zits, "visit your dermatologist to discuss prescription options, like birth control pills, oral spironolactone — which blocks oil — or topical Aczone 7.5 percent gel," says Zeichner. "It's shown to be particularly effective in adult women without causing irritation." Oral contraceptives level out those hormone fluctuations, keeping your oil production normal and your skin clear.
The Pore Normalizing Cleanser is designed just to cleanse, not treat, which is a good thing: The Nurse Practitioner study emphasizes the importance of washing with mild cleansers in conjunction with topical acne medications to combat or avoid excessive skin irritation. This one is water-based and fragrance-free, and uses sodium laureth sulfate (as opposed to its harsh cousin sodium lauryl sulfate) to eliminate any chance for irritation.
Wear sunscreen everyday and do not tan. Ultraviolet Radiation is the number one cause of premature aging. It also leads to skin cancer in high enough doses. Treat the sun like the death ray that it is. Exposing your skin to harmful UVA and UVB rays damages skin and prolongs post inflammatory erythema(PIE)--red acne marks, as the sunlight stimulates pigment-producing cells.
Dermal or subcutaneous fillers are substances injected into the skin to improve the appearance of acne scars. Fillers are used to increase natural collagen production in the skin and to increase skin volume and decrease the depth of acne scars. Examples of fillers used for this purpose include hyaluronic acid; poly(methyl methacrylate) microspheres with collagen; human and bovine collagen derivatives, and fat harvested from the person's own body (autologous fat transfer).
If one partner likes bringing devices to bed and the other partner doesn’t, there’s very little compromise to be found. Science is pretty unanimous on the fact that screens can cause harm to a healthy sleeper. Both partners should agree on a time to keep technology out of the bedroom or turn screens off. This will prevent both partners from having their sleep interrupted and can help you power down after a long day.
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