One of the biggest concerns with acne is the scarring it can leave behind, especially since it is our very-visible face that is affected – an obvious reason why many people with acne also have a poor self-image. It may be interesting to note, however, that what many think is an acne scar may actually be something different. Let us explore…
Acne is basically a disease of the oil glands found in the face, back and chest, whereby keratin (the skin’s protein) and/or sebum (the skin’s oil) block the gland and create what is known as a comedone (white or black head). If these comedones become infected with bacteria, or other matter, they will turn into an inflammatory lesion called a papule or pustule (aka. pimple or Zit). Sometimes these inflammatory lesions may burst, usually by people picking at their zits, which can then destroy the surrounding tissue and, if it happens at the deeper dermis level of the skin, will create a scar. This is real scarring and is very hard to remove, especially with any type of herbal medicines, although I have heard that laser treatments for acne scar removal can be effective.
In the picture below we can see some ‘real’ acne scarring. The deeper layer of the skin has been damaged due to this person picking their pimples!
Now another thing that happens in acne prone skin is that the inflammatory lesion can concentrate melanin (the same pigment that gives us our summer tan) in that area, creating a brown spot. After the pimple clears up this brown spot stays behind, becoming what many people think is a scar, but is not a real scar at all. In fact this brown spot, called ‘post-inflammatory hyper-pigmentation’, will usually go away all on its own, but may just take awhile (upwards of 6 or more months). When people have lots of pimples that are constantly coming and going, they will usually have many of these brown spots coming and going as well, which gives the impression that they are always there as a permanent feature of their skin but, rest assured, these spots will most likely go away and are not a real scar.
In the picture below we see active acne, showing signs of comedones, papules and pustules, with hyper-pigmentation in the background.
Then below we have a picture of the same patch of skin as above, but after being treated for a couple months with Chinese herbal medicines. We can see that most of the inflammatory lesions are gone and that hyper-pigmentation remains in its place. This is not scarring and will most likely go away, with the skin eventually returning to its normal natural colour once again.
In Chinese medicine, brown discoloured patches of skin are thought to be the result of the blood becoming static after much heat has congealed it. Herbal medicines that improve the micro-circulation of the skin can often help resolve these brown spots more quickly and are commonly used at the end stages of treatment, after much of the inflammatory (hot) aspects are distinguished.
Wishing you good health,
Dr. Trevor Erikson
Copyright © 2019 Dr. Trevor Erikson