What Is Acne?
Acne is a chronic inflammatory skin condition that affects the pilosebaceous unit, which consists of the hair follicle and sebaceous gland.
The condition develops when excess oil production combines with dead skin cells and debris within the follicle. This creates an environment where acne-causing bacteria can multiply, triggering inflammation within the skin.
As inflammation develops, different types of acne lesions can form, ranging from blackheads and whiteheads to painful cystic breakouts.
While acne is not dangerous, it can be distressing and may have lasting effects on both the skin and emotional wellbeing if left untreated.
What Causes Acne?
Acne is rarely caused by a single factor. Instead, it usually develops through a combination of biological, hormonal and environmental influences.
Hormonal Changes
Hormones play a major role in acne development. Increased androgen activity stimulates the sebaceous glands to produce more oil, increasing the likelihood of blocked pores and inflammation.
This is why acne commonly occurs during:
- Puberty
- Pregnancy
- Menopause
- Menstrual cycles
- Hormonal disorders such as PCOS
Excess Oil Production
Sebum plays an important role in protecting the skin, but excessive oil production can contribute to pore blockages and acne formation.
Bacteria
A naturally occurring bacteria known as Cutibacterium acnes can multiply within blocked follicles and contribute to inflammation.
Genetics
Some individuals are genetically predisposed to acne and may be more likely to experience persistent or severe breakouts.
Lifestyle Factors
Stress, poor sleep, certain cosmetic products and other environmental influences can contribute to flare-ups in susceptible individuals.
Different Types of Acne
Not all acne behaves in the same way.
Blackheads and Whiteheads
These are known as comedonal lesions and develop when pores become blocked with oil and dead skin cells.
Inflammatory Acne
Inflammatory acne appears as red, swollen bumps and pustules that may become painful or tender.
Hormonal Acne
Hormonal acne commonly affects the lower face, jawline and chin and is particularly common in adult women.
Nodular and Cystic Acne
These deeper lesions develop beneath the skin’s surface and often cause significant inflammation. They carry a higher risk of permanent scarring if not treated appropriately.
Adult Acne
Many adults continue to experience acne well beyond their teenage years. Adult acne often requires a different treatment approach due to hormonal influences and changes in skin behaviour.
Why Some People Develop Acne Scars
One of the most common concerns we hear in clinic is:
“Why did my acne leave scars?”
Acne scars develop when inflammation damages the deeper structures of the skin.
As the body attempts to repair this damage, collagen production becomes disrupted. In some cases, too little collagen is produced, leading to depressed scars and uneven skin texture.
The likelihood of scarring may increase when:
- Acne is severe
- Inflammation is prolonged
- Breakouts occur repeatedly
- Spots are picked or squeezed
- Treatment is delayed
This is why controlling active acne as early as possible is so important.
Types of Acne Scars
Ice Pick Scars
Ice pick scars are narrow, deep scars that extend into the skin. They often resemble small puncture marks and can be among the most challenging scar types to treat.
Boxcar Scars
Boxcar scars appear as wider depressions with defined edges. They are commonly found on the cheeks and temples.
Rolling Scars
Rolling scars create an undulating or wave-like appearance across the skin and occur when fibrous bands pull the skin downward.
Many patients present with a combination of scar types rather than a single pattern.
Post-Acne Redness (PIE)
Not every red mark left behind after acne is a scar.
Post-inflammatory erythema (PIE) occurs when inflammation damages tiny blood vessels within the skin.
This can leave persistent red, pink or purple marks that remain visible long after the acne itself has resolved.
Unlike true scars, PIE does not involve permanent textural changes and often responds well to treatments designed to target vascular redness.
Post-Inflammatory Hyperpigmentation (PIH)
Post-inflammatory hyperpigmentation develops when inflammation triggers excess melanin production.
These marks typically appear brown, grey or darker than the surrounding skin and are particularly common in medium and darker skin tones.
PIH is often mistaken for scarring but represents a pigment concern rather than a textural change.
The Emotional Impact of Acne
Acne can affect far more than the skin itself.
Many individuals report feeling self-conscious about their appearance and may avoid social situations, photographs or activities that draw attention to their skin.
The emotional impact of persistent acne should not be underestimated, which is why effective treatment and support can be so valuable.
When Should You Seek Professional Advice?
If acne is becoming persistent, painful, difficult to manage or is beginning to leave marks and scars behind, professional assessment may help identify appropriate treatment options.
Early intervention often provides the best opportunity to minimise long-term skin changes.
How Can Acne and Acne Scars Be Treated?
Treatment recommendations depend on the type and severity of acne present.
Options may include:
- Medical-grade skincare
- Hydrafacial
- BBL Forever Clear
- Microneedling
- HALO Laser Resurfacing
- ProFractional Laser
To learn more about how we treat acne and acne scarring, visit our dedicated Acne Treatment page.
