Acne Marks or Scars in Buca? How to Choose Treatment?
Buca, one of the largest and most vibrant districts of Izmir, has a unique atmosphere, especially due to the high concentration of young people brought by Dokuz Eylül University, the stress of campus life, the sleepless nights of exam periods, and the characteristic features of the Aegean climate. Within this dynamic life cycle, acne (pimples) is one of the most frequently encountered dermatological problems, ranging from adolescence to young adulthood and even old age. However, another issue that causes as much, or sometimes even more, discomfort than acne itself is the legacy left on the skin after acne. Many clients tend to categorize the redness, brown spots, or pits they see in the mirror in the same category. However, from a dermatological perspective, “Spots” and “Scars” have completely different formation mechanisms, different depths, and therefore completely different management protocols.
Incorrect definition leads to incorrect expectations and incorrect practices. For example, using only lightening creams for deep tissue loss (scarring) can be a waste of time, just as considering aggressive surgical methods for only a superficial pigmentation problem (spots) is an unnecessary cause for concern. Understanding the biological structure of the skin means solving half the problem. Now, let’s differentiate these two concepts in depth, taking into account the factors affecting our skin in the sunny streets of Buca.
Solving the Conceptual Confusion: What is a Spot, What is a Scar?
Conditions commonly referred to as “acne scars” are examined under two main headings in medical terminology: Post-Inflammatory Hyperpigmentation/Erythema (Spot) and Atrophic/Hypertrophic Scar (Scar). This distinction relates to which layer of the skin is damaged and how the body responds to this damage.
1. Acne Marks (Color Changes)
An acne mark is a change in skin color without any disruption (depression or swelling) in the skin’s texture. After acne heals, the skin surface feels smooth to the touch, but a red or brown mark remains. This is not permanent damage, but a temporary reaction of the skin.
- Post-Inflammatory Erythema (PIE): These are red or pinkish marks left after acne, usually seen in individuals with fair skin. This is due to capillaries that dilate during inflammation remaining dilated after healing. In hot regions like Buca, these red marks may become more prominent with increased heat.
Post-Inflammatory Hyperpigmentation (PIH): These are brown or blackish marks usually seen in individuals with darker skin (wheat and tan). During inflammation, the skin produces excess melanin (pigment) to protect itself. This excess pigment remains in the area even after the acne heals, creating a blemished appearance. Sunlight (UV) is the biggest trigger for these blemishes.
2. Acne Scars (Tissue Damage – Scars)
An acne scar is the actual loss or excess of tissue that occurs in the dermis layer of the skin. If the body cannot produce enough collagen or produces too much collagen while acne heals, the topography of the skin is disrupted. That is, when you touch the skin, you feel roughness, pits, or bumps.
Atrophic Scars (Depressions): This is the most common type of scar. They are depressions formed on the skin surface due to tissue loss. It is divided into subtypes: Icepick, Boxcar, and Rolling.
- Hypertrophic and Keloid Scars: These are hard tissues that are raised above the skin surface as a result of the uncontrolled proliferation of healing tissue.
Diagnostic Differences and Management Table
The following table is prepared to help you understand the nature of the problem you see when you look in the mirror (self-awareness) and to ask the right questions when consulting your specialist physician.
| Feature | Acne Mark (PIH / PIE) | Acne Scar (Scar) |
|---|---|---|
| Skin Surface | Smooth, not noticeable to the touch. | Rough, pits or bumps are felt. |
| Main Problem | Pigmentation (color) or vascular problems. | Structural breakdown in collagen and elastin fibers. |
| Sun’s Effect | Directly darkens and increases its permanence. | Does not affect the depth of the scar but makes the appearance more prominent. |
| Faints Over Time | May fade spontaneously within months (even without treatment). | It is permanent and will not fade without professional intervention. |
| General Approach | Spot-lightening agents, chemical peeling, laser toning. | Gold needle, fractional laser, subcision, filler. |
Environmental Factors and Selection Criteria in the Context of Buca
Environmental factors associated with living in Buca influence strategic decisions in the management of blemishes and scars. Izmir’s high UV index, in particular, is a critical risk factor for those experiencing “Acne Scars (PIH)”. When a healing pimple is exposed to the Buca sun without protection, the likelihood of the blemish becoming permanent increases by almost 100%. Therefore, seasonality is vital in treatment selection.
General Management and Approach Strategies
When you consult a specialist, the roadmap to be drawn up will be based on scientific principles, depending on whether the problem is a “spot” or a “scar”. Here are the general approaches in modern dermatology:
1. Approach for Spots (Pigment-Focused)
The goal is to suppress, disperse, or gently renew the top layer of skin by removing the spotted cells, thus reducing excess melanin production.
Home Care Supports: Ingredients such as Vitamin C, Arbutin, Niacinamide, and Tranexamic Acid are frequently recommended.
Professional Applications: Enzymatic peels, Q-Switch lasers (to break down pigment), Thulium lasers (for brightness), and mesotherapy cocktails are used in spot management.
2. Approach to Scarring (Collagen-Focused)
The goal is to put the body into “repair mode” to lift the sunken tissue. This is usually done by creating controlled damage to the skin.
Professional Applications:
– Fractional Lasers: Create micro-channels in the skin, contracting and renewing collagen through heat.
– Gold Needle (Radiofrequency): Deliver energy directly to the dermis (where the damage is located), initiating repair without damaging the surface.
– Subcision: Release of ligaments that pull the depression downwards using a needle.
– Fillers: Inject hyaluronic acid under deep depressions to eliminate the difference in level.
Most Common Mistakes Made in Treatment Selection
The most common mistake seen in clients visiting clinics in Buca is acting on “neighbor’s/friend’s advice.” A cream that works well for a friend’s red spots (PIE) will have no effect on your deep pitting (atrophic scar). Similarly, an aggressive laser treatment for deep scars may be unnecessary and risky for skin with only mild blemishes.
The correct treatment selection is made in the following order:
1. First, the active acne is completely stopped (the fire is extinguished).
2. Then, the type of remaining damage (blemish, scar, or both) is analyzed.
3. A combined plan is created taking into account the person’s skin type, lifestyle (sun exposure time, etc.), and budget.
Conclusion: Read Your Reflection in the Mirror Correctly
In conclusion, the first step in combating acne blemishes or scars in Buca is to correctly identify the problem. Knowing the difference between superficial discoloration and deep tissue loss will both set your expectations on a realistic footing and prevent you from wasting time with the wrong products or treatments. Technology and science offer powerful solutions for both problems; the important thing is to create a personalized roadmap with experts who understand your skin’s language.
