Acne is one of the most common skin problems. According to the National Institutes of Health, about 80 percent of people between the ages of 11 and 30 will develop acne at some point 2. For many, acne will be nothing more than a mild comedone (blackhead or whitehead) that clears up on its own with no noticeable scar tissue. Unfortunately, for others, acne may become a chronic problem leading to more severe inflammatory acne, such as acne cysts or nodules. Inflammatory acne causes greater damage to the skin, which can result in serious acne scars, including depressed scars known as "ice pick" scars.

Comedone

Ice pick scars begin as a mild form of acne called a comedone, also known as a whitehead or blackhead. A comedone forms when oil secreted by the sebaceous glands, known as sebum, combines with excess skin cells in the follicles of your skin. The combination of the two ingredients creates a soft plug blocking the follicle.

Inflammation

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Once a comedone has been formed, bacteria begin to multiply inside the blocked follicle. The body's immune system sends white blood cells to the affected area to fight off the infection. As white blood cells build up, pus is formed. As pus builds inside the follicle, the combination of sebum, bacteria and white blood cells can burst into the surrounding skin, resulting in further skin irritation and inflammation.

Pressure

As inflammation builds behind the acne lesion, pressure can build. The pressure causes the inflammation to move deeper into the skin, causing damage as the inflammation spreads. This leads to the formation of serious forms of acne known as cysts or nodules. According to the American Academy of Dermatology, if the pressure is not relieved, the cyst or nodule can burst, causing even more skin tissue damage 14.

Collagen and Fibrin

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As inflammation damages skin tissue, the production and structure of the collagen in the affected tissue becomes disrupted. This disruption results in the loss of collagen and fibrin in the affected area. Without this collagen and fibrin, the resulting scar tissue from the acne inflammation sinks into the skin, creating the appearance of an "ice pick" mark on the skin.