Atrophic, Hypertrophic & Keloids. Atrophic scars form below the level of the surrounding skin. Hypertrophic scare are bulged and projected scars above the level of the surrounding skin. These are especially common when wound is not protected. Keloids tend to form long after the wound has healed. These are due to massive overproduction of connective tissue fibres, which continue to grow over the wound and onto healthy skin like the claws of the crab.
I recommend a minimum sun protection factor (SPF) of 15 or greater. Patients should apply their topical acne therapy first thing in the morning, and then put on the sunscreen before they go outside. I recommend moisturizers for patients who are experiencing irritation from topical therapy.
One study of acne found that not washing at all made acne worse but washing four times a day had the same ill-effect. The best approach was to use a mild cleanser twice and day, morning and evening. Adult acne in previously clear-skinned people may be caused by not keeping the skin clean. Dead skin cells mix with skins natural sebum and block the pores. While the acne may not improve through cleansing alone, keeping your skin gently clean makes sure that you don't exacerbate the condition.
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