A Story about Acne Scarring, Post Traumatic Stress Disorders and its relation to the Developing Brain

We hear stories all the time about our patient's challenges with Acne Scarring who come to us for Acne Scar Treatment. The following is based on a true story. Below is a picture of a person with bad acne scarring in the left cheek as an example:

We had a 30 something Caucasian female, mother of two from California who came in for acne scar treatment.Here is her story:

P.B. was just like any other child growing up in Central California. It seemed like an instant that her life started to change once she starting getting acne. She went on to tell me how her classmates made fun of her and made her life unbearable during junior high. Words like "Pizza Face", "Crater Face", emotional and even physical abuse were used and involved during her time in Junior High. It became so bad that she dropped out of school to become home schooled by her parents. She was a beautiful girl. She showed me pictures of her active acne during her junior high and high school years and I was shocked. It was the worst case of active acne I have ever seen. Although P.B.'s active acne was particularly severe, she was lucky that her acne didn't turn into the most severe scars.

"I have no confidence. My face is so scarred. I can't live like this for the rest of my life. I had dreams and they're beginning to fade. I want to be all that I can be and I want to make some positive changes in my life." - P.B. said.

What struck me as unusual was that she was actually very beautiful and her scars were definitely not the worse I've seen. But her scars affected her so much that she was clinically and severely depressed. So I thought that she was a classic case of what happens when traumatic things happen to younger people.

Trauma and the developing brain:

What has been found is that repeated trauma, especially in younger children, leads to chronic activation of the hypothalamic-pituitary-adrenal (HPA) system in response to the stress. This can have major negative consequences in your neurophysiology especially in the developing brain. Chronic activation may over stress other parts of the body including the hippocampus, a major player in the brain involved in memory, cognition, and arousal.

Another set of neural systems that become sensitized by repetitive stressful and traumatic experiences (i.e. being made fun of in junior and high school years) are the catecholamine systems that involve dopamine and norepinephrine, the flight or fight system as you might have heard of. This system can become altered following traumatic stress. There can be changes in attention, impulse control, sleep, fine motor control and other functions mediated by this system. A variety of other emotional, cognitive and motor functions can become dysregulated and altered. Simply put, your thinking, emotions, and even your muscle movement can be dysfunctional!

The even more impactful thing is that it can continue unchecked into adulthood. Which brings us back to our patient P.B. from California. In the developing brain, repeated trauma in early life can markedly affect brain development. As children age during childhood and adolescence, millions and trillions of synapses in the brain are created and altered to mold the brain into the mature adult. Our higher brains are almost completely underdeveloped at birth. In contrast, our midbrain that controls feeding, breathing, and our basic functions is almost completely developed. Early trauma tends to lead to less inhibitory pathways in the higher parts of the brain that can control lower parts that govern fear, anger, happiness, calm and basically our emotions. What happens is that these people who suffer traumatic events early on will have: 1. A persistent fear response; 2. Hyperarousal; 3. Inability to have feelings of calm, well-being, and emotional stability; 4. Inability to adapt to normal social situations, etc. So in the case of P.B., mild and moderate scars can be perceived as the most severe scars that you have ever seen. Her response to the world's interactions with her can be markedly different. For P.B., her scars can be affecting her life more than normal, more than someone who had a more nurturing environment or other nurture versus nature reason.

Click here to read more about trauma and the developing brain: Understanding the Effects of Maltreatment on Brain Development.

It's unfortunate that people judge each other based on external appearances. But it is something that we can't avoid; it is in our DNA and our deepest nature. Click here to read more about Dr. Young's Theory on Beauty (and how Beauty is not vanity but is based on our strong desire for order in our lives). During her time with Acne scarring, she tried many treatments with minor improvements. That's when she eventually came to find us. After a psychiatric assessment and clearance, we were able to help her with her scar treatment through our Unique 5-7 step process. Her scars are much better now. We hope that she will be able to regain some confidence and feel better about herself.

Click here to see a new video on our acne scar treatment:

https://youtu.be/1vjuFG0zUIM

"I delight in weaknesses, in insults, in hardships, in persecutions, in difficulties. For when I am weak, then I am strong."

2 Corinthians 12:7-10

Thanks for reading

Dr. Philip Young

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