Physical trauma to the skin recruits an immune response leading to increased MMPs that degrade collagen and elastin, resulting in acne scars.

“the reason why we always say don't pick at your skin is when there's an in immune response in the skin the immune system is trying to fix something and fight something and in doing so it recruits different enzymes the most common enzyme is what you exactly describe Matrix metaloproteinases which are these enzymes that eat apart collagen and elastin to allow it to remodel when you cause physical trauma in the skin you recruit a much larger immune response than what was warranted for that that insult so these mmps these Matrix Metallo protases enter at a much higher amount and they eat away the collagen and elastin that's what leaves an acne score”