While some people are fortunate enough to have blemishes that come and go without leaving a mark, others are left with visual reminders of their past breakouts, which can take a real emotional toll.
As if acne isn’t bad enough, a scar that develops after a pimple can take weeks or months to fade — if it fades at all. (1)
If you think there’s no hope for stubborn scars, think again. The upside is that many treatments can remove or fade these scars, making them less noticeable and helping you regain your self-confidence.
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The reasons vary, but genetics is one risk factor for scarring. If a blood relative struggles with acne scarring, you might, too, according to the American Academy of Dermatology (AAD). (2) Also, scarring tends to happen more as the skin loses collagen with age. (3)
Because collagen plays a role in the healing process, your skin produces new collagen as it repairs itself after a breakout. But sometimes, it produces too little or too much, resulting in a scar. (2)
Keep in mind that acne is an inflammatory condition. Scar development has a lot to do with the extent and duration of skin inflammation, so delaying acne treatment raises the risk of scarring. (2)
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“Acne scars result from a complex and abnormal inflammatory response, which results in poor wound healing, ” says Kara Shah, MD, a board-certified dermatologist and medical monitor at Medpace in Cincinnati, Ohio.
Because scarring is a complication of acne, anyone who experiences a breakout can have temporary or permanent scars — yet scarring is most common in those who suffer from inflammatory acne characterized by numerous pimples and cysts, says Dr. Shah. (4)
“The types of scarring seen in acne include keloids or hypertrophic scars, which appear as red, firm, raised papules [bumps], ” Shah says. Atrophic scars appear as depressed or “sunken in” areas and may be larger, broad scars (boxcar scars and rolling scars) or small pits (ice pick) scars. (4)
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Identifying an acne scar from other types of scars isn’t too difficult, because an acne scar occurs in the spot where a pimple was.
According to Schweiger Dermatology, this is the most common type of acne scar. They’re shallow, wide, and have sloping edges. These scars tend to get more noticeable with age. (5)
These are flat, red (or brownish) spots that form in the spot of a previous acne lesion. They usually fade without leaving a permanent mark. (1)
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Acne scars caused by a loss of tissue are called depressed fibrotic scars (sometimes called boxcar scars) and ice-pick scars. They tend to appear sunken and look like pits in the skin, though ice-pick scars are deeper than boxcar scars. (6)
Some types of acne leave scars that appear as enlarged, raised growths of tissue. These acne scars are caused by too much scar tissue. Hypertrophic scars and keloids look similar, but the latter are more raised than the former. (6)
“The best prevention for acne scarring is to optimize acne treatment with a good skin-care routine, a healthy diet, and an appropriate treatment regimen, ” says Shah.
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You should treat acne with over-the-counter creams or facial washes containing active acne-fighting ingredients such as salicylic acid or benzoyl peroxide. If these don’t work, see a board-certified dermatologist, the Mayo Clinic advises. (7)
“Regular use of a topical retinoid like tretinoin (Retin-A), adapalene (Differin), or tazarotene (Tazorac) has been shown to both prevent and reduce the appearance of acne scars, and these are commonly prescribed by a dermatologist as part of an acne skin-care regimen, ” says Shah.
“Don’t pick at your acne, and avoid using any skin-care products that are abrasive, like scrubs and loofahs or washcloths, ” warns Shah. She also encourages daily sunscreen use to reduce hyperpigmentation and dark spots. (2)
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Dermabrasion This effective scar removal treatment uses a high-speed brush or other instrument to resurface your skin and remove or reduce the depth of scars. It can take up to three weeks for the skin to heal. (1)
Microdermabrasion For this less-intensive type of dermabrasion, a dermatologist or aesthetician uses a handheld device to remove surface skin. More than one treatment may be required, but there’s no downtime. (8)
Chemical Peel During a chemical peel, a chemical solution is applied to the skin. It removes the outer layer of your skin, resulting in a smoother, more even appearance. You may experience redness and peeling for three to seven days after the procedure. (9)
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Laser Your dermatologist can use a laser resurfacing treatment to remove the outer layer of your skin, contour areas of acne scars, or lighten redness around healed acne lesions. Healing may take between 3 and 10 days. (1)
Fillers A substance such as collagen, hyaluronic acid, or fat can be used to “fill out” certain types of acne scars. Since fillers are eventually absorbed into your skin, you’ll have to repeat filler injections, usually every few months, depending on the substance used. (8)
Punch Excisions This type of skin surgery removes acne scars by individually excising, or cutting out, the scar. The hole left by the incision can be repaired with stitches or a skin graft. A skin graft uses a small piece of normal skin (usually removed from behind the ear) to fill in an area of scarred skin. Bruising can occur for one to two weeks after the procedure. (8)
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Microneedling Also called collagen induction therapy, this procedure involves pricking the skin repeatedly with tiny needles to stimulate the growth of new collagen. This can reduce the appearance of scars. Microneedling can improve the appearance of wrinkles, stretch marks, and fine lines. Skin redness may last a few days. (10)
Even though dark spots may fade over time on their own, an over-the-counter medicated dark spot remover with hydroquinone may help these scars fade quicker, notes Yoram Harth, MD, a dermatologist and the medical director of MDacne in San Francisco.
In addition, acne treatments with alpha hydroxy acids can stimulate the growth of new skin, minimizing the appearance of old scars while simultaneously preventing the formation of new acne. When shopping for an acne treatment, look for products that contain alpha hydroxy acids like glycolic acid and lactic acid. (11)
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Because acne scars result from changes in the amount and structure of collagen and elastic fibers in the skin, the use of natural remedies such as apple cider vinegar, lemon juice, coconut oil, and other products aren’t effective in reducing scarring once it develops, says Shah.
But while dermatological procedures can help improve your skin’s appearance, your health insurance might not cover these cosmetic procedures, and treatment might not completely restore your skin. So be realistic about your expectations.
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Desperate for a cellulite solution, women turn to creams, diets, and skin brushing. Read our cellulite tips before wasting money and time on unproven ...Comprehensive acne scar treatment will determine a plan of treatments that best suits your needs. The optimal treatment approach for acne scarring depends upon the type of scarring and is often a combination of several techniques. Visit our dermatology clinic in Beverly Hills to see how we can help you relieve your stress about acne scarring.
Dr. Monika Kiripolsky is a board-certified dermatologist and cosmetic surgeon specializing in the treatment of acne scarring using a combination of multiple modalities including lasers, IPL, chemical peels, filler injections, microneedling, radiofrequency and surgery. Her office is located in Beverly Hills, California.
Acne affects more than 80% of the population over the course of our lifetimes. Contrary to popular belief, acne is not a condition limited to teenagers. Inflammation related to active acne can lead to scarring, red and brown skin discoloration (“post-inflammatory hyperpigmentation” or PIH), textural irregularities, and enlarged pores.
Laser Therapy For Atrophic Acne Scars: A Case And Evidence Based Updates
The optimal treatment approach for acne scarring depends upon the type of scarring and is often a combination of several techniques. The following treatments can be used alone or in combination to lessen the appearance of acne scarring:
Lightening agents (azelaic acid, kojic acid, and hydroquinone) and retinoids (tretinoin and retinol) can be used at home to treat the ruddy, brown discoloration related to acne scarring.
Salicylic acid treats not only the ruddy, brown discoloration associated with PIH, but also penetrates into the oil glands to treat active acne and
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