From effective treatment at home to state-of-the-art technology in the practice: the best tips from experts against acne scars.
According to Dermatologists:in, this is how you treat acne scars correctly
During the pandemic, many people experienced breakouts on their skin, including acne. Of course, this also led to increased concern about the scars and marks that such outbreaks leave behind. If you're wondering how best to deal with acne scars, in part because they can be very frustrating to treat, at least you can rest assured that with time, dedication, and the right products and treatments, you can heal the scars can be reduced effectively in the long term.
An important part of treating acne scars is first understanding what they are: they are small pits or indentations in the skin caused by moderate to severe acne. There are both sunken scars that look like indentations or craters or raised scars that are usually firm and hard. Secondly, it is important to know that there are several types, which are distinguished according to their size, shape, and contour:
This type occurs when the acne wounds have not healed properly. The scar then forms underneath the surrounding tissue due to insufficient new connective tissue forming, leaving a small visible depression, often referred to as an "ice pick scar".
The scars look like a ridge or bulge in the skin, which is because less quality tissue has been produced after becoming inflamed by a pimple. The structure of this tissue looks different than healthy and appears thicker and taller than the surrounding skin.
This is a type of wound healing disorder where scar tissue grows out of control and spreads to other areas of the skin. In rare cases, this form can occur with acne but is more commonly found after burns or chemical burns.
"Depending on the severity, acne breakouts can affect not only the top layer of skin but also the deeper layers of the skin," explains New York dermatologist Shereene Idriss. "As the inflammation subsides and the skin tries to heal, scar tissue can form," she explains. Highly inflammatory acne, external factors such as pressure, and delayed treatment initiation can lead to scarring."
Acne scars must be distinguished from superficial acne marks such as brown or red spots. "Although many of my patients use the terms scars and marks interchangeably, I make it a point to define these two very different types," explains Dr. Andrew Alexis, MPH, and Professor of Dermatology at the Icahn School of Medicine at Mount Sinai.
"First and foremost, if left untreated, scars are permanent and are characterized by a pit or indentation in the skin. Acne marks, on the other hand, eventually resolve and are characterized by flat or smooth dark spots (hyperpigmentation) or persistent red ones Spotting (erythema) at the sites of a recent acne lesion." But what's the easiest way to tell if it's an acne scar?
"Close your eyes and run your fingers over your face or acne-affected area," advises Idriss. "If you feel any structural changes, then you most likely have acne scars."
From prevention to the most effective at-home treatments and state-of-the-art therapies in the dermatology practice, here the pros weigh up how best to treat acne scars and marks.
"Start by controlling and treating the acne first—otherwise you may just create more scars," says dermatologist Dr. Naissan O. Wesley, FACMS, adding that some acne treatments help improve the appearance of acne scars in and of themselves. "Once the acne is under control and there is hardly any acne formation, it is advisable to have additional acne scar treatments, if needed, to treat any remaining scars."
When it comes to the best products to treat moderate to severe acne such as red bumps, pus bumps, and cystic acne under the skin, Dr. Alexis undergoes an acne treatment prescribed by a dermatologist. For an over-the-counter treatment, Wesley recommends a soothing daily acne treatment routine, such as anti-dark spot, anti-red spot and acne pads, and a gentle cleansing lotion.
"When I think about how to treat acne scars, I always encourage my patients to first address the discoloration within the scars," explains Shereene Idriss. "It's amazing that when you even out the color of the scar, the changes in skin texture often don't bother my patients as much as they previously thought." Of course, acne affects different skin tones differently, which is something to keep in mind when identifying and treating acne marks and scars. "Lighter skin tones, or skin that gets sunburnt more easily, is often prone to red spots after acne, while darker skin tones, or skin that gets tanned more easily, often gets brown spots after acne," explains Dr. Wesley
One of the most effective topical treatments for removing discoloration is a vitamin C serum, which is packed with antioxidants and protects the skin from harmful free radicals caused by sun exposure. It also brightens the skin, reducing the appearance of dark spots. Additionally, retinol — a derivative of vitamin A, which is one of the body's key nutrients for increasing cellular metabolism and stimulating collagen production — can help treat discoloration when carefully and gradually incorporated into skincare routines. Another at-home option is regular, mild exfoliation, enriched with acids like lactic, glycolic, and trichloroacetic acids that gently exfoliate to reveal smoother, more even skin.
Unfortunately, once an acne mark has healed, it is permanent. In this case, professional in-office laser treatments combined with local applications can offer the best results. "Lasers can be very effective in improving acne, acne marks, and acne scars", explains Dr. Wesley She adds that photodynamic therapy (light therapy) can be used to reduce inflammation in active acne, while vascular lasers and broadband light treatments such as pulsed dye lasers or IPL (intense pulsed light) can be used to improve post-inflammatory pigmentation.
Most notably, non-ablative and ablative resurfacing lasers are among the most effective treatments for acne scars, especially recessed scars. For the less common hypertrophic or keloid acne scars, dermatologists often use vascular lasers or resurfacing lasers in combination with local cortisone or intralesional cortisone injections (i.e. injections directly into the scar) to improve the skin's appearance.
In addition to the lasers, according to Dr. Wesley also uses other outpatient treatments, such as medical-grade chemical peels and micro-needling (particularly when combined with PRP, which stands for platelet-rich plasma), to help reduce acne marks and scars.
The important thing to know is that no matter what type of acne abrasion treatment you choose, patience is key. This is especially true for scars, where the timing and outcome depend on the type of scar itself and the types of treatment chosen to treat it.
Nevertheless, there have never been such promising technologies and products as now, whether for local treatment at home or for medical treatment in a dermatologist's office. "Acne scars can be uncomfortable and I'm grateful that we can now do so much to help patients deal with acne scars. We want them to look beautiful as they are and feel beautiful on the inside," says Dr. Wesley.