The acne cycle can be difficult, especially when it comes to scarring. You get a new breakout, you apply your favorite acne scar treatments, but then you’re left with a scar that constantly reminds you of the zits that once were. First things first, let’s remember that scarring is totally normal and nothing to be ashamed of, but acne scars, pigmentation, and discoloration can definitely be frustrating—so we’re here to help.
According to Sonäge Skincare founder Anisha Khanna, more recent scars have a higher potential to disappear. “The older the scar, the more stubborn it is, and the more difficult it is to treat,” she says. “The biggest cause of acne scarring is the skin inflammation that results from the breakouts. As the skin's natural response is to produce collagen, if there’s any over-production, it leads to scarring.”
It goes without saying, but the best treatment for preventing scarring is by not picking or squeezing your breakouts. “Picking can lead to even more damage and inflammation because it causes your skin and collagen to respond in a way that leads to scarring,” says AbsoluteJOI Skincare founder, Anne Beal, MD. “Additionally, if you delay treating your acne, that also increases the likelihood of developing scars. This is particularly important if you have cystic acne, which is deeper in the skin and causes the damage and inflammation that leads to scarring.”
Keep reading for everything you need to know about acne scarring and how to treat it.
About the Experts:
When the body produces too little collagen, that creates depressed, or atrophic, scars. “Atrophic scars are the most common and are caused by loss of skin cells, which, in turn, cause a pit or depression on the skin's surface,” Khanna says. “This results from breakout inflammation. Atrophic scars are the most difficult to treat since they may be deep-rooted due to the loss of tissue.”
Ice pick: Narrow but deep pitted scars that form a “V” shape in the skin. Of atrophic scars, this is the most challenging type to treat.
Boxcar: Scars that appear to be “punched out” of the skin in a round or square shape with sharp edges.
Rolling: Broad depressions in the skin with sloping edges.
Dr. Beal explains that “raised [or hypertrophic scars] are the result of too much collagen production. Raised scars are more common in people with melanin-rich skin, particularly those who are prone to keloids.”
The red or brown discolorations that appear on the skin from acne are not scars per se, but they are marks created by the inflammation from acne breakouts. These occur when the skin over-produces melanin during the healing process.
While acne scars are frustrating, they don’t have to be permanent. There are several treatment options that allow you and your physician to create a plan that works for you.
Chemical peels remove dead skin cells, unclog the pores, and stimulate the production of new collagen. “This can help address a wide range of skin issues, including skin discoloration, dark spots, fine lines, dullness, acne breakouts, and acne scars,” Khanna says. There are different types of chemical peels that may be selected for you depending on your skin type, skin tone, and the extent of scarring. Since chemical peels contain active ingredients, there is potential for the skin to become irritated, red, or more sensitive—so Khanna recommends consulting with a professional to figure out which type is best for you.
Traditional chemical peels utilize exfoliating acids (such as glycolic, mandelic, lactic, or salicylic acid) to amp up skin cell turnover—key for treating scarring—but those with deep-pitted scars should ask their doctor about the Trichloroacetic (or TCA) CROSS technique. “A high concentration of trichloroacetic acid is precisely applied in a pitted scar to promote re-healing and collagen synthesis,” says dermatologist Annie Chiu, MD. “Patients can expect a 70 to 90 percent improvement over three to four treatments.”
If chemical peels freak you out, or you’d rather attempt treatment from the comfort of your personal space, Khanna suggests professional spa grade products that can help you from home. She recommends the SONÄGE Zitlox Salicylic Acne Gel because it loosens dead cells, unclogs pores, and removes dead skin cells, while increasing cell turnover and encouraging the skin to rebuild.
While creating a mass of tiny holes in the skin with a needle-laden roller could sound like something out of a horror film, it’s become an increasingly popular way to minimize the appearance of acne scars. “This collagen induction therapy punctures through epidermal and dermal layers of the skin,” says Dr. Chiu. “It stimulates the body’s natural collagen and elastin production to smooth depressed acne scarring.” Best of all? There’s no downtime post-treatment, and there are even safe at-home versions to help maintain your results.
This minimally invasive treatment is a little bit like sanding a piece of furniture: Your doctor uses an abrasive applicator to exfoliate and rejuvenate the outer layer of the skin. Dr. Chiu recommends microdermabrasion for those with surface marks and very light scars—or those hoping to prevent future scar-inducing breakouts—as it won’t address deeper acne scars.
“When it comes to lasers, we’re looking at fractional ablative, non-ablative, and Clear and Brilliant Lasers,” says Dr. Chiu. “These resurface and re-stimulate the skin for a smoother, more even texture.” Ablative lasers remove outer layers of the skin as they penetrate, so you can expect anesthetic injections or even sedation beforehand. Non-ablative lasers pass through the top layers without removing them, so there’s minimal pain and only topical numbing cream is required. Clear and Brilliant, which sometimes requires numbing cream, is even less invasive. It creates millions of microscopic treatment “zones” in the outermost layers of the skin to stimulate collagen production. “Like all acne scarring procedures, lasers usually require multiple sessions and downtime can vary from hours to a few weeks,” says Dr. Chiu.
Typically reserved for more severe depressed acne scars, fillers can buy you up to five years of smooth, even skin. “I use Bellafill, which stretches out and flattens depressed scars,” says Dr. Chiu. “Its collagen immediately adds volume to lift depressed acne scars, while polymethylmethacrylate (or pMMA) microspheres stimulate collagen production. During injection, I also use a subcision technique to break up any fibrous bands pulling down acne scars.” While you may see some redness, swelling, or bruising, there’s typically little to no downtime.
“Since the primary cause of scarring is inflammation, the at-home management should focus on reducing inflammation and further skin damage,” says Dr. Beal. “Hyperpigmentation responds well to a home regimen to help with skin turnover and reduce inflammation.
When done properly, regular, gentle exfoliation can help reduce the appearance of scars by sloughing away dead skin cells to resurface the skin. Exfoliation can especially help smooth texture, but be sure to never exfoliate broken skin. You can use a chemical exfoliant like the HERO Exfoliating Jelly Cleanser that uses konjac jelly to exfoliate without scrubbing. Or you can use a physical exfoliant like the FRESH Sugar Strawberry Exfoliating Cleanser that refines skin with sugar.
Khanna is a fan of peel pads—she personally suggests SONÄGE Glow to Go Peel Pads, which utilize glycolic acid to brighten and even out skin tone, refine skin texture, reduce the appearance of dark spots, minimize the appearance of fine lines, and deeply moisturize and decongest pores.
With a reputation for brightening, it’s easy to see why Vitamin C serums can be a great option for treating acne scars at home. The antioxidant vitamin decreases hyperpigmentation and protects your skin from further damage. Try it for yourself with the BUTTAH SKIN Vitamin C Serum.
No matter what approach you take to caring for your skin daily, broad-spectrum SPF protection that’s at least an SPF of 30 is an absolute requirement. Without that protection, you leave your skin vulnerable to developing more dark marks and prolonging the healing process of existing marks. The SUPERGOOP! Unseen Sunscreen is a great option that doesn’t leave a chalky, white caste.
Alpha-hydroxy acids (like glycolic, lactic, and mandelic acid) slough away dead skin cells and bring younger skin cells to the surface. Meanwhile, you might recognize the beta-hydroxy acid (or BHA) salicylic acid from some of your go-to acne products. AHAs and BHAs not only treat and prevent clogged pores, but also subtly reduce scar depth, size, and discoloration. The HERBIVORE PRISM Botanical AHA + BHA Exfoliating Glow Facial is a pampering way to incorporate these powerhouse ingredients into your routine.
The gold-standard anti-aging ingredient is famous for its ability to fight fine lines and wrinkles, even out skin tone, and up collagen production. It improves overall skin texture, and those with light acne scars should definitely see an improvement. The URBAN SKIN RX Retinol Rapid Repair & Dark Spots treatment is proven to have serious results for reducing hyperpigmentation and evening skin tone.
Aloe vera is one of the most available and versatile plants out there. “Its gel is natural and safe for sensitive skin, while being easily accessible and relatively inexpensive,” explains Khanna. To use, apply the gel as a spot treatment and leave on for 15 to 20 minutes before washing off.
There’s a good chance you have vitamin E laying around your house—and while it may not work for super stubborn acne scars, it’ll do more good than harm. “It’s a natural antioxidant that may help in reducing the appearance of acne scars,” Khanna says, adding that all you need is a pea-size amount applied to the affected area. “It helps repair the skin and encourages rebuilding. Although it may take consistency and several weeks or months for you to see results.”
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