As if breaking out isn’t bad enough, many people with severe acne can end up with long-lasting scars. Chronic conditions like cystic acne, and bad habits like picking, squeezing and popping your pimples can cause acne scars that are really tough to get rid of.
But that doesn’t mean you have to live with scarred skin for the rest of your life. In recent years, treating and getting rid of acne scars has become easier to accomplish, thanks to new innovations in dermatology. There are a few options you have, depending on your type of scar. The first step is knowing if your skin imperfections actually constitute as scars.
If the “scars” you’re referring to are discolored spots that aren’t indented, here’s some great news: They’re not actually scars! The spots you see are just hyperpigmentation left behind from the inflammation. “As long as it’s flat and there’s no change to the texture of the skin there, you’re not going to have a scar,” dermatologist Ted Lain, M.D., of ATX Dermatology in Texas, explained to us. However, for some people, hyperpigmentation can turn into scars over time, so it’s important to treat the discoloration once the acne is no longer flared up. Try a nighttime treatment like Renee Rouleau Post-Breakout Fading Gel ($30), which uses gentle brightening and exfoliating ingredients to fade discoloration left behind from a breakout.
Three Types of Acne Scars:
“There are three main types of acne scars,” Dr. Lain said. The first is called an icepick scar, which is a deep, narrow indentation in the skin. These are the hardest types of scars to fix. Next is a boxcar scar, which looks like a rectangular indentation; the third and most common is a rolling acne scar, which looks like a small wave in the skin.So what determines how you’ll scar? It’s partially genetic, Lain said. The other factor is how you treat your acne. “The more you pick [at your skin], the more your risk of an icepick scar goes up,” he said. In terms of inflammation, the longer you let acne linger after a breakout, the larger your chance of scarring further. “If you can get rid of it quickly, the scar goes away sooner and depth is less too,” he continued. Try treating inflamed breakouts with a bacteria-squashing and calming treatment like Dermalogica Breakout Control ($46). It works as a spot treatment, yet also calms inflamed skin, reducing discoloration and decreasing the chance dark spots will be left behind.
When it comes to actual indented scars (like the three main types mentioned above), Lain regretted to inform us that overall, over-the-counter skincare products don’t really cut it. “Creams don’t get enough penetration,” he said. The scar tissue needs to be remodeled, so you need something that will actually create new collagen beneath the cells so that skin can renew itself from the inside out.
It’s also important to know that products created to fade scars, like those from a surgery or injury, are not going to work either. Those types of scars are usually raised, so the products are formulated to reduce both pressure and the chance of skin raising where the scar is forming. “Acne scars are totally different,” Lain pointed out. “We don’t want to prevent raising — we want to get the scar to raise, with added collagen.”
Acne Scar Treatments That Work:
The right treatment for you depends on the depth of your scars, how many you have, and how much downtime you’re willing to endure. Here are the typical methods your dermatologist might suggest.
Subcision: This is the first thing most derms will recommend. Subcision involves numbing the skin with local anesthesia, and then taking a special needle and performing a sweeping motion underneath the scars. The goal is to break the tethers holding those scars together. “Most scars have tethers tying them to underlying tissue,” so breaking this connection can help raise the indents automatically, Lain explained. This specifically helps rolling scars, and can be safely combined with other scar treatments.
Fractional Laser: “Next, we need to start thinking about how we force scar to remodel itself and build collagen,” Lain said. Using a fractional laser is one way to do that. A laser like Fraxel works by poking a precise number of holes into the skin, at a predetermined depth. It usually takes multiple treatments to acheive the results you want. Lasers tend to require more downtime than microneedling [see below] because of the increased swelling and redness they create, but they’re generally more effective.
Lasers are also more expensive, so that’s something to keep in mind when figuring out your budget for scar treatment — and ask your derm what other costs (like prescription after-care lotions) you should plan on, too. However, if fine lines and large pores are also on your list of skin concerns, a laser can help improve those at the same time it’s fixing your scars, so you’ll get some extra bang for your buck.
Microneedling: Instead of using a laser to form a hole, microneedling employs thin needles to form similar holes without the heat, while still building collagen and remodeling scar tissue. One type you might see at your derm’s office is EndyMed Intensif. “It works by using radiofrequency (RF) tipped needles, which penetrate into the dermis. The energy from the current destroys the tissue where the scars are and then helps create new collagen,” explains Dr. Michael H. Gold, board-certified dermatologist and founder and director of Gold Skin Care Center in Nashville, Tennessee.
Microneedling works on anyone with acne scars, no matter skin type or color. You can expect a little discomfort, but Dr. Gold notes he applies a numbing cream first when using this microneedling device on his patients. “Patients can see results quickly – usually as fast as one to two weeks,” Gold said. Costs vary between $400-$600 per treatment, but can get up to $1,000 depending on location. Several treatments spaced two to four weeks apart gives optimum results.
To stay scar-free in the future, the key is to keep your acne under control as much as possible. If you just have mild acne, OTC products will work fine. Look for acne treatments with ingredients like benzoyl peroxide, salicyclic acid, and glycolic acid. And stop picking!
Skincare products are great for controlling breakouts and getting rid of acne, but once a scar forms, there’s not much you can do to fix it at home. “If you have 10 to 15 pimples or large cystic bumps that are there for months, you should go see a doctor,” Lain recommended, since that type of severe acne is what usually leads to scarring. To have totally scar-free skin, prevention is your #1 best bet.
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