What’s worse than a breakout? The unwanted parting gift it leaves behind, aka acne scars. The truth is that acne scars are super common for anyone who deals with breakouts. “A study showed that one third of acne patients experience scarring,” says Michelle Henry, MD, clinical instructor in dermatology at Weill Cornell Medical College. So…you’re not alone.
Scars show up as acne erythema—or red marks— in lighter-skinned patients, and as post-inflammatory hyperpigmentation—or brown marks—in darker skin tones, says Y. Claire Chang, MD, a dermatologist at Union Square Laser Dermatology in NYC. In some cases, skin texture can become permanently uneven and pitted.
All scarring stinks, but there are different types based on their appearance. The depth, width, and duration of an acne cyst will determine the type of scar. There are two types of acne scars, explains Ken Howe, MD, a dermatologist at Wexler Dermatology. First, there’s hypertrophic acne scarring, where the scar tissue grows in lumps or bumps and creates keloid scarring. The second type is called atrophic acne scarring, which is when the scarred skin has been thinned out, resulting in holes, dips, or depressions.
If you want to get a little more technical, there are a few subtypes of of atrophic acne scarring, including the below.
- Ice pick: These are deep, sharply demarcated pits but narrow scars. They look as if an ice pick literally damaged the skin.
- Boxcar scar: Sunken scars that have sharp square edges.
- Rolling scar: Sunken scars with smooth or wavy edges.
- Hypertrophic scar: Raised scars, especially around the edges.
Before you dive into how to get rid of acne scars (don’t worry—your complete guide is coming!), you need know why they happen.
What causes acne scarring?
“Pimples cause a lot of inflammation in the skin, and the way many skin types respond to inflammation and injury is to release color from cells,” says Rachel Nazarian, MD, a dermatologist at Schweiger Dermatology Group in NYC. “You can see this happen with insect bites, cuts, and yes, pimples.”
The good news: Red and brown acne scars will likely heal on their own, although it may take several months for them to improve, says dermatologist Joshua Zeichner MD. But in case you needed another reminder not to pick your pimples, messing with them can lead to worse discoloration and an increased risk of scarring, Dr. Chang adds.
While deeper, pitted scars don’t really respond to OTC treatments (you’ll need to go to see a derm for laser resurfacing, chemical peels, or other treatments), there are certain at-home ingredients that can get rid of brown and red acne scars a little faster. So next time you’re dealing with a post-inflammatory hyperpigmentation on your face, try one of these treatments for acne scars (and keep them from getting worse):
Factors That Determine If You’re More Prone To Acne Scarring:
Genetics:
According to Dr. Howe, those with a family history of acne scarring are more likely to develop acne scars. Although he notes that some patients with neither family history nor severe acne deal with acne scars.
Skin Type:
Oily skin is most prone to breakouts and acne than combination or dryer skin types, according to Marisa Martino, esthetician and co-owner of SKINNEY Medspa. “Acne is caused when an overproduction of oil clogs your pore which causes bacteria to begin to exasperate and create sebum and puss underneath your skin,” she says.
Cystic Acne:
Dermatologists Hadley King, MD and Dr. Howe agree that those with deep cystic acne and lesions are typically more prone to creating scarring.
Darker Skin Tones:
“Post-inflammatory hyperpigmentation is more common in darker skin types that have more pigment potential,” says Dr. King. Give your melanin some extra TLC with skincare products specially formulated to target hyperpigmentation in deeper skin tones, such as Dr. Barbara Sturm’s Darker Skin Tones collection.
So how do I get rid of acne scars?
1. Use a retinoid.
Using a retinoid in your skin care routine will stimulate collagen production to fill concave scars and soften the edges. All of this will improve skin’s overall texture.
For her patients, Dr. Henry like Epiduo Forte, a prescription medication that combines a retinoid with benzoyl peroxide to fight acne and improve skin tone and texture. But if you’re looking for an over-the-counter retinoid option, she recommends one with between 0.5 and one percent retinol, like PCA’s. Dr. Zeichner is also a fan of retinoids, and recommends Differin Gel to help boost cell turnover which results in a more even skin tone, texture, and pigmentation.
However, if you have sensitive skin are tent to react to active ingredients, like benzoyl peroxide, salicylic acid, and retinoids, then it’s best to avoid products with those ingredients, says Dr. King. “For post-inflammatory hyperpigmentation in sensitive skin types, I would recommend avoiding any products that are irritating the skin enough to cause inflammation and potentially additional post-inflammatory hyperpigmentation because this will be counterproductive,” she adds.
2. Up your exfoliation game.
Apply a product with glycolic acid to get rid of dead skin cells. Think of it as chemical sand paper—it will soften and smooth the edges of your scar over time. These peel pads from Peter Thomas Roth contain 10 percent glycolic acid plus two percent salicylic acid to exfoliate your skin and treat acne scarring, says Dr. Chang.
3. Glow with Vitamin C.
Dr. Zeichner typically recommends vitamin C as part of your regular skin care regimen, “a potent antioxidant that blocks the production of abnormal pigmentation and can lighten dark marks” to his acne patients.
4. Microneedling is an option.
“At home microneedling can be effective, however you can achieve faster results with medical grade options,” says Martino. To improve the texture of your skin at home, look for a face roll that uses surgical grade stainless steel like Gold Roll CIT.
5. Don’t skip on sunscreen.
The most important acne scar treatment in your arsenal is actually SPF. Sunscreens help tremendously with reducing hyperpigmentation associated with scars, says Dr. Henry. Bonus: It also prevents your acne scar from getting any darker.
6. It might sound weird, but try to avoid coconut oil.
Some people like this ingredient to soothe inflammation, but on the face it can do the opposite. It can actually clog pores and cause scars, says Dr. Henry.
7. For faster results, try a laser resurfacing treatment.
Dr. Henry recommends the Fraxel Dual laser or Lutronic Infini laser for acne scaring, specifically rolling or boxcar scars. Both lasers create micro injuries in the skin (don’t worry, they’re basically invisible), which activate the production of collagen as they heal.
If you’re noticing more post inflammatory redness than brown pigmentation, try the VBeam or IPL laser, which both targets the red capillaries.
8. Do a chemical peel.
In-office chemical peels, like the Sensi peel by PCA and the VI Peel, can improve skin’s tone and texture, helping to reduce the appearance of scars. While these can be good for rolling and boxcar scars, ice pick scars may require a more intense peel, like TCA (trichloroacetic acid) cross therapy. In this treatment, high strength TCA is applied to the base of the scar to induce healing.
9. When in doubt, ask your derm about cortisone.
For raised (hypertrophic) scars, Dr. Henry often treats acne scarring with a shot of dilute cortisone to reduce inflammation and help flatten the scar.
via How to Get Rid of Acne Scars, According To Dermatologists
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