This article has been contributed by the experts at AEDITION.
Acne scars and marks come in many forms, but the one thing they have in common is that they are long-lasting and disfiguring.
Fortunately, most acne scars and marks can be effectively treated with some TLC and a little help from your doctor. We spoke to West Hollywood plastic surgeon Dr. Roger Tsai, MD to get his expert advice on the best ways to treat them and leave acne in your past.
What Causes Acne Scars and Marks?
Simply put, acne scars and marks are caused by pimples that did not heal properly, whether from picking, popping or not treating them properly.
Remember how your mom told you to not pick your zits? Now you know why! However, even if you followed every rule in the book, you can still find yourself with marks and scarring later on. This is because genetics play a huge role in the acne aftermath, which makes it hard to determine why one person develops scars and another one does not.
The best way to avoid them is to take extra precautions when caring for acne-prone skin. In addition,
resist the urge to pick and pop blemishes,
avoid excess sun exposure and stick to a skin care routine that uses doctor recommended products.
AlmasiSkincare Tip: Avoid excess sun exposure by wearing a wide-brimmed hat and using a sunscreen like Neutrogena Age Shield Face Lotion Sunscreen with Broadspectrum SPF 110
The Difference Between Acne Marks and Scars
Unlike acne scars, acne marks are dark spots that are smooth to the touch. When a pimple is healing, inflammation can produce excess pigmentation which can leave behind a dark spot or stain. While they can look daunting, according to Dr. Tsai, acne marks are much easier to treat than acne scars because there is no collagen damage to the skin. They may not look pretty, but they usually fade away over a few months, depending on the person and the treatment. There are several common and effective treatments available, according to Dr. Tsai.
Sunblock: While sunscreen should be a part of everyone’s daily skin care routine, it is critical for acne sufferers. Excessive sun exposure can worsen pimple breakouts, prolong acne marks, and even make acne marks more prominent by darkening the pigmentation. Wear sunscreen every day, year round, and even inside and on cloudy days. Look for zinc-based products and acne-friendly brands, like Neutrogena, COOLA or Farmacy.
Chemical Peels: Chemical peels work by removing the top layer of skin cells which increases skin cell turnover and improves the skin’s texture. This process helps remove dead skin on the surface of the skin and addresses hyper pigmentation that can be caused by acne flares. There are quite a number of chemical peel products, ranging from at-home to in-clinic and low to high strength, so always consult with your acne doctor on which type of chemical peel, if any, is right for you and your skin type.
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Laser Resurfacing Treatments: “Lasers like an IPL (Intense Pulse Light) are effective for removing darker pigmentation quicker,” Dr. Roger Tsai recommends. Fractional resurfacing lasers, like FRAXEL, and picosecond lasers, like PicoSure, as they have also been proven to help with skin texture issues including dark marks.
Topical Serums/Creams: One popular topical solution is Vitamin C serum, which uses powerful antioxidants to promote skin healing. Before applying the serum to your face, first exfoliate to aid absorption through the skin. Vitamin C serums have been shown to treat dark acne marks and offer anti-aging benefits to boot.
AlmasiSkincare recommends Go Radiance Best Vitamin C Serum for Face
Dr. Tsai also recommends skin exfoliation creams and retinoids, like Tretinoin as well as skin brightening products, like Hydroquinone to help quicken skin turn over for some patients. Retinoids can not only treat dark marks but they also have been shown to prevent acne breakouts in the first place. Retinoids have to be prescribed by a doctor and they can be harsh on the skin. When using retinoids, always remember to stay out of the sun and wear sunscreen to prevent further skin damage.
Different Types of Acne Scars and Their Treatments
Acne scars are caused when the healing process replaces normal skin tissue with fibrous tissue instead. “Acne scars are actual indentations created from scar tissue that has grown into the empty space of the pimple and has created a contour deformity,” says Dr. Tsai.
Sometimes the body can respond by producing too much of the fibrous tissue or not enough. When too much tissue is formed, the result is a raised keloid or hypertrophic scar.
On the other hand, when not enough tissue is formed, the result is a depression in the skin, known as an atrophic scar. Because scars form for different reasons, there are different treatment protocols for each type. In general, compared to acne marks, acne scars are more permanent and harder to treat, although their appearance can be softened with certain acne treatments.
Ice Pick Scars
An ice pick scar is a type of atrophic or depressed scar that goes very deep into the skin. Like the name implies, ice pick scars resemble a puncture. Because they are so deep in the skin, ice pick scars are often thought to be the hardest of acne scars to correct.
Microneedling : When there are multiple ice pick scars, all-over treatments like microneedling are suitable. These treatments work to build collagen and fill the depressions from the inside out. Like most scar treatments, some can work better than others, depending on the skin tone and skin type.
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CO2 Laser: When there are multiple ice pick scars, a CO2 laser also offers suitable treatment.
Dermal Filler: Dermal filler can be an effective acne scar treatment option. Bellafill is commonly used to treat acne scarring and is injected underneath the surface of the scar to fill it out. The semi-permanent filler can last up to 18 months, which means multiple sessions are needed for upkeep.
Punch Excision: Correcting an ice pick scar through punch excision (also known as a punch biopsy or subcision) requires surgically removing or cutting it out. The surgeon will “punch” out the scar to create an opening that will allow extraction of the cyst or pore. After removal, the doctor will either stitch up the hole or use skin grafting (also known as punch grafting), which uses skin from another part of the body to fill the hole.
Other Solutions: For less invasive options, chemical peels and tretinoin cream can show improvements as with acne marks.
Boxcar Scars
Like icepick scars, boxcar scars are also atrophic acne scars, but they are different from ice pick scars because of their broader or boxier shape. Since boxcar scars are also a result of insufficient tissue formation, they are treated the same way as ice pick scars.
Microneedling: Microneedling is recommended to build new collagen and fill the boxcar scar depressions. According to Dr. Roger Tsai, microneedling is better for mild to moderate skin irregularities.
CO2 Lasers: CO2 lasers are also recommended to build new collagen and fill the boxcar scar depressions. According to Dr. Roger Tsai, a CO2 laser treatment is better suited for significant contour deformities.
Dermal Filler: For isolated boxcar scars, injectables like Bellafill can also help.
Rolling Scars
Rolling scars are shallower than ice pick scars and boxcar scars and have more of a “rolling hills” appearance, meaning they don’t look like punctures. Treatment includes a combination of microfat injections and microneedling with platelet-rich plasma (PRP).
Microfat Injections: Microfat injections, also known as microfat grafting, works by removing fat from another part of the body and then injected into another site (like the face in the case of rolling scars).
Microneedling: Microneedling stimulates new collagen production by pricking the skin to create tiny wounds. The body then naturally responds by making collagen to kickstart the healing process.
Other Solutions: Alternatively, less invasive options include chemical peels and tretinoin cream.
