Dear pimples, if you’re going to live on my face, I need to see some rent. Or else..
Experts Reveal the Best Ways to Fix Acne Scars
If you’re living with some type of acne, you’re certainly not alone. The American Academy of Dermatology notes that acne affects up to 50 million Americans annually — with 85% of people between 12 and 24 experiencing minor acne — and can continue into your 30s and 40s.
Acne comes in all shapes and sizes. For example, one of the most common types of acne (the one you get as a teenager and into your early 20s) is known as hormonal acne (think: hormones) while more prolonged conditions are typically cystic acne and can leave lingering damage. There’s also inflammatory acne, which is often red, painful and sourced to some sort of bacterial infection. Noninflammatory acne includes blackheads and whiteheads, which are often less severe and require less significant treatment.
As personal acne conditions worsen or get better, the marks often leave behind scarring, causing a range of new conditions on their own. As wide as the range of conditions are, the range of treatments is perhaps even broader.
In-office vs. at-home, prescription vs. over-the-counter, natural vs. synthetic … there seem to be endless opinions on the best treatment for acne scars, but really, it all depends on your personal situation.
“First and foremost, don’t touch [them],” says dermatologist Dr. Marnie Nussbaum about breakouts.
She says that it’s important to get to a dermatologist within the first 24-48 hours for professional treatments like an intralesional steroid injection, which will typically resolve the condition within an additional one or two days.
Different Types of Acne Scarring
You might be surprised to know that the most common forms of acne scarring actually have specific names and directives based on they’ve appeared and how they look:
- Ice Pick Scars: Small depressions in the skin that may look like a needle prick
- Boxcar Scar: A similar depression in the skin, but has very sharp edges
- Rolling Acne Scars: Smooth-edged “valleys” in the skin
- Keloid Acne Scar: Raised bumps over the skin
- Hyperpigmentation: Dark spots and discoloration in the skin
Preventing Acne and Acne Scarring
Although prevention really comes down to your specific skins and needs, there are some general guidelines and practices worth taking into consideration.
“When it comes to preventing acne for men, it often starts with having a clean shave and cleansing the skin efficiently to eradicate any built up oil, dirt and sweat,” says SkinOwl founder Annie Tevelin. “Trauma or pH confusion can lead to acne in many cases. Cleansing solely at night will keep the overnight oils on your skin which will protect and lubricate. A cleanser would remove said oils and at times, exacerbate the skin.
“[Some] acne scarring can be prevented by using emollient plant oils before bed. The oleic and linoleic acids in cold pressed oils help with hyperpigmentation and scarring in conjunction with red and blue light treatments. Argan, tamanu, baobab and moringa oil are all wonderful oils to help with inflammation and dark spots.”
At-Home Acne Scarring Treatments
Not surprisingly, treatment at home begins with one of the most obvious skin damagers.
“It is important to reduce breakouts, reduce inflammation and protect your skin from the sun,” says Dr. Jeremy Brauer, dermatologist and clinical associate professor at NYU. “Use of a broad spectrum UVA/UVB sunscreen should be part of everyone’s skincare regimen.”
He adds that retinol-containing topicals — such as Differin gel — may help improve the appearance of scarring by stimulating collagen growth. Additionally, over the counter agents containing hydroquinone and non-hydroquinone lightening agents (such as tranexamic acid) can help lighten pigmented scars.
Another option is to go with more natural remedies like SkinOwl’s Maqui Berry Beauty Drops. Maqui is a South American tree berry that has garnered buzz in recent years for a variety of antioxidant and healing properties. (Indigenous tribes have been using the berry for generations.) These particular drops work towards revitalizing dull skin and reducing cell damage.
However, it’s important to test oils and serums on a small patch of skin before using on your entire face. Even with essential oils and other natural products, some skin types don’t tolerate oil and it can aggravate existing conditions.
In-Office Acne Scarring Treatments
For more significant results, Nussbaum suggests in-office treatments such as Hydrafacial and Clear and Brilliant.
“These are what I try first for mild-moderate acne prone skin and the reddish-brown pigmented scars that are associated with it,” she says. “Hydrafacial exfoliates, hydrates and soothes, and Clear and Brilliant decongests, tones and decreases pigmentation. For deep acne scars, our RF Redensify treatments work to correct pitted scars and pockmarks and Fraxel 1550 (3-5 treatments spaced 4 weeks apart) has had amazing success.”
Brauer recommends treatments focused on stimulating new collagen formation.
“In office, energy based device [and] laser treatments are the gold standard, and have been proven to help improve the appearance of acne scars — specifically ablative (wounding, removing thin layers of skin) and non-ablative laser (non wounding, stimulating collagen growth and skin tightening) resurfacing with devices such as Fraxel Repair (ablative) and Fraxel Dual and Clear & Brilliant (non-ablative),” he says.
“Additionally, fillers such as Bellafill (FDA approved) have been used to add volume to atrophic or depressed scars. For pigmented as well as erythematous (red) scars, lasers designed to target pigmentation and vasculature can be used. Elevated or hypertrophic scars can be treated with a combination of lasers and injectable agents.”
He adds that skin tone is a factor to consider with laser resurfacing as one of several that guides the appropriate selection of treatment device and parameters. In general, when treating skin of color, lower energies and densities are often used, with longer treatment intervals, resulting in prolonged treatment courses.
The goals of treatment should still be the same, therefore if these procedures are performed appropriately, outcomes shouldn’t be affected.
Treatment and Result Times
Brauer says that in office, non-ablative laser resurfacing often requires application of topical anesthesia and administration of antiviral prophylaxis (to minimize the risk of developing a cold sore) prior to treatment.
While treatment times will vary depending on the area(s) of concern, these procedures take approximately fifteen minutes, on average. With Fraxel Dual treatment of the face, you should expect to be red and swollen for approximately two days (usually a few hours to a day with the Clear & Brilliant Permea) at which time, depending on which wavelength is used, you can expect to see the formation of tiny adherent brown spots, often described as feeling like “sandpaper.” These can last several more days after a Fraxel treatment, and by seven days, your skin should look and feel refreshed. At this point, most patients can appreciate an overall improvement in tone and texture of their skin, but the true benefit of new collagen formation will develop in the months following.
Above all, both of our medical experts recommend getting a proper evaluation from a certified dermatologist. Everyone’s skin is different and will react differently to treatment, so the best course of action is an open dialogue with your medical professional.
If you need help finding the right doctor, the American Academy of Dermatology Association has a great resource for finding dermatologists.