Acne Scars
Skincare

Acne breakouts can be frustrating, and they can also leave scars on the face and other areas of the body. Some people find that acne scars are an unwanted reminder of a painful and bothersome condition. However, acne scars do not have to be permanent, as some home remedies and medical treatments can help get rid of them.

Scars are formed when a breakout penetrates the skin deeply and damages the tissues beneath it. Before treating your scars, it’s essential to know what type they are. Each type responds to treatment differently, and some treatments are better for particular types than others.

Types of acne scar

Suitable treatment options may vary slightly depending on the type of scarring that acne has caused. There are three types of acne scars:

1. Atrophic Scars

These scars appear as small indentations in the skin. They occur when the skin does not make enough fibroblasts in the healing process. Fibroblasts are cells that play a crucial role in wound healing and collagen synthesis. They’re formed when insufficient collagen is made while the wound is healing. There are three types of atrophic scars:

a) Boxcar

 These are wide, U-shaped scars that have sharp edges. They can be shallow or deep. The shallower they are, the better they respond to skin resurfacing treatments.

b) Ice Pick

Ice pick scars are narrow, V-shaped scars that can go deep into the skin. They can look like small round or oval holes, like a chickenpox scar. These are the most difficult scars to treat because they can extend far under the surface of the skin.

c) Rolling

These wide depressions typically have rounded edges and a distinctive, rolling appearance.

2. Hypertrophic Scars

These occur when the skin makes too many fibroblasts as the acne spot heals, causing a raised scar. These lesions of scar tissue rise off the skin. They’re caused when fibrous tissues, the collagen, in the skin region overgrow. These scars are usually found on the chest, back and shoulders, and jawline and can be itchy, tender, or painful.

3. Keloid Scars

Are similar to hypertrophic scars but are typically much thicker than the original acne spot. They are usually darker than the surrounding skin and red or brown. Keloid scars may also cause symptoms, such as itchiness or pain.

Symptoms

Acne signs vary depending on the severity of your condition:

Whiteheads (closed plugged pores)

Blackheads (open plugged pores)

Small red, tender bumps (papules)

Pimples (pustules), which are papules with pus at their tips

Large, solid, painful lumps under the skin (nodules)

Painful, pus-filled lumps under the skin (cystic lesions)

Acne usually appears on the face, forehead, chest, upper back, and shoulders.

Causes of acne scars

Acne scars are often the product of an inflamed lesion, such as a papule, pustule, or cyst. Inflamed blemishes occur when the follicle or pore becomes engorged with excess oil, dead skin cells, and bacteria. The pore swells, causing a break in the follicle wall. Inflammation is the single greatest gauge of scar development. The greater the inflammation on the skin, the more likely scarring occurs. Deep breakouts that take a long time to heal also increase the chance of scarring.

If the rupture occurs near the skin’s surface, the lesion is usually minor and heals quickly. More serious lesions arise when there is a deep break in the follicle wall. The infected material spills out into the dermis and destroys healthy skin tissue. To repair the damage done to the dermis, the skin forms new collagen fibers. Collagen is the fibrous protein that gives the skin its strength and flexibility. Unfortunately, the finished “repair job” never looks as smooth and flawless as before the injury.

Prevention of acne scars

You can’t completely prevent scarring, but these steps can minimize your chance of developing acne scars.

Treat Acne As Soon As It Develops

The best thing you can do is get acne under control as soon as possible. Begin treating it right away, and see your healthcare provider immediately if your acne isn’t getting any better with over-the-counter acne treatments. Quick treatment helps to keep breakouts to a minimum and prevents acne from developing into a more severe form. Prevent pimples, and you’ll prevent scarring.

Reduce Inflammation

Significant, inflamed acne blemishes are more likely to leave scars behind than non-inflamed breakouts and blackheads. Your goal should always be to calm inflammation and avoid doing anything that will further irritate your skin. Aggressive scrubbing and harsh skincare products should be avoided.

Don’t Squeeze, Pop, or Pick at Pimples.

Pass up the temptation to pick or squeeze a pimple. Doing so can force debris deeper into the dermis, spreading an infection to other tissue and worsening inflammation. This is especially true for deep, severe blemishes like nodules and cysts. Remind yourself that popping pimples can extend the healing time and ups the chance of it leaving a permanent scar. Allow the blemish to heal on its own. If you’ve already picked at a blemish, take steps to help heal it and minimize skin damage.

Don’t Pick at Scabs

Picking at scabs should also be avoided. A scab is the skin’s natural “bandage,” which protects the wound as it heals. Picking a scab off a wound before it is ready prolongs the healing process and increases the chances of scarring.

Know If You Are Prone to Scarring

The reality is some people are more prone to scarring while others come through a case of severe acne without a scar in sight. If you are highly prone to scarring, see a dermatologist right away to discuss acne treatment options.

See Your Healthcare Provider for Deep Breakouts or Cysts

While more minor blemishes can still scar the skin, it’s the big guys that usually do the damage. Because they extend deeper into the skin, deep nodular breakouts or cystic breakouts are more likely to destroy skin tissue and leave scars. Over-the-counter acne products won’t help these types of breakouts. Get an appointment with a dermatologist. Quick, effective treatment can help lessen the chance of developing deep scars.

Home remedies for acne scars

Various remedies are available over the counter, many of which can help people manage their acne and reduce the appearance of scars.

Salicylic Acid

Salicylic acid is a naturally occurring compound that is often an ingredient in acne skincare products. Salicylic acid helps clear dirt, skin cells, and other debris that leads to acne from the skin’s pores. It also helps reduce swelling and redness in the area, which may minimize the appearance of scarring.

Salicylic acid is beneficial for all scar types. It makes an excellent addition to a daily skincare routine for most people who live with acne. People with sensitive skin may need to test a product containing this acid on a small skin area before using it on their entire face, as it may cause dryness or irritation.

Retinoids

Some topical retinoids may help get rid of acne scars. As the authors of a review in the journal Dermatology and Therapy note, topical retinoids block inflammation, reduce acne lesions, and speed up cell regeneration. Retinoids could help lighten hyperpigmented acne scars, including those with darker skin tones. It is important to note that retinoids can make the skin sensitive to the sun. Anyone using retinoids for acne or scar treatment should wear sunscreen when going outdoors.

Alpha Hydroxy Acids

Alpha hydroxy acids (AHAs) can help rid dead skin cells and prevent clogged pores. Doctors may recommend AHAs for treating acne and reducing the appearance of acne scars. AHAs are a mild form of acid that scrapes away the outer layer of skin to reveal fresh, new skin underneath. This process may help with discoloration due to scarring.

Lactic acid

Lactic acid can act as a gentle peel to pull away dead skin cells. It may help reduce the appearance of scars and smooth the skin’s overall texture. Lactic acid may also help lighten dark scar tissue, although it sometimes causes hyperpigmentation. Due to this possible adverse effect, it is best to test products that contain lactic acid on a small patch of skin before using them to treat acne scarring. Many products for acne contain lactic acid. It is also present in diluted apple cider vinegar, making for a more natural, cost-effective treatment.

Medical treatment

If medical treatments don’t seem to be making a difference, a skincare specialist or your healthcare provider can help with your medicines. 

Dermabrasion

Dermabrasion is one of the most effective and common treatments for facial scars. While it uses the same general principle as the microdermabrasion kits you can do at home, healthcare providers use a wire brush or a wheel to exfoliate the top layer of the skin more deeply.

Best for: Scars close to the surface like a shallow boxcar or rolling scars. However, deeper scars may also become less noticeable.

Chemical Peels

These aren’t the kind of face masks you binge-watch your favorite guilty pleasure with. A chemical peel is a strong acid used to remove the top layer of the skin to reduce deeper scars. Some chemical peels are mild enough to be used at home, but your healthcare provider can provide a stronger solution with more dramatic results. There are many different chemical peels, so it’s best to talk to your healthcare provider about which one is right for you.

Best for All types of acne scars, often used for deeper scars.

Laser Resurfacing

Much like a chemical peel and dermabrasion, laser resurfacing removes the top layer of the skin. This treatment typically has a faster healing time than other resurfacing treatments. However, you have to keep the area covered with a bandage until it’s completely healed. This treatment is also not a good option for anyone who’s still getting breakouts, and it’s not as effective on darker skin tones.

Best for All acne scars and lighter skin tones.

Fillers

Healthcare providers use fillers to fill in acne scars and help even out the skin. The fillers can be made with collagen, fat, or a commercial filler. They’re injected under the skin's surface to help plump up and smooth out depressed scars. Most fillers last between 6 and 18 months before they need to be redone, but some are permanent.

Best for: Someone with a small number of a boxcar or rolling scars.

Microneedling

This newer treatment uses a small, handheld, needle-studded roller or handheld “pen” on the surface of the scars. The needles puncture the numbed skin — but don’t go through it like a shot! As the skin heals, it makes collagen. Evidence suggests that micro-needling helps reduce the depth of acne scars, but this treatment can take up to 9 months to see changes. Outside of the slight fear factor, it’s a safe treatment that works for all skin tones.

Best for Depressed acne scars.

Injections

A few different medications can be injected into raised scars to help soften and flatten them, including corticosteroids and chemotherapy drugs fluorouracil (5-FU) and interferons. The injections are usually performed as a series, with one every few weeks.

Best for Raised scars.

When to see a Doctor

If self-care remedies don’t clear your acne, see your primary care doctor. They can prescribe stronger medications. If acne persists or is severe, you may want to seek medical treatment from a doctor specializing in the skin (dermatologist or pediatric dermatologist). For many women, acne can persist for decades, with flares common a week before menstruation. This type of acne tends to clear up without treatment in women who use contraceptives. Sudden onset of severe acne may signal an underlying disease requiring medical attention in older adults.

The Food and Drug Administration (FDA) warns that some popular nonprescription acne lotions, cleansers, and other skin products can cause a severe reaction. This type of reaction is quite rare, so don’t confuse it with any redness, irritation, or itchiness that occurs in areas where you’ve applied medications or products. Seek emergency medical help if, after using a skin product you experience:

Faintness

Difficulty breathing

Swelling of the eyes, face, lips, or tongue

Tightness of the throat

Best products for acne scars and dark spots

1. Differin Gel Adapalene Gel 0.1% Acne Treatment

Best for All types of acne scars

Differin gel is an over-the-counter (OTC) retinoid treatment that has been on the market for some time. The active ingredient is adapalene, which helps decrease swelling and inflammation, prevent breakouts, and treat scarring. “It can help discoloration and textural changes that go along with acne scars by evening out the skin tone and boosting collagen production.” it’s safe to use once daily. Still, it’s best to start just a few times per week and increase the frequency as tolerated.

2. Neutrogena Rapid Clear 2-in-1 Fight & Fade Toner

Best for All types of acne scars

Toners are a crucial part of your skincare routine that’s done after cleansing. While there are many toners, Neutrogena Rapid Clear 2-in-1 Fight & Fade Toner is a fan-favorite for fighting acne. The toner contains salicylic acid, which is known to help reduce breakouts and fade discoloration caused by breakouts.

3. Skin better science AlphaRet Exfoliating Peel Pads

Best for All types of acne scars

This product falls on the pricier side of this list (a pack runs you about $100), but you only need to use them one or two times per week. The pads contain hydroxy acids, including lactic acid, salicylic acid, and glycolic acid, combined with AlphaRet, a retinoid that helps boost collagen. It’s easy to use and an excellent option for those looking for an exfoliant to help brighten the skin and improve the skin tone and texture associated with acne scars. Two acids — glycolic acid and lactic acid — help with lightening discoloration, while salicylic acid helps unclog pores.

4. SkinMedica AHA/BHA Exfoliating Cleanser

Best for All types of acne scarring

This cleanser exfoliates and cleanses all at once. The ingredients include a mix of alpha-hydroxy acids (AHAs) (including lactic acid, glycolic acid, citric acid, and malic acid). These help to improve skin tone and texture and prevent breakouts. Reviews show that, even as an exfoliant, it’s still gentle enough to use regularly. Those with sensitive skin should be mindful of temporary redness after exfoliating.

5. Dove Gentle Exfoliating Body Wash

Best for All types of acne scars

Although acne is relatively common on the face, it can also show up on your body. Those with scarring from body acne will appreciate the results from this budget-friendly cleanser. It’s made with sensitive skin in mind, gently exfoliating the skin and leaving it smooth and moisturized.

CeraVe Resurfacing Retinol Serum

Best for All types of acne scars

This CeraVe retinol serum is ideal for all types of acne scars, especially if you’re new to retinol. Retinol helps with resurfacing skin texture, while licorice root extract brightens the skin and improves overall appearance. The ceramides aid in restoring and maintaining the skin’s natural barrier, while the niacinamide brings down inflammation and calms the skin.

6. EltaMD UV Daily Broad-Spectrum SPF 40

Best for Discoloration

Sunscreen is a must, no matter what your skincare routine is. But when it comes to dealing with acne, sunscreen also plays a crucial role in preventing scars from becoming darker. This popular EltaMD sunscreen contains niacinamide, which helps soothe the skin, calms any possible redness, and improves discoloration. Reviewers love that this sunscreen is good enough for sensitive skin and wears well under makeup. Even though some customers say it’s on the pricier side, they believe it’s worth every penny because of its effectiveness.

7. SkinCeuticals Blemish + Age Defense

Best for Discoloration

This dual-performing oil-free face serum is expensive but highly rated. It combines 2% dioic acid with salicylic acid and glycolic acid. The dioic acid reduces sebum. The salicylic and glycolic acids help reduce breakouts and post-acne marks by brightening the skin and improving the skin’s texture.

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