The truth is that, there’s no secret ingredient or miracle gadget that makes scars totally disappear overnight. But don’t get discouraged. Top dermatologists from across the country share how to handle acne scars. This ranges from prevention to treatment.
Also, many of what you think are acne scars are really not. They are just brown or red spots rather than an actual change in the texture of the skin. Acne scars actually can seem like double punishment. First you had to deal with the pimples, now you have marks as a reminder.
You can learn about acne treatments that can remove or reduce their appearance in this article. These acne scar treatments are not cure-alls though. But they do help to minimize the appearance of scars. But before you try to treat your scars, it’s important to know the causes and what type they are. Each type responds to treatment differently, and some treatments are better for particular types than others.
What causes acne scars?
When acne breakouts penetrate the skin deeply, they damage the skin and the tissue beneath it. As the acne clears, the body tries to repair this damage.
During the healing process, the body produces collagen — a substance that gives the skin support. If the body produces too little or too much collagen, you will see a scar. The type of scar depends on how much collagen your body makes.
Types of Acne Scars
There are two types of acne scarring. “Depressed” or “atrophic” and “keloid” or “hypertophic” scars.
1. Depressed or atrophic
These scars are the most common. This type develops as dents in the skin where tissue has been lost. They occurs when not enough collagen is made while the wound is healing. There are three types of atrophic scars:
I. Ice pick scars
As the name suggests, ice pick scars are very deep acne scars. They look like the skin has been punctured with… an ice pick. They occur as small round or oval holes. It occurs when the body produces too little collagen in response to an injury. Ice pick scars represent the result of infected sebaceous gland openings on the skin. They are usually the most difficult to correct because they can extend far under the surface of the skin.
II. Boxcar scars
Boxcar scars are broader and boxier than ice picks. 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.
III. Rolling Scars
These are caused by damage under the skin. There are usually wider than 4–5mm and lead to shadowing on the skin surface. They typically have rounded edges and an irregular, rolling appearance. About 15–25% of atrophic scars are rolling scars.
2. Keloid or hypertrophic scars
This is where the skin creates new fibres of collagen – the protein that gives skin strength and flexibility. These scars are most common with chest and back acne. They stand above the surface of the surrounding skin and are caused by too much collagen during healing.
3. Dark spots
Discoloration left behind after a zit has cleared isn’t a scar. The purple, red, or brown marks will fade over a few months on their own.
There are treatments that can diminish acne scars whether depressions or raised acne scars. Many treatments are available.
Best treatment for acne scars
Dermatologist can help you determine the best method to reduce the appearance of your scars. They also make sure that the marks on your skin are actually scars and not another condition.
Acne scars office treatments
Common scar removal treatments include:
Acne scar surgery
This sounds scarier than it is. Dermatologists often perform this minor surgery to treat very noticeable acne scars. The goal is to create a less-noticeable scar. The remaining scar should fade with time.
To perform acne scar surgery, a dermatologist may lift the scar. Bringing a scar closer to the surface of the skin tends to make it less noticeable. Another type of acne scar surgery involves breaking up scar tissue.
A dermatologist or dermatologic surgeon can safely perform acne scar surgery in a medical office. Patients remain awake but numb so that they do not feel pain.
Best for: Treating a few depressed scars.
A chemical peel is a strong acid that’s used to remove the top layer of the skin to reduce deeper scars. A chemical peel may be administered by a doctor, nurse or spa aesthetician. It involves applying a chemical to your skin to remove its outer layer. This gives it a smoother and more even appearance. Depending on the strength of the acid used, you may experience redness and peeling for a few days afterwards.
Best for: All types of acne scars, often used for deeper scars.
Dermabrasion is one of the most effective and common treatments for facial scars. A healthcare provider uses a wire brush or a wheel to more deeply exfoliate the top layer of the skin. It can remodel the structural proteins of your skin, making it look smoother. You will need several days to heal afterwards.
Best for: Scars close to the surface like shallow boxcar or rolling scars. However, deeper scars may also become less noticeable.
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.
Dermatologists use fillers to safely and effectively plump depressed acne scars. A dermatologist may fill acne scars with collagen, the patient’s own fat, or another substance. Many fillers give us temporary results, which last between 6 and 18 months. Some fillers are permanent.
Both temporary and permanent fillers have unique pros and cons. If this is a treatment option for you, be sure to ask your dermatologist about the pros and cons of the recommended filler.
Best for: Treating a few depressed scars, but not icepick scars.
There are different versions of the punch technique, but all involve surgically removing the scars and smoothing the skin. This type of skin surgery can either be by individually excising, or cutting out, the scar. The hole left by the incision can be repaired with stitches or a skin graft.
Best for: Depressed acne scars.
Also known as “needling” or “micro-needling,” this treatment encourages your body to make more collagen.
To perform this procedure, a dermatologist moves a sterile, handheld needle-studded roller across the depressed acne scars. This punctures your skin. As your skin heals, it produces collagen.
It takes time to see the results, sometimes as long as 9 months. Most people, however, notice gradual changes before 9 months. Many patients require between 3 and 6 treatments and return every 2 to 6 weeks for a treatment.
After each treatment, you may have some swelling and possibly bruising. These side effects usually clear within 4 to 5 days. You will need to follow a skin care plan while undergoing treatment. Research shows that this is a safe treatment for people of all skin colors.
Best for: Widespread depressed acne scars.
Your dermatologist may recommend injecting medicine directly into the scars. This can soften and flatten raised, thick scars.
Getting the best results often requires repeat visits. These injections are usually given once every few weeks. How often you will need to return for treatment depends on the scar and many other considerations. You may need to return once every 2 to 6 weeks for a while.
Many patients receive injections of corticosteroids. A chemotherapy medicine known as fluorouracil (5-FU) can also be effective in treating raised acne scars. Some scars respond best when injections of both 5-FU and corticosteroids are used.
If the scar does not respond (or stops responding) after you receive the 4th injection, acne scar surgery may be recommended.
Best for: Painful, raised scars.
Lasers and other light treatments can treat raised scars safely and effectively. Your dermatologist can use a laser to remove the outer layer of your skin, contour areas of acne scars, or lighten redness around healed acne lesions. Various types of lasers are used, depending on whether the acne scar is raised or flat. More than one laser treatment may be required and, depending on the laser used, you may need to several days to heal.
Best for: All types of acne scars.
Home treatments and care
As with any skin condition, it’s best to consult your regular dermatologist to see which option is best for you. You won’t be able to remove acne scars completely. However, you may be able to help reduce the appearance of acne scars over time simply at home with some common sense measures.
Your skin needs moisture to heal and improve its appearance. The top layer of skin alone can absorb three times its weight in water. If you suffer from acne scarring on your body moisturize with lotion such as Vaseline® Intensive Care Deep Restore Lotion. They contain nutrients and multi-layer moisture to penetrate deep down. They can also help keep skin hydrated and healthy-looking.
Topical retinoids are another acne treatment with scar-smoothing benefits. In addition to speeding up your cell growth and improving your skin’s texture, retinoids can also help reduce discoloration.
However, they can also make your skin especially sensitive to the sun.
Applied a retinoic acid cream directly to the scar. This can help reduce its appearance. Also always wear sunscreen daily when using anything that contains retinoids.
You can find creams and serums with retinoids over the counter, but your healthcare provider can also prescribe you higher concentrations. Look for products that list retinol as one of the active ingredients.
Silicone dressings and bandages
They are available without a prescription. These can be used at home to treat raised scars. They can help reduce the itch and discomfort as well as shrink, flatten, and fade raised scars.
They can be especially helpful. Although no one knows for sure how these work. A possibility is that silicone helps hydrate the skin. This may reduce the itch and pain as well as make the skin more flexible.
To be effective, these products must be used continuously. This can be difficult, especially for scars on the face. Many people are willing to do this because these treatments have little risk of side effects. Even so, with continuous use, some people develop itchy, irritated skin. This usually clears when the person stops using the product.
Best for: Reducing scar size and discomfort. None is likely to eliminate a raised scar.
Avoid the Sun
The sun’s strong UV rays trigger your melanin-producing cells (melanocytes). This can darken your skin and make scars appear more visible. Wear sunscreen of SPF 15 or higher, and reapply often. The sun is at its strongest from 11am to 3pm, so avoid direct sunlight during these hours.
It clears pores, reduces swelling and redness. It also exfoliates the skin when applied topically. It’s considered to be one of the best treatments for acne scars. You can add products with salicylic acid into your daily routine. Your skin care specialist may also use it for less frequent chemical peels.
It might take a few weeks to see a difference when using salicylic acid. It can also cause dryness or irritation. You may need to use the product less often or try spot treating if you have sensitive skin.
Best for: All acne scars.
Even if you treat your breakouts correctly, you may still scar. There are a few simple preventative steps that could help reduce acne occurrence in the first place. Remember, no one has perfect skin. Everyone has had a pimple, a scar or a blemish at some point. While you can’t remove acne scars completely, you can reduce acne scars and learn to embrace your skin.