Acne is kind of like a bad breakup: painful, tender, and not nearly as easy to get over as you hope. In the case of breakouts, that last part is maybe the most annoying to deal with of all. Enter acne scars, the pesky pitted or raised marks that stick around long after pimples hit the road. Prone to scarring? Read on for all the best at-home and in-office treatments that’ll finally send those frustrating marks on their way. When in doubt, though, always see your dermatologist to diagnose scarring and discuss the treatment methods that will be most effective for you and your skincare routine.
Carl Thornfeldt, MD, is a dermatologist in Fruitland, Idaho with more than 30 years of experience in skin research.
Annie Chiu, MD, is a board-certified dermatologist and founder of The Derm Institute in Redondo Beach, California.
Jessie Cheung, MD, is a board-certified dermatologist and founder of Cheung Aesthetics and Wellness in Chicago. She specialises in both surgical and cosmetic procedures.
First things first: what your scars look like depend on a variety of factors. “The depth and severity depends on how severe the acne was, how long it lasted, and how much picking or damage occurred during that time,” says Dr. Thornfeldt. However, acne scars generally fall under two broad categories: raised (which sit on top of the skin) and depressed (which appear as holes or pits in the skin). Dr. Cheung explains how to identify exactly which kind of scarring you see.
Hypertrophic: Thick, raised scars that appear on the surface of the skin.
Keloid: A more severe variation of hypertrophic scars, which tend to become even larger than the original wound caused by a pimple. (Some people are more prone to keloids.)
Ice Pick: Narrow but deep, pitted scars that form a “V” shape in the skin. These are the most difficult scars to treat.
Boxcar: Scars that appear to be “punched out” of the skin in a round or square shape with sharp edges.
Rolling: Broad depressions in the skin with sloping edges.
The exfoliating acids (such as glycolic, mandelic, lactic, or salicylic acid) in traditional chemical peels amp up skin cell turnover—key for treating scarring—but those with deep, pitted scars should ask their doctor about the Trichloroacetic (or TCA) CROSS technique. “A high concentration of trichloroacetic acid is precisely applied in a pitted scar to promote re-healing and collagen synthesis,” says Dr. Chiu. “Patients can expect a 70 to 90 percent improvement over three to four treatments.”
Puncturing thousands of tiny holes into the skin might sound intimidating, but microneedling is actually one of the chillest ways to treat scarring. Zero downtime and safe at-home versions to maintain results? Sign us up. “This collagen induction therapy punctures through epidermal and dermal layers of the skin,” says Dr. Chiu. “It stimulates the body’s natural collagen and elastin production to smooth depressed acne scarring.”
“We’re looking at fractional ablative, non-ablative, and Clear and Brilliant Lasers,” says Dr. Chiu. “These resurface and re-stimulate the skin for a smoother, more even texture.” Ablative lasers remove outer layers of the skin as they penetrate, so you can expect anesthetic injections or even sedation beforehand. Non-ablative lasers pass through the top layers without removing them, so there’s minimal pain and only topical numbing cream is required.
Clear and Brilliant, which sometimes requires numbing cream, is even less invasive. It creates millions of microscopic treatment “zones” in the outermost layers of the skin to stimulate collagen production. “Like all acne scarring procedures, lasers usually require multiple sessions and downtime can vary from hours to a few weeks,” says Dr. Chiu.
Experiencing severe depressed scarring? Fillers can buy you up to five years of smooth, even skin. “I use Bellafill, which stretches out and flattens depressed scars,” says Dr. Chiu. “Its collagen immediately adds volume to lift depressed acnes, while polymethylmethacrylate (or pMMA) microspheres stimulate collagen production. During injection, I also use a subcision technique to break up any fibrous bands pulling down acne scars.” You might have some redness, swelling, or bruising, but there’s typically little to no downtime after this procedure.
Only treatments administered by a doctor can completely get rid of acne scars—but that doesn’t mean you can’t seriously fade them at home. These are the most promising ingredients to look out for.
The gold standard anti-aging ingredient is a powerhouse because of its ability to speed up skin cell turnover and boost collagen production—two things that are also key to helping your complexion rebuild damaged, scarred skin. CLARK’S BOTANICALS Retinol Rescue Overnight Cream includes a time-release version that’s gentler on the skin, plus nourishing vitamin E, so you’re less likely to experience irritation.
“Glycolic acid, lactic acid, and mandelic acid are great if you are treating discoloration from acne (or post-inflammatory pigmentation) in addition to the lesions themselves,” says Dr. Chiu. Like full-on chemical peels, these ingredients also quicken cell turnover. SUNDAY RILEY Good Genes All-in-One Lactic Acid Treatment combines lactic acid with soothing prickly pear extract to even out and balance your complexion.
You know vitamin C for its serious brightening benefits. While it won’t help improve a scar’s texture, it can really do a number on the hyperpigmentation that often comes as part of the package. A lightweight, concentrated version like 111SKIN Vitamin C Brightening Booster Serum diminishes dark spots without clogging pores.
Let’s get real: If you’re continuing to break out while treating your acne scars, you’re kind of going one step forward and two steps back. “Salicylic acid is great at exfoliating pores to prevent them from clogging in the first place,” says Dr. Chiu. CANE + AUSTIN Acne Retexture Pad 5% Glycolic Acid and 2% Salicylic Acid combines two of the most effective ingredients for keeping pores clear and acne at bay, all in a convenient pad format.
Aloe vera, honey, turmeric, pumpkin… these are just a few of the DIY acne scar remedies that are floating around the internet. While these ingredients have some excellent nourishing, antioxidant, and anti-inflammatory properties—and certainly aren’t dangerous to test out—you likely won’t notice a substantial difference in your scarring. Stick with the tried-and-true ingredients we mentioned above, and visit your dermatologist for the most dramatic results.
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