Treating Acne Scars

  • My Skin Glow Pro Admin

Treating Acne Scars

Acne causes pimples on the face, neck, shoulders, back, and chest. There are different types of acne,  and many different factors are related to acne including: hormone problems, stress, certain foods,  medications, makeup, sweat,  and some personal care products can make acne worse.

While there are lots of factors related to acne, it is caused mainly by dead skin cells and oil clogging the pores. This in turn causes inflammation and a bacterial infection. Once the skin is inflamed, irritated or injured, the wound healing process starts. The healing process is complex, but it is this process that causes acne scarring. Acne scars vary in appearance depending on the type and severity of the acne , because of this the treatment of acne scarring is also varied.


There are 4 different categories of acne scarring: 

Post-inflammatory hyperpigmentation (Dark spots)

Post-inflammatory erythema (Red spots)

Atrophic or depressed scars (Deep scars)

Hypertrophic or raised scars 


Treatment for Dark Spots / Hyperpigmentation (Topical , OTC)

Post-inflammatory Hyperpigmentation (PIH) is brown, grey or black marks caused by an inflammatory reaction, when your pigment skin cells are stimulated during the wound healing process, producing an overproduction of melanin. The darkened spots are a concentration of melanin in one area. Those dark spots left behind after a pimple heals, can be even more aggravating than pimples themselves.

The treatment of post-inflammatory hyperpigmentation is a prolonged process that requires consistency and can take 4-12 months to achieve the desired results. There are a variety of topical treatments available to treat hyperpigmentation.


  1. Sun Protection

Sunscreen is of utmost importance in treating and preventing hyperpigmentation. It prevents damage which leads to the post inflammatory hyperpigmentation that develops after acne.  Additionally, many treatments for acne and hyperpigmentation like retinoids and acids thin the skin's barrier, increasing its sensitivity to the sun's UV rays, in turn  amplifying the sun's effects on the skin. So for hyper-pigmented skin, sun protection is essential because it protects your skin from further sun damage and helps to maintain progress made in treating existing hyperpigmentation.  Daily use of a broad-spectrum sunscreen (sun protection factor 30 or greater) is an essential part of any regimen.

Products to try:


  1. Retinoid/Retinol 

Retinoids are derived from vitamin A and they are tried and true remedies for aging, acne and hyperpigmentation.  They are great at treating all types of acne scars. These work by going deep beneath your skin to reduce inflammation, increasing the speed at which skin cells are replaced, stimulating collagen production, reducing discoloration, and smoothing skin to make scars less noticeable. However, they can make your skin especially sensitive to the sun, as such wearing sunscreen during the day is necessary when using retinoids. 

Products to try




  1. Azelaic acid

Azelaic acid is a great option if you’re dealing with both active acne and hyperpigmentation. It has antimicrobial and anti-inflammatory properties. It clears pores of the bacteria that may cause acne and reduces inflammation so that acne is less visible and the skin is less irritated, and it encourages cell turnover so that the skin heals faster, in turn minimizing scarring. Furthermore, it is also a Tyrosinase Inhibitor which lessens the production of melanin.

Products to try:



  1. Alpha Arbutin

Alpha Arbutin is another Tyrosinase Inhibitor which lessens the formation of melanin. It is gentle and there are no known negative interactions between arbutin and other skincare ingredients, which means it can be combined with many other skincare ingredients that offer similar brightening effects, such as vitamin C and AHA. While Arbutin is a naturally occurring derivative of hydroquinone it is effective without the risks posed by hydroquinone.


Products to try:


  1. Niacinamide

Niacinamide is a powerhouse of a skincare ingredient,  made from niacin (vitamin B-3). It decreases hyperpigmentation, aids in water retention, increases collagen production, reduces sebum production, improves texture by making pores look smaller and also supports the reduction of acne.

It’s commonly found in wrinkle creams and other anti-aging products because of its ability to aid in water retention and can also increase collagen production.

While niacinamide may be useful for treating hyperpigmentation, it it is most beneficial to use this ingredient in combination with other products like Retinoids.  

Products to try:


  1. Vitamin C 

Vitamin C is an essential nutrient and a powerful antioxidant required for the growth and repair of tissue in the body, including the skin.  It is found naturally in fruits and vegetables and is produced synthetically in skincare products.

It has many names and is produced in many forms in skincare. In its pure form it is called: ascorbic acid and L-ascorbic acid. Derivatives include: sodium ascorbyl phosphate, ascorbyl palmitate, retinyl ascorbate, ascorbyl glucoside, tetrahexyldecyl ascorbate, ascorbyl tetraisopalmitate, ethylated ascorbic acid and magnesium ascorbyl phosphate. The pure Vitamin C, L-ascorbic acid, is very unstable in the presence of oxygen and water, so the many derivatives are produced to keep the Vitamin C stable, so that it is released only when it comes in contact with the skin. 

Topical Vitamin C and its derivatives offers a wide array of benefits to the skin including anti-aging effects and the treatment hyperpigmentation as well, by exhibiting tyrosinase inhibiting properties.

Products to try:

  1. Glutathione 

Glutathione is an antioxidant which works to regulate the production of melanin. As a Tyrosinase inhibitor it lessens the production of melanin. Since overproduction of melanin is the primary cause of hyperpigmentation, glutathione is effective at treating skin discolouration and post -inflammatory hyperpigmentation 

Products to try:


  1. Glycolic acid

Glycolic acid is the smallest of the Alpha Hydroxy Acids (AHA) , so it penetrates the skin quickly and deeply to help shed dead, damaged skin cells. This chemical exfoliation helps reduce the colour and appearance of post inflammatory hyperpigmentation. In addition, it helps new skin cells to the surface of the skin, thereby also revealing healthier skin and promoting a more even skin tone and texture. 

Products to try:


  1. Lactic Acid

Lactic acid is an alpha hydroxy acid (AHA) that exfoliates dead skin cells from the skin’s surface and is also a humectant. It is great for those with sensitive  and dry skin.  Lactic Acid helps to improve texture, and pigmentation of the skin and lighten acne scars.  The exfoliation reduces existing fine lines and wrinkles, fades hyperpigmentation, and clears acne. Lactic acid is also a humectant meaning it chemically attracts water molecules to itself, thereby drawing moisture to the newly exfoliated skin and helps prevent new fine lines and wrinkles from forming. 

Products to try: 


  1. Mandelic Acid

Mandelic Acid is an alpha-hydroxy acid (AHA). It is an exfoliant  that treats hyperpigmentation and prevents acne.  It is less irritating than glycolic acid, due to its larger molecular size. It is for this reason that it is often recommended over glycolic acid for use on skin of colour. 

Products to try:


  1. Tranexamic Acid

Tranexamic acid is another Tyrosinase inhibitor and it works well with other skincare ingredients so it may be combined with other topical brighteners like retinoids, vitamin C, and kojic acid.


Products to try:

 
  1. Kojic Acid

Kojic acid, known as Koji in Japan, is a fungal product derived from mushrooms and it inhibits and prevents the formation of Tyrosine, which is needed to produce melanin. 

Products to try:

  • Kojie San Lightening Soap
  • SkinCeuticals Discoloration Defense

  1. Licorice root 

Licorice is derived from the licorice plant and functions as a tyrosinase inhibitor to treat hyperpigmentation and brighten skin.  

Products to try:


  1. Chemical peel

Chemical peels use acids to help “peel” away the outer layer of your skin. They contain either AHAs, such as glycolic acid, lactic acid, or beta-hydroxy acids (BHAs), such as salicylic acid. Chemical peels are simply higher concentrations of over the counter  (OTC) acids found in many serums and creams on the market. OTC AHAs and BHAs  remove the epidermis only, while professional peels done by dermatologists can go deeper and target the dermis (middle) layer of the skin. If you have very dark stubborn spots and the OTC products have not worked , then you may need to get a professional peel from a dermatologist. Chemical peels of high concentration, while they are available widely on the internet, should not be attempted at home because if used improperly, they may lead to post inflammatory hyperpigmentation and further scarring in people with skin of colour.


Additional Recommendations:

An example of a basic routine for post inflammatory hyperpigmentation would be:

Vitamin c and Alpha Arbutin in the day, with Niacinamide and Retinoid in the evening. 

AHAs and BHAs such as glycolic , lactic acid and salicylic acids should be used alone and not combined in the same routine with Vitamin C or retinoids, however they may be used on alternative nights.

The topical over the counter treatments mentioned here can be offered at stronger concentrations if professional treatment is sought. Talk to a dermatologist about options for professional treatment. The exact treatment you choose will depend on the severity of your skin condition, as well as your skin type and tone. 


Post Inflammatory Erythema (Red Spots)

Post Inflammatory Erythema (PIE) are the red or purplish marks left behind by acne. The redness is from damage or dilation of capillaries near the surface of the skin, which may also be thinner as it heals, resulting in small flat red marks. PIE tends to happen most often in lighter skin tones, while hyperpigmentation happens more in darker skin tones.   

Treatment for Red Spots  (Topical / OTC)

Topical treatments for PIE help decrease inflammation, reduce blood vessel dilation, promote wound healing, and improve skin barrier function . Treatment used to treat  PIE that are also used to treat post-inflammatory hyperpigmentation include: Niacinamide, Vitamin C and Retinoids (please see above for more info).

Other topical treatments include: 

  • Centella Asiatica

Centella asiatica is a herb that is primarily grown in Asia, with antioxidant and anti-inflammatory properties. It  is also rich in amino acids, hydrating and soothes irritated skin.The plant is well known in traditional medicine. Korean skin-care products containing centella asiatica are often labeled “cica,” which is an indication that they treat and calm irritated skin.

Products to try: 


  • Salicylic acid 

Salicylic acid is a common ingredient in acne skin care products. Salicylic acid helps clear the pores of the skin which helps prevent acne, however it also helps reduce redness in the area, which in turn minimizes scarring.


Products to try:


Treatment for Red Spots (Professional)

  • PDL laser

The Pulsed Dye Laser, or PDL uses a concentrated beam of light that targets blood vessels in the skin. The light is converted into heat, destroying the blood vessel while leaving the surrounding skin undamaged.



Atrophic or Depressed Scars

Atrophic or Depressed Scars are scars formed after acne that sit below the surrounding skin. They are formed when not enough collagen is made while the wound is healing. 


Deep Acne Scar Treatments (OTC /At Home )

The effectiveness of at-home or over the counter treatment of these scars are limited. The use of exfoliants like glycolic acid and lactic acid may improve the appearance of scars to a limited extent.  For severe scarring professional treatment should be considered. Also it is best to consider treatment for scars only if the active pimple formation and redness have subsided. 


  • Microdermabrasion

Microdermabrasion is an exfoliating treatment that takes off the outer layers of dead skin to visibly improve your skin's texture, while reducing the appearance of  dark spots, fine lines, wrinkles, dullness, and pore size. It is done by a handheld exfoliator that exfoliates the skin with super-fine crystal particles. It is typically done by a dermatologist, however at home devices are available. The in-office microdermabrasion tools used by dermatologists are more powerful and effective.  While the at home devices may deliver similar results, one must be extremely careful to not over exfoliate, leaving the skin damaged and raw. Following instruction precisely is highly recommended. 

Products to try:

PMD Personal Microderm Elite Pro  

Deep Acne Scar Treatments (Professional)

  • Dermabrasion 

Dermabrasion is an effective and common treatment for scars. While it is similar to at home microdermabrasion , the dermatologist uses machines that are more powerful and that provide a deeper exfoliation.  

  • Chemical peels

A chemical peel is a strong concentration of acids that remove the top layer of the skin to reduce deeper scars. While there are some chemical peels that are mild enough to be used at home, a dermatologist can use a  stronger peel and provide better results.  

  • Laser

Like chemical peels and dermabrasion, laser resurfacing removes the top layer of the skin. Some lasers are not effective on darker skin tones.

  • Subcision

A dermatologist lifts the scar by loosening the fibres underneath it.

  • Filler 

A dermatologist injects fillers under the surface of the skin to plump up and smooth out depressed scars.  

  • Microneedling

A roller or “pen” studded with micro-needles are used to puncture the skin. As the micro injuries heal, collagen production is stimulated causing the scars to heal with a smoother appearance and reduced depth. 


Hypertrophic or Raised Scars

Hypertrophic or Raised Scars Treatment (Professional)

These scars occur most often with chest and back acne. They are above the surface of the surrounding skin and are caused by too much collagen during healing.

  • Injections of corticosteroids

Corticosteroids can be injected into raised scars by a dermatologist to help soften and flatten raised scars.


Conclusion

Acne scars can be frustrating, stubborn and complicated to treat, but there are many options available for treatment and with consistency, results can be gained.  The exact treatment you choose will depend on the severity of your skin condition, as well as your skin type and tone. For more severe scarring , talk with a dermatologist about your options for professional treatment. The exact treatment you choose will depend on the severity of your skin condition, as well as your skin type and tone. 

The best way to treat acne scars is to prevent it in the first place. Acne scars are less likely to develop if you have less breakouts, avoid popping the pimples, avoid using products that irritate the skin and protect your skin from the sun.















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