As if acne wasn’t annoying enough, the aftermath is often all the more dreadful. Whenever a pimple leaves behind a scar — it can be a darkened spot or an indentation on the skin — you pray to the grooming gods that it won’t last long.
What’s worse is that you (possibly) even followed all those boring rules, such as never picking or popping the pimple in the first place, but are still left with a long-term reminder on display for the world to see.
Don’t worry, hope is not lost. There are ways to prevent and even get rid of acne scars. To find out how, we spoke with board-certified dermatologists Robert Finney and Dhaval Bhanusali. Here’s how to banish the last of your blemish.
What Are Acne Scars?
Acne scars can appear in different ways, and are often predetermined by the kind of acne experienced in that location. Specifically, there are three types of acne scars. The first is called atrophic scarring, often referred to as ‘ice-pick acne’ due to the depression or indentation it leaves behind. These are usually the most difficult type of acne scars to heal.
The other types are keloid and hypertrophic lesions, and are most common on the jawline and areas such as the chest. While both present as elevated and firm, their difference is that hypertrophic scars are typically confined to the area the pimple inhabited, while keloid scarring often spreads past the initial spot.
What Causes Acne Scars?
Acne scars are caused by acne, unsurprisingly. However, their appearance is based on the size, duration and healing process of the initial lesion and whether or not you left it alone.
“Any wound-healing process involves the formation of new collagen that is often disrupted and not equivalent to the normal collagen,” says Finney. The result can then be a scar. “The longer the lesion is present, the larger it is, the more it’s picked at, the more likely it is to leave a scar.”
Do Acne Scars Go Away?
Some acne scars can disappear with treatment, while others might simply lessen in scale. “If scars are deep, they can take a ton of aggressive treatments,” says Bhanusali, “whereas keloids can sometimes respond in one or two treatments of steroid injections.”
Keloid and hypertrophic acne scars can also respond to lasering. For atrophic acne scars, Bhanusali recommends bio stimulators like Sculptra (a lactic acid facial injection) to create new collagen.
Though be mindful that your body may already be working in your favour. “Scars will often improve on their own with time as well. A scar takes a full year to remodel and ‘heal’, so its appearance at two months is often worse than what it is at a year.”
How To Prevent Acne Scars
To prevent acne scars, first and foremost don’t pick at your pimples, and don’t pop them, as tempting as that may be. That’s the easiest way to cause scarring. In the case of severe acne, both doctors suggest visiting a board-certified dermatologist to get tailored recommendations, and to handle them quickly.
“We often [neutralise] the lesions by injecting Kenalog (a steroid), or give them a spot treatment to prevent permanent damage.”
The Best Acne Scar Treatments
Purported remedies for acne scars are numerous and widely discussed. We look into some of them below.
Dermal Fillers For Acne Scars
Dermal fillers can be used to treat atrophic acne scars because they help firm over the depressions. However, they aren’t necessarily a permanent solution. “The duration of how long the filler lasts depends on the product,” says Finney, with the shortest lasting around six months.
Typically made up of hyaluronic acid, dermal fillers are charged by the syringe, and can near £750 ($1,000) in more severe cases. One syringe is usually enough for most patients unless they are experiencing extensive scarring.
Microdermabrasion For Acne Scars
“Microdermabrasion is a mechanical resurfacing procedure where the very superficial layers of skin are removed,” says Finney. Think of it as a thorough exfoliation process, often done with a crystal-tipped device. “It stimulates cellular turnover and boosts collagen.”
Alas, the results are usually not great for acne scars, he says. Because of its lower success level, many dermatologists won’t perform microdermabrasion and therefore this procedure is often done by aestheticians instead.
Laser Treatment For Acne Scars
There are numerous types of laser treatments available to treat acne scars. “There are devices that can eliminate the redness left behind, ones for dark marks, and also those that improve atrophic or hypertrophic scarring,” says Finney.
Ask your doctor specifically about fractional ablative devices (the most intense treatment costing roughly £1,200 [$1,500]) and non-ablative devices (a less aggressive option costing roughly £750 [$1,000]). Finney deems these the best treatment options. Laser therapy is often the most expensive choice but yields the best, most lasting results (with several sessions).
Microneedling For Acne Scars
Like other methods, microneedling also aims to get rid of acne scars by boosting the skin’s collagen production, but in a different and a more effective way. It involves tiny needles that pierce the skin to create a large number of micro-injuries that stimulate the body’s natural response to healing wounds.
Finney says that some micro-needling devices also emit radiofrequency for increased improvement and that you can add a plasma injection (often used for soft-tissue repair and hair loss) for an additional boost. On average a full-face procedure costs around £400 ($500) (with 4-6 procedures recommended), with an additional £300 ($400) for plasma.
Chemical Peel For Acne Scars
Think of this as your chemical exfoliator on steroids. “Peels using acidic or basic compounds create a controlled skin injury that results in unclogging of pores and stimulation of collagen and elastin,” says Finney. “These can help treat active acne, as well as the dark marks left behind by blemishes and scarring.”
If you want significant results, then go deep, but heed this warning: “The deeper the peel, the more potential benefit, but also the higher risk of side effects such as additional scarring or discolouration.” These will cost you around £150-£300 ($200-$400) per session.
Best Products For Acne Scars
An ingredient frequently used to help fade dark spots, Niacinamide (a form of vitamin B3) has multiple uses. “Niacinamide is anti-inflammatory which can help with active acne, but it is also good at reducing redness left behind from blemishes. It can improve the appearance of fine lines and wrinkles as well,” says Kinney.
Glycolic acid also boosts cell turnover, helps unclog pores, treat active acne, reduce dark marks and, as Finney puts it, “potentially stimulate collagen to improve the appearance of scarring. The latter is more likely if you are doing a peel with glycolic acid at higher concentrations.”
A topical or ingested vitamin A derivative, retinol stimulates cell turnover and is deemed one of the best anti-ageing ingredients on the market. “There is evidence that, as a single agent, topical retinol can improve the appearance of scarring,” Finney says. “It is also a good treatment for active acne and helping reduce the dark marks left behind from lesions. It is a great topical that everyone should be using.”
Using an SPF of 30 or higher can prevent acne lesions from leaving dark or red marks on your skin. “It will also reduce the chance of redness and discolouration hanging around for longer,” says Finney. “Acne patients should only use products that say ‘oil-free’ or ‘non-comedogenic’. You should use an SPF moisturiser year-round, every day, regardless of the sun’s directness or intensity.
“Vitamin C is a powerful antioxidant that helps cells repair themselves due to any trauma, sun, or similar wear. It is recommended to apply every morning before sunscreen, to help with redness and discolouration,” says Finney. While topical products will target the problem areas more precisely, it’s still a good excuse to chug a glass of orange juice on the daily.