A. How to Get Rid of (and Prevent) Acne Scars, According to Dermatologists
Even though fighting pimples is a distant memory that high school algebra and gymnastics tests have eliminated, acne marks and scars can persist annoyingly long after the pimples go away. “When someone develops a very large spine or cyst, the skin’s natural healing process creates a scar,” says David Avram, dermatologist Heights Dermatology and Laser. “The more intense the inflammation, the more likely it is to leave a scar.”
Real acne scars – like lumps on the skin like ice pick scars – can only be removed by professional procedures like microneedles or lasers. Fortunately, according to Julia Tzu, founder and medical director of Wall Street Dermatology, what most of us call “scars” are actually signs that will be caused by post-inflammatory hyperpigmentation (brown spots) or post-inflammatory erythema (red spots) on fades for several months or years. Fortunately, there are also products that can speed up the process.
We spoke with Tzu, Avram and seven other dermatologists for their recommendations on the treatment, prevention and camouflage of acne markers.
1. Best overall product for acne scars
As ultraviolet rays and visible sunlight can further darken acne spots, all dermatologists agree that it is important to use sunscreen every day. “Sunscreen can make a big difference in the duration or not of these signs,” said Arielle Nagler, a dermatologist at NYU Langone Medical Center. She generally recommends that patients wait a year with careful sunscreen to see what their scars will look like before deciding on an expensive or invasive procedure.
The best choice among dermatologists for facial sunscreen, this EltaMD sunscreen is also recommended to mitigate acne blemishes. Dermatologist Natalie Moulton-Levy likes that “it contains lactic acid, an ingredient that reduces post-inflammatory hyperpigmentation”, while Debra Jaliman, assistant professor of dermatology at the Icahn School of Medicine on Mount Sinai, says it is rich in niacinamide is another ingredient that attenuates dark spots. Dr. Dendy Engelman, of Medical Dermatology & Cosmetic Surgery, is a fan of this product because, in addition to lactic acid, it “contains zinc oxide to protect against [UVA / UVB] rays and antioxidants to repair damage”.
Another sunscreen approved by Derm is this La Roche-Posay mineral option, developed by Dr. Michele Farber of Schweiger Dermatology is recommended. “It’s one of my favorites because it works smoothly and has ample coverage and antioxidants for an extra layer of UV protection,” she says. This formula also contains zinc oxide, a key ingredient in reducing hyperpigmentation.
2. Best hydroquinone products for acne scars
According to some of the dermos we spoke with, the hydroquinone skin lightener is one of the most effective ingredients to mitigate acne scars. Naissan Wesley, a dermatologist at Skin Care and Laser Physicians in Beverly Hills, explains that hydroquinone “can help acne marks disappear more quickly, preventing melanocytes [pigment-producing cells in the skin] from producing more pigment.”
Ambi Fade Cream contains 2 percent hydroquinone, the highest concentration allowed without a prescription. “It also contains soy, which is known to treat pigmentation problems, and vitamin E, which helps with scars,” says Tzu. Although the FDA considers hydroquinone safe, it is banned in Europe and can cause additional irritation or discoloration. Therefore, be sure to do the contact test and ask a dermatologist if it is right for you.
Although much more expensive than Ambi cream, this serum recommended by dermatologist Y. Claire Chang of Union Square Laser Dermatology combines hydroquinone with vitamin C and glycolic acid, two other proven anti-brand ingredients. “Glycolic acid helps to improve existing brown spots, increasing skin cell renewal and chemically exfoliating the skin,” she says. “[E] Vitamin C is a powerful antioxidant that can brighten the skin.” Writer Or Gotham is also a fan of Murad serum and told us he saw “a noticeable reduction in dark spots” after just three days.
3. The best hydroquinone-free products for acne scars
If you don’t want to use hydroquinone, there are other ways to treat acne scars. One is azelaic acid, which Farber says inhibits the formation of an enzyme called tyrosinase, which in turn disrupts the mechanism that makes melanin to darken the skin. Moulton-Levy recommends this affordable and effective normal azelaic acid treatment.
Like Murad Serum, this treatment combines vitamin C with glycolic acid (and lactic acid, another exfoliator) to fade the marks, but without the hydroquinone. Nagler recommends vitamin C because it is “a free radical damage prevention tool that helps pigmentation” and says that the most effective formulas – like this one – tend to be more expensive because vitamin C is an ingredient that is difficult to stabilize.
Farber also likes vitamin C, which she believes prevents free radical damage, while helping to reduce pigment changes. Like Cut’s beauty director, Kathleen Hou, and style and beauty editor Barret Wertz (and all other well-known beauty editors), she is a fan of CE Ferulic, which offers a high and stable concentration of a notoriously unstable ingredient (hence the price)). It also has other ingredients that make it great, like vitamin E and ferulic acid, which increases its effectiveness. In the cheaper end, Moulton-Levy says that this strong toner of glycolic acid is another great option for fading acne markers.
4. Best cleanser for acne scars
In addition to sunscreen and targeted treatments, the right cleanser can help minimize acne blemishes. This cleanser is popular with Moulton-Levy and Chang and promotes cell renewal without drying out the skin. Chang says that “it contains glycolic acid to remove dead skin cells from the top layer of the skin, leaving it very clean and improving acne blemishes”.
Although this AHA / BHA cleanser usually helps to lighten and even out the skin, this formula can also help with acne scars, according to Tsu. Alpha and beta hydroxy acids chemically exfoliate the skin, which removes dead skin cells, while licorice helps to reduce hyperpigmentation caused by acne scars.
Tsu also likes this Glytone cleanser, which she believes helps to lighten and even out skin discoloration. The superstar ingredient in this formula is glycolic acid, which helps to speed up cell renewal and make the skin reappear (which makes dark spots disappear faster). It is also oil-free, great for anyone with oily and combination skin, or even normal skin.
5. Best acne scar prevention products
When it comes to acne scars – those that are marked or protruding, especially difficult to treat – the best insult is a good defense. If you are still fighting active acne and want to avoid future scarring, Avram likes the Neutrogena drugstore cleanser because it contains salicylic acid, which “exfoliates the skin, soothes the appearance of acne itself and has some antibacterial properties”. Chang agrees that the cleanser “can help clog pores, treat comedones (white spots) and blackheads and prevent active acne”.
If you are looking to treat both current pimples and existing scars, these exfoliating pads recommended by Chang contain ingredients that will help both. “Salicylic acid increases skin cell turnover and clogs pores to reduce blackheads,” she says. “Glycolic acid chemically exfoliates the skin to even out skin tone and reduce blemishes.” Commonly used in acne treatments, salicylic acid is a beta-hydroxy acid that prevents and treats acne, which means fewer blemishes and scars.
Differin is a prescribed retinoid that was available over the counter a few years ago. It affects cell turnover more quickly than OTC retinol to prevent new acne from forming, but is still “milder compared to other retinoids,” according to Engelman. Avram recommends it to anyone who is dealing with many small pimples and only an occasional monster cyst. As Nagler says that retinoids “promote collagen remodeling”, a well-tolerated formula like Differin can reduce the appearance of deeper scars. Moulton-Levy also likes to light up existing markings.
For good over-the-counter retinol, Farber recommends SkinBetter AlphaRet, which she describes as “wonderful” as it is well tolerated by more sensitive skin types. She also likes the fact that it contains AHAs, another pigment-reducing ingredient for extra exfoliation.
B. The best ways to get rid of acne scars
The acne rash can be frustrating, leaving scars on the face and other areas of the body. Some people find that acne scars are an unwanted reminder of a painful and uncomfortable condition. However, acne scars need not be permanent, as some home remedies and medical treatments can help to eliminate them. In this article, you will learn about the different ways to reduce the appearance of acne scars and promote healthy skin.
1. Home remedies
Several over-the-counter remedies are available, many of which can help people control their acne and reduce the appearance of scarring.
a. Salicylic acid
Salicylic acid is a natural compound that is often found in acne skin products. Salicylic acid helps to remove dirt, skin cells and other debris that cause acne from skin pores. It also helps to reduce swelling and redness in the area, which can minimize the appearance of scarring.
Salicylic acid is beneficial for all types of scarring. It is a good addition to a daily skin care regimen for most people living with acne. People with sensitive skin may need to test a product that contains this acid on a small area of the skin before applying it across the face, as it can cause dryness or irritation.
Some topical retinoids can help eliminate acne scars. As noted by the authors of a review in the journal Dermatology and Therapy, topical retinoids block inflammation, reduce acne lesions and accelerate cell regeneration. The authors also claim that retinoids can help lighten hyperpigmented acne scars, even in people with darker skin tones.
It is important to note that retinoids can make the skin sensitive to the sun. Anyone who uses retinoids to treat acne or scars should use sunscreen when leaving the house.
c. Alpha hydroxy acids
Alpha-hydroxy acids (AHAs) can help eliminate dead skin cells and prevent pore clogging. Doctors can recommend AHAs to treat acne and reduce the appearance of acne scars.
AHAs are a mild form of acid that scrapes the outer layer of the skin to reveal new, fresh skin underneath. This process can help with discoloration due to scarring.
d. Lactic acid
Lactic acid can act as a mild scrub to remove dead skin cells. It can help to reduce the appearance of scars and smooth the overall texture of the skin.
Lactic acid can also help lighten dark scar tissue, although it sometimes causes hyperpigmentation. Because of this potential adverse effect, it is best to test products that contain lactic acid on a small area of the skin before using them to treat acne scars. Many acne products contain lactic acid. It is also found in diluted apple cider vinegar, which makes the treatment more natural and less expensive.
e. Natural Remedies
Many people use natural remedies to get rid of acne scars, but the science behind it is unclear. Some can cause more irritation or other problems, so people should proceed with caution.
The home remedies that people traditionally use to treat acne scars include:
- Coconut oil
- Karite butter
- Aloe Vera Gel
- Raw honey
- Sodium bicarbonate
- Lemon juice
2. Medical treatment
Various medical treatments are available to reduce acne scars. A dermatologist may recommend different procedures depending on the type of skin and the extent of the scar.
Medical treatments for acne scars include:
a. Chemical peels
A dermatologist can recommend a type of scrub suitable for a person’s skin type, severity of acne and scarring. The authors of a 2017 report on treatments for acne scars found that six out of ten participants who used a certain type of chemical peel called trichloroacetic acid (ACT) had at least a 70 percent improvement in their displayed acne scars.
Other chemical peels may be less effective. For example, 25% of people who used glycolic acid saw no reduction in the appearance of scars. A person may need to try different types of scrubs to determine which one is right for them.
Corticosteroid injections can help treat the increase in acne scar tissue when a person has hypertrophic scars or keloids. Treatment usually consists of a series of injections. A dermatologist can give these injections to your office every few weeks and monitor the results.
c. Dermal padding
In some cases, dermatologists may recommend using soft tissue fillers to reduce the appearance of scarring. Dermatologists can choose a filler made from a collagen-based product that may require an allergy test. Alternatively, removing fat from another part of the body may be an option. You can also use other commercially available fillers, such as polymethylmethacrylate (PMMA), hyaluronic acid (HA) and poly-L-lactic acid (PLLA).
Dermal fillers work best on atrophic scars, but many are temporary. Treatment usually lasts between 6 and 18 months. However, there are some permanent options that a person can discuss with their dermatologist.
Microneedling involves the insertion of tiny needles into the skin around the scar to stimulate the body to produce more collagen. This collagen can reduce the appearance of acne scars by smoothing the skin. In a 2017 review, microneedling improved the appearance of acne scars by 31 to 62 percent.
However, microneedling can cause side effects. Many people experience redness, pain and inflammation after treatment, but this decreases over time.
e. Laser treatment
Laser treatment resurfaces the skin without using chemicals or exfoliating. It removes the top layer of the skin to expose younger skin cells, which can help reduce the appearance of scarring. However, laser treatment is not for everyone, as its success depends mainly on acne scars and a person’s skin type. Treatment can also cause a reaction in some people, especially in people with sensitive skin.
3. Types of acne scars
The appropriate treatment options may vary slightly, depending on the type of scarring caused by acne. There are three types of acne scars:
- Atrophic scars: these scars appear as small depressions in the skin. They occur when the skin does not produce enough fibroblasts in the healing process. Fibroblasts are cells that play a crucial role in wound healing and collagen synthesis.
- Hypertrophic scars: occur when the skin produces too many fibroblasts while the acne blemish is healing, resulting in an increased scar.
- Keloid scars: They are similar to hypertrophic scars, but are usually much thicker than the original acne spot. They are usually darker than the surrounding skin and can be red or brown. Keloid scars can also cause symptoms such as itching or pain.
Acne scars can be an unwanted reminder of acne and lower self-esteem in some people, but it doesn’t have to be permanent. Many people are successful with one or more home remedies. For stubborn scars, medical treatment at the dermatologist’s office can also help get rid of acne scars.