Acne Scars and What You Can Do About Them
Acne scars are an unpleasant reminder of one of the most embarrassing experiences of adolescence and early adulthood, but there are simple methods that usually can reduce or eliminate smaller acne scars with home treatment.
- Acne scars are reminder of acne that can last not just for months or years but for decades if untreated.
- The healthiest skin usually forms the worst acne scars.
- Young skin scars easily.
- People who have vigorous immune systems get worse scars.
- People who have brown or black skin, especially men in their late teens and early twenties, are at greater risk for pink, tough scars growing over “pimples” around ingrown hairs.
- It’s always better to treat scars sooner rather than later.
- Alpha- and beta-hydroxy acids stimulate the growth of skin under indented scars.
- Silicone sheets can tighten the skin over outward-facing scars.
- Medical procedures almost never completely heal scars with just one treatment.
- Exposed Skin Care can help you gradually improve existing scars and stop new scars before they start.
Why Acne Leaves Scars
Among people who have the condition called acne vulgaris or common acne, the most prominent acne scars form on the healthiest skin. When children get acne, their skin grows so fast that a pore that is inflamed by acne is simply left out of the growing process, and gets covered by scar tissue. Teenage acne leaves slightly less severe scars for the same reason.
The small, inward sinking scars caused by adult acne are usually the result of an overly exuberant response of the immune system to acne infection. White blood cells including monocytes, macrophages, and neutrophils attack not just acne bacteria but also the collagen around the lining of a pore. The collagen scaffolding holding the skin together around the pore becomes tangled and loses its regular shape. When the skin begins to close over the area of infection it cannot find its usual framework and leaves an indented scar. The stronger the immune system’s reaction to acne, the more prominent the scar.
Keloidal scars are tough pink tissue that protrudes upward over an area of healed acne. This kind of acne scarring is more common on brown, black, and Asian skin. The rich tones of Asian, brown, and black skin are due to melanin. This pigment relieves inflammation in the skin and helps it heal.
Melanin-stimulating hormone also makes collagen soluble. As pimples heal, the skin gets darker, but collagen dissolves and floats to the top of the skin. It accumulates as a poorly unorganized mass of pink skin over the healed pore, tough but ugly.
Skin Peels for Minor Acne Scars
Acne scars differ from other kinds of scars only by their location. Any kind of scar on the delicate skin of the face is always hard to treat without causing a new skin problem, whether the underlying problem was acne or not. Treatments that work for other causes of facial scarring, however, will also work for acne scars, assuming acne is not still active.
It is always easier to treat smaller and newer scars than it is to treat larger and older scars. Small, indented scars can be treated with products that contain glycolic acid (an alpha-hydroxy acid) or salicylic acid (the only beta-hydroxy acid used in skin care), or both. These skin peeling acids work by stimulating the production of collagen underneath the skin, helping it grow at the edges of the scar, raising the scar tissue to the contour of the skin.
For glycolic acid or salicylic acid to work, however, you need the right amount of the product at the right pH. You need 3 to 10% glycolic acid at a pH above 3 and below 4, or 0.5% to 3% of salicylic acid at a pH above 3 and below 4, or there will be very little benefit for your skin. Usually stinging sensations are not a good thing in skin care products, but alpha- and beta-hydroxy acids have to cause a little irritation to do their work.
Exposed Skin Care’s Clearing Tonic is a good example of a product that can slowly erase acne scars while preventing new blemishes. The 35% glycolic acid skin peel by Skin Laboratory and the 40% glycolic acid skin rejuvenator by Skin Obsession will work even faster—but it is very easy to burn your skin with these products. That makes scars worse.
A silicone gel scar sheet can help reduce small, raised scars. You simply place the silicone sheet over scarred skin every night like a tight bandage. Over a period of a few weeks to a few months, your skin grows into a more even contour. It is important to pay special attention to removing the glue with a non-abrasive cleanser every morning to prevent whiteheads and blackheads from forming on the skin covered by the edges of the silicone sheet. You can also use a silicone gel or cream. Missing just one treatment, however, can undo weeks of skin care.
Microdermabrasion for Small Acne Scars
Another way to deal with small acne scars is simply to grind them away with microdermabrasion. The idea behind dermabrasion is to remove skin down to the “quick,” that is, until you begin to bleed, to encourage healthy regrowth of smooth skin. This method strips away about 25 layers of skin cells.
The idea behind microdermabrasion is to remove just 1 or 2 layers of skin cells to expose younger and more deeply colored skin beneath them. The additional color in your skin makes scars less noticeable, and encourages the (slower) growth of healthy skin to help fill in scars.
Aestheticians usually do microdermabrasion with a spray jet of aluminum oxide crystals, along with a vacuum hose to remove them from your skin. There are at-home microdermabrasion products that encourage you to rub aluminum oxide crystals into your skin, but they usually don’t come with the vacuum tube to remove them.
Aluminum oxide can irritate your skin, so better at home microdermabrasion systems use corundum crystals instead. You still need to rinse your skin thoroughly after using the microdermabrasion scrub, but there is very little risk of skin irritation when you use corundum. Or you can just gently scrub scar tissue with a polyethylene microdermabrasion cloth. You will gradually remove the edges around raised scars and lighten pigmented skin left behind by pimples.
When Medical Treatment Is Necessary
Medical treatment is necessary for the worst acne scars, but it is important to understand that you won’t walk out of the doctor’s office with clear, smooth skin. Even the best medical treatments for acne scars are usually only partially successful—since the doctor has to avoid creating a new scar while removing the old scar. Here is a roundup of the most common treatment methods.
- Steroid injections make pink, raised scars less noticeable, but if they are repeated too often, they lighten and thin the skin.
- Surgery can cut out scarred skin, with the risk of creating a new scar. Usually scars are injected with steroids for several weeks before surgery so less skin has to be removed.
- Laser ablation can shrink scars—or form new ones. There also tends to be a sharp line where the laser treatment ends.
- Radiofrequency ablation is the latest trend in acne scar treatment, but it destroys hair follicles and also leaves distinct changes in the color of the skin.
The best way to deal with acne scars is to stop them before they start. The younger and healthier your skin, the more important it is for you keep pimples under control. There are many helpful products by many manufacturers for general acne skin care, but many people find it easier to get everything they need from just one source, such as Exposed Skin Care.