With many experiencing an uptick in breakouts while in lockdown, the concern around blemishes, and the marks they leave behind, has only grown. So if you’re wondering how to manage acne scars, trust that—while they can be frustratingly stubborn to treat—with time, dedication, and the right arsenal of products and treatments in your stable, you can effectively reduce their appearance.
A vital part of treating acne scars is first understanding what they are: small depressions or indentations in the skin that result from moderate to severe acne. Secondly, it’s important to note that there are different types, which include ice pick, rolling, and boxcar scars depending on their size, shape, and contour. “Acne breakouts, depending on the severity, can affect not only the top layer of the skin but also the deeper levels as well,” explains New York City dermatologist Shereene Idriss. “As the inflammation subsides and the skin tries to heal, scar tissue can ensue. Severely inflammatory acne, external factors such as picking, and delayed onset of treatment can all lead to scarring.”
Acne scars must be distinguished from superficial acne marks, like brown or red spots. “While many of my patients use the terms scars and marks interchangeably, I do make a point of defining these two very different sequelae of acne,” explains Andrew Alexis, M.D., MPH, and professor of dermatology at the Icahn School of Medicine at Mount Sinai. “Most notably, acne scars are permanent if not treated and are characterized by having an indentation or depression in the skin. Acne marks, on the other hand, do resolve eventually and are characterized by flat or smooth dark spots (hyperpigmentation) or persistent red spots (erythema) at the sites of a recent acne lesion.” The easiest way to tell if you have an acne scar? “Close your eyes and run your fingers over your face or the acne affected area,” Idriss advises. “If you feel textural changes, then you most likely have acne scars.”
From prevention to the most effective at-home and cutting-edge in-office treatments, here the pros weigh in on how best to treat acne scars and marks.
Begin With Prevention
“Start with controlling and treating the acne first—otherwise, you may just be chasing more scars,” says dermatologist Naissan O. Wesley, M.D., FACMS, adding that some acne treatments will help improve the appearance of acne scars in and of themselves. “Once the acne is under control and there is not much new acne formation, then it would be appropriate to undergo additional acne scar treatments if needed to treat any scars still present.” In terms of the best products to treat moderate to severe acne, such as red bumps, pus bumps, and +/- cystic lesions beneath the skin, Alexis recommends following an acne regimen prescribed by a dermatologist. For an over-the-counter treatment, Wesley recommends a soothing daily acne treatment, such as Arbonne Clear Future Corrective Acne Treatment Pads. “They contain salicylic acid and willow bark extract in a pad form to help reduce acne inflammation and gently exfoliate the skin surface to heal acne and acne marks faster,” she explains, “as well as prebiotics, polysaccharides, calendula, and sage to help heal and maintain the skin’s moisture barrier.”
“When thinking of how to treat acne scars, I always encourage my patients to address the discoloration within the scars first,” explains Shereene Idriss. “It is amazing that when you even out the color of the scar, oftentimes the textual changes do not bother my patients as much as they think they would.” Needless to say, acne has different effects on different skin tones, which is helpful to keep in mind when identifying and addressing acne marks and scars. “Lighter-color skin tones or skin that sunburns more easily will often produce red marks after acne, whereas darker-color skin tones or skin that tans more easily will often produce brown marks after acne,” explains Wesley.
One of the most robust topical treatments for fading discoloration is a vitamin C serum, which is packed with antioxidants and protects the skin from harmful free radicals caused by sun exposure while brightening it to reduce the appearance of dark spots. Additionally, when carefully and slowly incorporated into your skin-care regimen, retinol—a derivative of vitamin A, which is one of the body’s key nutrients for boosting cell turnover and stimulating collagen production—can help treat discoloration. Another at-home strategy is doing regular mild peels infused with acids such as lactic, glycolic, and trichloroacetic, which gently exfoliate to reveal smoother and more even skin.
Try In-Office Treatments
The unfortunate truth is that once an acne blemish has scarred, it’s permanent, and in tandem with topicals, professional in-office treatments with lasers will offer maximum results in improving its appearance. “Lasers can be very effective in helping improve acne, acne marks, and acne scars,” explains Wesley. She adds that photodynamic therapy (light therapy) can be used to decrease inflammation of active acne, while vascular lasers and broadband light treatments, such as pulsed dye laser or IPL (intense pulse light), can be used to improve post-inflammatory pigmentation. Most significantly, non-ablative and ablative resurfacing lasers are some of our best treatments for treating acne scars, particularly those that are indented. For rarer hypertrophic or keloid scars from acne, dermatologists will often use the vascular lasers or resurfacing lasers combined with topical cortisone or intralesional cortisone injections (meaning injecting directly into the scar) to improve the scar appearance.
In addition to lasers, Wesley says other in-office treatments, like medical-grade chemical peels and microneedling (especially combined with PRP, which stands for platelet-rich plasma), can help diminish acne marks and scars. What’s important to note across the board is that patience is key, no matter what kind of acne abrasion you’re seeking to treat. This holds particularly true in the case of scars, where timing and results are contingent on the nature of the scar itself and the types of treatments chosen to treat it. That being said, from at-home topical treatments to medical treatments at the dermatologist’s office, there has never been more promising technology. “Acne scarring can be disfiguring, and I feel fortunate that we can do so much now to help patients treat acne scarring, hopefully making them look and feel just as beautiful on the outside as they are and feel inside,” says Wesley.