Get Rid of Acne Scars

As if struggling through acne wasn't hard enough, it can also leave behind scars if you try to pop it or pick it off, and post inflammatory erythema marks long after puberty! However, it is possible to get rid of those acne scars and marks — you just need to find a method that works for you, Note, this does not work for every one . Methods of dealing with these scars can vary from simple creams to invasive surgery and, everything in between.

Steps

Getting Rid of Scars

  1. Figure out what kind of scars are on your skin. Acne scars fall into four types, and knowing what you're dealing with can help you choose the right treatment.[1]
    • Icepick scars are the most common marks left behind by acne. They're characterized by deep pits that are relatively narrow on the surface.
    • Boxcar scars occur primarily on the temples or cheeks, and feature deep, angular edges that resemble chicken pox scars.
    • Rolling scars give skin a wave-like appearance and have tapering edges, that start shallow and go deeper.
    • Keloid (or hypertrophic) scars are thick and raised from the skin, caused by excess collagen sent to repair the original scar.
  2. Try topical treatments for atrophic scars. Atrophic scars (or, anything that is not a keloid or raised scar) might respond well to topical treatments designed to boost collagen production. Look for compounds that contain:
    • An alpha-hydroxy acid (AHA). Glycolic acid is one of many AHAs available. To be effective, AHA peels sold over-the-counter must be between a pH of 3 and 4.[2] Be sure to apply at night as AHAs cause photosensitivity. Use sunscreen and be aware of sun exposure sunlight if you use this method. Glycolic acid is safe for pregnancy if it is under 10%.
    • A Beta-hydroxy acid (BHA). BHAs must be at the correct pH between 3 and 4 to exfoliate skin. Salicylic acid is a BHA. BHA's are not recommended during pregnancy.
    • Retinoic acid, or vitamin A. In some countries, such as the U.S., you might need to get a prescription for Retin-A because it can cause birth defects if you happen to get pregnant. Ask a dermatologist as prescription medication carries side effects.
  3. Try microdermabrasion for atrophic scars.[3] Microdermabrasion buffs down the skin surrounding the scar, evening out the surface and making pits and shadows less apparent. Microdermabrasion exfoliates the skin with tiny crystals, which is relatively painless and usually bloodless. It also can help boost your own collagen formation in your skin. Many dermatologist offices offer microdermabrasion.
    • Ask around for a recommendation. If at all possible, consult someone who has undergone microdermabrasion for acne scars.
    • Some people with deep scars skip the "micro" and go straight for dermabrasion, which is a more intensive process that goes deeper into the skin. Ask your doctor if this is the best option for you.
    • Be prepared for the recovery time. Your skin will be red and sensitive after the treatment. Avoid direct sunlight for a few weeks, and always use sunscreen.
  4. Get a chemical peel. A chemical peel will remove the top layer (or a few more) of your skin, so that new skin can regenerate without pigmentation or scars. Chemical peels should always be administered by a doctor or aesthetician working with a doctor, though they shouldn't feel too painful — the sensation should be a light tingling or burning.
    • Ask your doctor about what kind of peel you need. There are several different formulations tailored to different skin problems, as well as how deeply the peel needs to go into your skin. Chemical peels usually work best when used several times.
    • Stay out of the sun and use sunscreen. Your skin will be extremely sensitive after the peel. Don't undo the good work with a sunburn!
  5. Get laser treatments.[4] Laser treatments work for both atrophic and keloid (or raised) acne scars. There are several laser treatments available, and a dermatologist will help you determine which is right for you.
    • Laser resurfacing for atrophic acne scars: Like microdermabrasion, laser resurfacing buffs down the skin around the scars, reducing the appearance of pitting and shadows.
    • Pulsed dye laser treatments for keloid or red scars: This procedure can induce apoptosis (or individual cell death) and bring the scars down as well as reduce redness.[5]
    • The Smoothbeam laser also improves atrophic scars by helping your body build new collagen.
  6. Ask your doctor about fillers. Sometimes acne scars are so deep that skin resurfacing alone won't help. In this situation, you could consider getting injectable fillers which plump out the scars and make them less noticeable.
    • The only downside to fillers is that the material gets absorbed by the body over time, so you will need to receive repeat injections every six to 12 months, on average.[6]
  7. Try steroid injections. Steroid, or cortisone injections, soften and then shrink hard scars. This is a particularly effective treatment for keloid scars.[7] Your doctor will inject the scar tissue, which may help decrease any itching, redness, or burning, and may also soften and shrink the tissue as well.[7]
  8. Consider surgery as a last resort.[8] Surgery is effective but carries its own risks.
    • A punch excision involves a cut into the skin around the scar, which is then closed with stitches, eliminating the original scar.[9]
    • For small scars, you'll probably get a very careful line of stitches over the punch excision site; for larger areas, though, you might need a skin graft from another part of your body, usually behind the ear.[9]

Treating Post Inflammatory Erythema

  1. Understand the terminology. While they are cause by acne, post-inflammatory erythema (PIE) and post-inflammatory hyperpigmentation (PIH) are not actually scars, but rather discoloration of the skin.[10]
    • PIE are the pink and red discolorations caused by inflammation and acne lesions. PIH marks are the brown marks that are causes by the excess production of melanin.
    • You can distinguish between PIE and PIH by the color, and also by the press test: PIE disappears when you apply pressure to the area, while PIH does not.
    • The term "scar" really only describes indentations in the skin caused by acne, though many people who have had severe acne are also interested in reducing the appearance of their PIE and PIH.
  2. Treat PIE and PIH. Unlike scarring, PIE will eventually fade away due to slow collagen production. But since the process can take six months to several years, many people prefer to speed up the process using treatments.
    • Effective treatments should contain skin-lightening or tone-correcting ingredients. These lotions are often popular in Asian countries, where light skin tone is considered desirable.
    • Look for ingredients such as kojic acid, vitamin C, arbutin, niacinamide, mulberry extract, azelaic acid, and licorice extract. As these ingredients are scientifically reviewed as skin-lightening agents, they are generally safe to use and should not cause any adverse reactions when used as directed.
    • Some doctors will prescribe a cream containing hydroquinone, but this should be used carefully and only for a short period of time due to possible side effects.
    • Vitamin C serums rebuild collagen, evening skin tone to treat PIE. It's important to note that many over-the-counter Vitamin C products do not contain a high enough percentage to effectively work. A Vitamin C serum is the best route available by prescription from your dermatologist is the best choice.
    • Wear sunscreen. Sunscreen protects skin from UVA and UVB damage, which can reduce the amount of time it takes for PIE to clear up on its own.
  3. Try chemical exfoliation. Over-the-counter products containing alpha hydroxy-acids (AHA) exfoliate the skin and help skin cell turnover, treating acne and PIE.[2]
    • AHAs are effective exfoliants — which means that they encourage skin to shed its top layers faster and reveal fresh, unblemished skin beneath. Wear sunscreen as AHAs cause photosensitivity, which can result in a sunburn.
    • Consider getting a chemical peel treatment (which uses glycolic acid or other AHA or BHA acids) at the dermatologist. This is much more intensive than the OTC AHA products and will penetrate deeper layers of the skin, but of course it is also more expensive and will result in several days or even weeks of redness and irritation on your skin.
  4. Use retinoids. Retinoids are acidic vitamin A derivatives which are highly effective in treating a number of skin issues, such as fine lines and wrinkles, acne and discoloration.
    • Retinoid creams will help to fade PIH marks by speeding up cell turnover, and retinoids can also help with atrophic scarring as they stimulate collagen production.
    • Retinoid creams are mainly available by prescription, so you may need to make an appointment with your dermatologist to pursue this treatment. It's also important to be aware that retinoids make your skin very sensitive to sunlight, so they should only be applied at night.
    • A a retinoid called Differin gel (adapalene gel) is now available over-the-counter in the US. It is prescription-strength, but somewhat milder than other prescription brands.
    • A weaker form, known as retinol, is a common OTC ingredient in many popular skin care products. These products claim to produce the same effects as retinoid creams, but they are not nearly as effective.
  5. Consider laser treatment. If PIH or PIE marks do not fade within several months, you could consider getting laser treatment to fade the marks and make them much less noticeable.
    • The latest laser therapies can resurface the skin, thus getting rid of any marked, discolored patches of PIH. These lasers can also boost collagen production to fill in atrophic scars. Other lasers such as the Pulsed-dye laser, target the redness and discoloration of the skin caused by acne.
    • The only downside is that laser treatment is expensive and you make require up to three sessions to completely erase the PIH, and can cause sensitivity and irritation. However, the results are often fast, effective, and permanent.[6]
  6. Experiment with home remedies. Although medical procedures and treatments have the highest rates of effectiveness, you may prefer less invasive, home ingredients readily available and safe to use.
    • Honey mask: Honey contains sugars, amino acids, and lactic acid. This means that honey will attract moisture and trap it on your skin while mildly exfoliating and treating acne. Prep your skin by pouring hot water into a bowl and putting your face near the surface, draping a towel over your head and the bowl to trap the steam. The steam will help your pores better absorb the honey. After a few minutes, rub pure grade A honey on your face and let it sit for 15 minutes before washing it off.
    • Aloe vera: Aloe vera is another moisturizing product which helps to soothe and rejuvenate hyperpigmented skin. Although you can buy skin care products containing aloe vera, aloe vera is readily available with an aloe plant. Break off a leaf and use the gel-like sap directly on the skin. If you like, you can mix a drop (and no more) of pure medicinal grade tea tree oil in with the aloe before applying. Tea tree oil undiluted causes chemical burns, so it must be diluted. Tea tree is antibacterial and helps to promote clear skin by treating acne. Diluted neem oil is another additional oil to add that also treats acne.
  7. Know what home remedies to avoid. There are many articles online that advise the use of products that are dangerous or damaging to the skin. Be sure to do your own research and only use products that are safe for topical use.
    • Just because it is "natural" doesn't mean it is "safe." You would not put naturally occurring mercury or poison ivy on your skin, so be cautious of ingredients that are marketed as "natural," home remedies, or are trademarked. Do however use ingredients scientifically proven to treat skin.
    • Just because it is a food, doesn't mean it is safe for your skin. The pH of certain foods may harm your skin. Treat your skin as the delicate organ it is, not as a dinner plate.
    • In particular, avoid recipes or home remedies that include lemon juice or baking soda. Both should be avoided in facial care as they could cause chemical burns and worsen erythema. Additionally, lemon juice causes photosensitivity. Both have a pH too far from the natural 5.5 pH of healthy skin and aren't usually recommended for use on your skin.

Caring for Your Skin

  1. Use a pH balanced cleanser. Be kind to your skin and use a pH balanced cleanser of 5.5. This is the natural acidic condition of skin and the optimal pH. At this pH the skin forms an adequate acid mantle to prevent acne vulgaris growth.
    • Make sure the cleanser you choose is specifically recommended for your face, and optimally for acne-prone or sensitive skin.
    • Carefully patch-test. Carefully test a new product on a small section of your skin for a period of time to gauge for any adverse effects. Discontinue use if irritation occurs. Add new products carefully. For some, a pH balanced cleanser may result in irritation due to fragrance sensitivity. Try another product or simply use coconut oil to clean your skin instead.
    • Avoid washing your face with very hot water (as this can dry out the skin) and don't use rough washcloth or sponges for physical exfoliation, as these can irritate and inflame the skin. Use lukewarm water with a pH balanced cleanser.
  2. Exfoliate. It is important to use a chemical exfoliant with an AHA or BHA to treat acne and erythema. Exfoliation sloughs off dead skin cells, unclogging pore and treating acne.[2] It also smooths out the skin, which can help to minimize the appearance of both acne scars and erythema marks.
    • An AHA and BHA must be at the correct pH between three and four to have any efficacy. Use a BHA as often as twice a day. Use a AHA at night, as AHA use in the day will cause photosensitivity. If using an AHA in the day, be sure to wear sunscreen.
  3. Exfoliate gently. For gentle physical exfoliation use a Konjac sponge, or a soft washcloth dampened with water. Gently rub the wash cloth against your skin, using small circular motions.
    • For physical exfoliation, exfoliate once a week, or as often as deemed necessary. However, if you tend to have dry skin, and your skin is feeling tight as a result, exfoliate less often.
    • Avoid physical exfoliation with plastic micro-beads or walnut shells as the former contributes to environmental pollution while the latter damages the skin and contributes to aging.
    • If you notice that your skin becomes very red or irritated, reduce the frequency of exfoliation or try a different product.
  4. Wear sunscreen and do not tan. Ultraviolet radiation is the number one cause of premature aging. It also leads to skin cancer. Exposing your skin to harmful UVA and UVB rays damages skin and contributes to PIH formation, as the sunlight stimulates pigment-producing cells. It also prolongs PIE damage.
    • Not only can the sun prolong PIE appearance and create PIH, it can lead to premature aging including sun spots, fine lines and wrinkles. Sunscreen is an anti-aging must for all ages young and old — preventing future skin cancer. Prevention is better than treatment. There is no such thing as safe tanning but there is sun damage.
    • Wear sunscreen every day, with an SPF of 30.
    • When out in the sun for long periods of time, stick to the shade as much as possible and wear a wide-brimmed hat and light, long-sleeved clothing. Wear sunglasses, especially if you have blue or green eyes. Consider carrying a parasol. In Asia, they are a popular fashionable accessory.
  5. Drink more water and eat a healthy diet. Although drinking lots of water and eating a healthy diet won't get rid of your acne scars all by itself, it will help your body to function at optimum levels and encourage skin rejuvenation.
    • Water flushes toxins from the body and hydrates your skin, making it look fresh, plump and healthy. You should aim to drink six to eight glasses a day.
    • Eating lots of fruit and vegetables provides your body with the vitamins and nutrients it needs to keep skin healthy. Focus on getting enough of vitamins A, C and E (found in produce like broccoli, spinach, carrots, tomatoes, avocados and sweet potatoes) as these are the most beneficial for the skin.
  6. Avoid picking at spots and touching your face. It's hard to do, but resist the urge to pop, scratch, pick or otherwise put your hands on your face — it'll only make your skin worse for the long haul.
    • Instead, resolve that you'll touch your face twice a day, when you wash it morning and night and apply products, and leave it alone for the rest of the day.
    • Change your pillowcase regularly as the bacterial growth and oil accumulation there may contribute to acne.
    • If you're still battling active acne, try these helpful wikiHow articles: How to Avoid Acne and How to Prevent Acne Outbreaks



Tips

  • Moisture helps scars heal, so be sure to moisturize. Avoid lotions that aren't listed as non-comedogenic (which can cause blackheads).
  • Excessive sun exposure without using SPF will contribute to photoaging, making scars darker and more permanent. Always wear sunscreen with adequate UVA and UVB protection.
  • Make sure to talk to your doctor if you are pregnant or breastfeeding. Not all treatments or medications are safe during pregnancy or breastfeeding.
  • To combat pitted shadows that can make scars more noticeable, try evening out your skin tone with makeup. Make sure the makeup is oil-free and noncomedogenic. Mineral-based makeup is often a good choice.

Related Articles

Sources and Citations

  1. ↑ http://en.wikipedia.org/wiki/Acne_scars#Scars
  2. ↑ 2.0 2.1 2.2 http://europepmc.org/abstract/MED/15002658
  3. ↑ http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1512335/
  4. ↑ http://www.ncbi.nlm.nih.gov/pubmed/19951190
  5. ↑ http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3799037/
  6. ↑ 6.0 6.1 http://www.webmd.com/skin-problems-and-treatments/acne/acne-care-11/acne-scars?page=2
  7. ↑ 7.0 7.1 http://www.hopkinsmedicine.org/healthlibrary/conditions/dermatology/scars_85,P00313/
  8. ↑ http://www.ncbi.nlm.nih.gov/pubmed/14725663
  9. ↑ 9.0 9.1 https://www.asds.net/Excision-and-Punch-Replacement-Graft-for-Acne-Scars/
  10. ↑ http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3780804/
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