Signs of acne don’t always go away when a breakout clears. Sometimes, you may be left with lingering discoloration or scarring, which can be even more difficult to treat than the breakouts themselves.
Board-certified dermatologists, Mohs surgeons and cosmetic surgeons Drs. Joel and Daniel Schlessinger are well-versed in improving acne and any lingering signs. In this blog, we’ll discuss the ins and outs of acne scarring, including:
- Everything you need to know about acne scars
- Microneedling for acne scars
- Chemical peel for acne scars
- Acne scar laser treatment
- Other treatments your dermatologist may recommend
- The best products for acne scars
Everything you need to know about acne scars
Acne scarring is typically caused by deep, cystic acne. However, untreated breakouts may also cause acne scarring. That’s where the most important kernel about acne scarring comes from—an ounce of prevention is worth a pound of cure.
If you’re experiencing new or worsening breakouts, it’s important you see a dermatologist as soon as possible. “There is no benefit to leaving acne alone or letting it run its course. Acne treatments have gotten better over the years, and there is no reason nowadays to let acne progress to the point of scarring,” Dr. Daniel Schlessinger says.
However, if you have an active acne breakout and acne scarring, the active acne must be treated before the scarring can be addressed. “I like to compare this to trying to clean up from a fire while the fire is still burning; you need to fully put out the fire first before picking up the pieces it left behind. The same goes for acne scarring,” Dr. Daniel Schlessinger says.
There are different types of acne scarring, though their types (icepick, boxcar or rolling) are mostly relevant to dermatologists, as some respond better to certain treatments than others. Acne scars can either be raised (hypertrophic or keloidal) or atrophic (indented or depressed). What treatments you and your dermatologist decide upon may depend on the type of scarring you have.
Microneedling for acne scars
Microneedling is a common procedure for people with textural concerns and is a minimally invasive treatment that superficially punctures the skin with small needles to stimulate the body’s wound-healing response. This treatment can help improve collagen and elastin production in the area.
While microneedling on its own may provide slight improvements, it shows the best results when combined with other treatments. “We do microneedling treatments with the ENDYMED System, which uses radiofrequency to stimulate collagen. Many of the acne scarring cases we see are a result of collagen loss, which is why ENDYMED can help,” Dr. Joel Schlessinger says.
He continues, “AQUAGOLD® Fine Touch™ Microneedling is another option, which combines microneedling with fillers, like Juvederm or Restylane, but it may also contain BOTOX®, which can help remodel scars.”
We recommend visiting a licensed medical aesthetician or board-certified dermatologist for a microneedling treatment in any variety to prevent additional scarring or skin damage.
Chemical peel for acne scars
Chemical peels are another common treatment for those with acne scarring. It uses a chemical substance to stimulate skin regeneration. However, chemical peels come with their own set of risks and can even exacerbate scars if not performed correctly. If you’re considering a chemical peel to help with your acne scarring, it’s important to seek the advice of a board-certified dermatologist and make sure a licensed medical aesthetician administers it.
“Chemical peels are a great option for someone with scarring in its early stages. It can help up to six to twelve months after a scar is formed, but it isn’t as effective for older scarring. I recommend glycolic peels or the afa® Clay Peel, which incorporates bentonite clay and a proprietary ingredient called afaLUXE™. This ingredient works similarly to glycolic acid, but patients tend to experience less irritation and side effects. It is gentle and can help with active acne, some scarring and post-inflammatory hyperpigmentation,” Dr. Joel Schlessinger says.
Acne scar laser treatment
Lasers can be effective for certain kinds of acne scarring. Depending on the type and extent of acne scarring, as well as the patient’s skin type, acne scar laser treatment can be effective. Single or multiple laser types may be used depending on your dermatologist’s guidance.
Exercise the same caution when getting a laser treatment as you would with microneedling or chemical peels. However, laser treatments can potentially exacerbate symptoms if not performed correctly.
“For redness, IPL or BBL can be quite helpful. For textural concerns in skin of color, MOXI® is safe and effective, though it is gentler and will require a series of treatments over time to achieve maximal results. For lighter skin types, HALO, Erbium ProFractional, Erbium TRL and CO2 may all be reasonable treatment options,” Dr. Daniel Schlessinger says.
The type of laser you and your dermatologist decide on depends on your skin tone, your overall concerns and the type of scarring. Each laser works on a different wavelength and with different strengths, which is why it’s important to discuss it with a board-certified dermatologist.
Other treatments your dermatologist may recommend
Lasers, microneedling and chemical peels aren’t the only solutions for acne scars.
“Depending on the type and extent of acne scars, subcision or fillers may be great options as well. Subcision involves numbing the area of scarring with lidocaine and using a needle to enter the skin from beside the scar to release the tethering that pulls skin down. It can be quite effective. Sometimes, it is done in conjunction with fillers or laser resurfacing for even better results,” Dr. Daniel Schlessinger says.
“As far as deeper scarring goes, it remains a challenge even with invasive treatments like lasers and peels,” Dr. Joel Schlessinger adds. “Topical sheets of silicone or silicone-based gels such as Stratpharma products can help in the early phases of healing,” he says.
The best products for acne scars
Some acne scars aren’t actual scars but simply pigment left behind by a breakout. “We call that post-inflammatory hyperpigmentation, or PIH for short,” Dr. Joel Schlessinger says.
“PIH can be improved by products that target pigment and improve cell turnover. We recommend LovelySkin LUXE Clarifying Gel Cleanser, along with the LovelySkin LUXE treatment gels, which are made in graduated strengths. The cleanser and treatment gels are made with the same ingredient afaLUXE™ found in the afa® Clay Peel, but are designed to be used daily.
We recommend starting with Acne Care Gel 9% or Exfoliating Gel Mild 11%. Once you’ve finished a full bottle with no side effects, you may graduate to Exfoliating Gel Plus 15% before moving on to Exfoliating Gel Max 19%,” he continues.
Ready for your dermatologist to help you learn how to improve acne scars? You can schedule a consultation using our appointment portal today.