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Acne in itself is quite emotionally draining but the scars it leaves behind can lead to more stress. Fortunately, these scars can be treated. 

We have put together information that will make it easier for you to understand more about acne marks and how you can treat them.

Highlights:

One must keep in mind to address the scars after treating the acne.

What is Acne Scarring?

Acne scars are the result of breakouts, caused by blocked skin pores. Acne breakouts are the sudden formation of zits/cysts on the face. 

Blocking leads to swelling of the pores, causing a break in the follicle wall. This may create deep or shallow lesions that prominently appear on the skin.

Why Do We Get Acne Scars?

Acne scars are the result of inflamed lesions. These lesions penetrate through your skin, damaging the tissues beneath it. This may leave a mark or pit behind.

Types Of Acne Scars

Types of acne scars

Acne scars can be atrophic (caused by a loss of tissue) or hypertrophic (caused by excess tissue). These are further segregated into ice pick scars, boxcar scars and rolling scars. 

1. Ice Pick Scars 

Ice pick scars are the result of a severe acne lesion. They usually develop after an infection from cysts that work their way deep into the skin. 

These scars are narrower than boxcars and rolling scars but are deeper and more noticeable to the naked eye. Home remedies may not work for these scars. 

2. Boxcar 

Boxcar scars are wider than ice pick scars. They look like round craters with sharp edges, giving the skin a pitted, uneven appearance. They can be narrow or deep.

They occur due to inflammatory breakouts that destroy the collagen. This leads to loss of tissue. This creates depressions in the skin. 

3. Rolling Scars 

As the name suggests, rolling scars are wide with rounded edges. They make the skin look uneven and irregular. 

These scars are the result of a development of fibrous bands of tissue between the skin and subcutaneous tissue below. The bands pull the epidermis, giving the skin a rolling appearance. 

4. Hypertrophic Scars

These scars appear raised and are the result of excess tissue in the area where the lesion had developed.

How To Remove Acne Scars

There are several home treatments and in-office methods that people use to get rid of acne scars. (1)

a. Home Treatments

Before starting any treatment for scars, it is recommended to consult a dermatologist. 

1.Salicylic Acid

Salicylic acid is a popular ingredient in most anti-acne skincare products. It helps to reduce swelling and redness, clears dirt from your pores and reduces scarring. (2)

This magic ingredient can be used to treat any type of acne scars. It is recommended for people with sensitive skin to conduct a patch test before using this on their entire face. 

2.Alpha Hydroxy Acids

Not just are they used to treat acne, alpha hydroxy acids also contribute to reduction of scars.

These acids help exfoliate the rough surface of the skin to improve texture and reduce the appearance of scars. (3)

3.Lactic Acid

This is found in the form of various creams and lotions, available at your nearest drugstore. Lactic Acid improves texture of the skin and reduces the prominence of scars. (4) Yet, lactic acid may at times cause hyperpigmentation. It is advised to conduct a patch test before using it.

Diluted apple cider vinegar can be used in place of a drugstore product due to its natural lactic acid components.

4.Retinoids

Topical retinoids come in the form of creams and lotions. Dermatologists recommend these to reduce discoloration and improve skin texture. (5)

Topical retinoids may cause sun-sensitivity. Wearing sunscreen before you step-out is a must.

5.Azelaic acid

Azelaic acid has anti-inflammatory and antimicrobial properties. It helps treat acne and scars left behind by it. 

Azelaic acid reduces the amount of acne-causing bacteria and allows your pores to breathe. It is used to treat mild or moderate acne. Azelaic acid is available in the form of creams, gels and foams.

6.Niacinamide 

Niacinamide is a form of Vitamin B3 that plays a vital role in keeping your skin healthy. It has anti-inflammatory properties that helps treat acne and reduce scarring. (6)

7.Sunscreen

Sunscreen plays an important role in skin health maintenance. Whether or not you suffer from a skin condition, sunscreen is a must. It helps protect the skin from the UV rays of the sun and also reduces the appearance of scars. Direct exposure to the sun may darken acne scars.

Always buy a sunscreen that suits your skin type.

8.Home Remedies

Some people prefer using natural ingredients to address their skin issues. Here is a list of home remedies that people have traditionally used to treat acne scars. There is no science behind these methods, although they are economical. 

8.1.Coconut Oil 

Studies indicate that coconut oil keeps your skin moist. It prevents the skin from overproducing serum that reduces the risk of acne scars. (7)

People with extremely oily skin should avoid directly applying coconut oil. It may clog pores and worsen the situation. 

8.2.Shea Butter

Shea butter contains anti-inflammatory properties that help fight bacteria causing acne. It also helps reduce discoloration and acne marks. 

8.3.Turmeric Powder

The anti-inflammatory properties of turmeric help fight acne and prevent scarring.

8.4.Lemon and Honey

Lemon and honey together can work wonders for your skin. Lemon is acidic in nature and contains antibacterial qualities. This may relieve your skin of excess oil and fight bacteria. 

Lemon may not suit everybody’s skin due to its acidic qualities. Conduct a patch test before you apply it to your face.

Honey is a good antiseptic for your skin and body. It contributes to your body’s healing process. This helps reduce scars faster. It is also a great way to naturally moisturize your skin and prevent it from producing too much sebum.

8.5.Baking Soda

Baking soda with its anti-inflammatory properties can help fight acne and scars. However, skincare professionals do not recommend baking soda. It is considered to soak up essential oils that may even cause the skin to overproduce sebum. 

8.6.Aloe Vera

Melanin is responsible for your skin, hair and eye color. Sometimes certain areas of your skin may produce too much melanin.

This leads to hyperpigmentation. Hyperpigmentation may also be the result of scarring. Aloe vera helps regulate the production of melanin. This helps reduce pigmentation and discoloration. 

8.7.Essential Oils

Essential oils have wound-healing properties. They help prevent scar tissue from forming. They contribute to reducing inflammation, redness and smoothing texture of the skin.  

8.8.Apple Cider Vinegar

The acidic properties of apple cider vinegar helps remove the top layer of the skin. This reduces the appearance of scars.

b.Common Scar Removal Treatments (In-office) 

Based on your skin type and the depth of your scars, a number of lab treatments are available to reduce scarring caused by acne. 

1.Chemical Peeling 

If you have shallow scars, this may be a good option for you.

Chemical peels reduce discoloration and scarring They prevent breakouts and smooth the skin. These peels work by removing the top layer of the skin and are a great way to rejuvenate the skin. 

Chemical peels usually don’t work well for those with deep scars. One may have to try out a couple of peels before determining which one works better for them. 

2.Microneedling or Rolling 

Microneedling is highly beneficial to reduce scars, wrinkles, stretchmarks and discoloration. It also contributes to skin rejuvenation and improvement in texture. (8)

The medical process involves inserting micro-needles around scars. This stimulates the body to produce more collagen.

Microneedling or rolling can cause temporary side effects like redness, pain and inflammation.

3.Injections

Hypertrophic scars or keloids can be treated with corticosteroid injections. The process is conducted once in every few weeks. Your dermatologist may combine these with other treatments. 

4.Dermal Fillers

Dermal fillers are often confused with Botox. However, the former type smooths out the skin by filling scars or wrinkles, as opposed to “freezing” muscles. Dermal fillers are usually temporary, lasting between 6-18 months after treatment. A few permanent options are available that you can discuss with your dermatologist. 

These fillers work best for atrophic scars. Other commercial fillers like polymethylmethacrylate (PMMA), hyaluronic acid (HA), and poly-L-lactic acid (PLLA) can also be used. (9)

5.Laser Treatment 

Laser treatment helps reduce scars without scrubs and chemicals by removing the uppermost layer of the skin. This process uses focused light therapy. It may not be suitable for those with sensitive skin. 

What to keep in mind before getting a laser treatment done

  • Requires a board-certified dermatologist to conduct the treatment
  • Side effects include redness, itching, swelling and temporary oozing
  • At times sedation is required, depending on the depth of your scars.

6.Dermabrasion 

Dermabrasion is the process of using a rapidly rotating device to sand the outer layers of the skin. It is used to treat acne scars, wrinkles, patchy skin and dark areas. The skin that grows back is younger looking and smooth. (10)

This process can be conducted alone or in combination with other cosmetic procedures. It can cause temporary redness, lasting upto weeks.

7.Surgery

Dermatologists may advise a patient to undergo surgery in case of deep scars. Keep in mind to get this done by a board-certified dermatologist.

8.Platelet-Rich Plasma Technique (PRP)

Platelet-rich plasma technique to reduce scars draws inspiration from the belief that the body can heal on its own. Platelet-rich plasma technique (PRP) involves a large amount of platelets. These are concentrated into a small volume of plasma to stimulate growth factors in the body. This fixes broken tissues. 

According to a study, rolling scars responded better to PRP as compared to ice pick and boxcar scars. (11)

9.Punch Techniques

Punch techniques are used to treat ice pick and boxcar scars. They come in three forms:

9.1.Punch Excision (For Mild Acne Scars)

In this technique, the scar is surgically removed and the skin is sealed to achieve a smooth texture

9.2.Punch Elevation (To Treat Boxcar Scars)

The procedure involves surgical removal of the scar, leaving the sides. The base is then reattached to the sides to give a smooth appearance. 

9.3.Punch Grafting (For Deep Ice Pick Scars)

In this process, the wound is plugged with a sample of skin taken from another part of the body, usually the back or the ear.

How Can You Prevent Acne Scars?

Prevention is better than cure.

Here are some skincare tips for you to avoid acne and scarring.

Do’s and Don’ts :

1. Avoid The Sun 

    Being adventurous is fun but not at the cost of your health. Too much sun exposure can dehydrate your body. 

    This may cause it to over-produce oil, sometimes leading to blocked pores. If you stay out in the sun on a daily basis, make it a point to stay hydrated.

    2. Don’t Pop Your Pimples

      Popping pimples may increase inflammation. This may not only leave a scar behind but can cause an acne breakout. 

      Avoid touching your face as your hands carry bacteria and dirt that may lead to clogged pores.

      3. Follow A Skin Care Routine

        Maintain a skin-care regimen. Remember to wash your face and remove your make up before hitting the pillow. Cleanse, tone and moisturize on a regular basis. Stay hydrated. 

        4. Don’t Scrub Too Hard

          Don’t exfoliate your face on the daily. This may cause skin inflammation, redness and itching and may lead to breakouts. 

          5. Stay Hydrated

            Water plays a major role in preventing acne and scarring. In order to refrain your body from over-producing oil (that may sometimes lead to clogged pores) and stay hydrated. As it is rightly said, “water is the cure for everything.”

            Are Acne Marks Permanent?

            People often confuse between acne scars and marks. Brown or red patches (discoloration) left behind by acne on a person’s face are marks that fade away with time. However, pits and craters are scars that stay. 

            Post Inflammatory Hyperpigmentation are acne marks that look like a flat, discolored surface. As the skin heals, it produces excess melanin. 

            This causes darkening of the patch. PIH however, does not damage the follicle and fades away over time, usually in about 24 months.

            Scars may slightly fade over time but are permanent. However, there are several home and medical remedies with which you can get rid of them.

            How Long Do Acne Scars Take To Go Away?

            Acne marks (discoloration) usually fade away within 3-6 months. There are many ways to speed up the process. However, scars remain and can be removed medically or by using home remedies. 

            What's The Difference Between Acne Scars and Acne Marks? 

            Acne Marks 

            People with a darker complexion may experience PIH (marks that appear brown). People with a lighter complexion usually develop post-inflammatory erythema (purple/red marks). (12) 

            These fade away with time. However, there are faster ways of getting rid of acne marks. 

            Acne Scars

            Acne scars are deep indentations. They are usually caused from picking at a blemish and take much longer to heal. Although they may slightly fade over time, acne scars are usually permanent. 

            It usually takes for a person to undergo medical treatment to reduce scarring completely. Atrophic scars appear as indentations in the skin. 

            In today’s technologically advanced world, treating acne scars has become an easy task. One must keep in mind to always follow a skincare regimen and maintain skin hygiene to avoid future outbreaks.