The Biggest Mistake You Can Make If You Have Acne, According To A Dermatologist

photographed by Ana Larruy
If you have acne, you'll know that the spots are just one tiny part of the skin issue. Big or small, most breakouts tend to leave behind a mark or a scar, sometimes deep and pitted, sometimes superficial, but one thing is for certain, they take much longer to treat than the actual spot itself.
Thankfully though, there are heaps of techniques, from peels to laser, which are beneficial in minimising the appearance of acne marks and scars, but according to consultant dermatologist at Skin 55 and author of The Skincare Bible, Dr. Anjali Mahto, one of the biggest mistakes she sees in clinic is when an attempt is made to treat the acne scarring while the acne is ongoing. In fact, it's an enormous no-no and a total waste of your money.
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Before we get to the good bit, it pays to know exactly what type of scars you could be dealing with. "Ice pick scars are deep, narrow pitted scars that often follow acne to the forehead or mid to upper cheeks," Dr. Mahto told R29. "Rolling scars are broad scars with sloping edges that give the skin a rippled appearance and boxcar scars are broad scars with sharply defined edges giving skin a 'crater-like' appearance." And that's before we've touched on hyperpigmentation or skin staining, often referred to as 'scarring', too.
Taking to Instagram to discuss the issue further, Dr. Mahto said, "I see many patients who have had treatments such as peels, microneedling, and lasers for scarring who are still getting new spots - this is not a good way to treat the skin. I always say that acne and acne scarring should be thought of as two step process. Firstly, the acne itself needs switching off; secondly, once it is switched off, then focus can shift to treating scarring."
She continued: "Firstly, it’s a waste of your time and money to have scar treatments when you’re still getting new spots. The process creating the scarring is ongoing so even if some scars improve, you are still getting new ones. It’s a bit like driving with the handbrake on - it’s not going to give you the results you want and you’ll spend a lot of cash in the process.
"Secondly, many scar treatments themselves can lead to a flare-up or worsening of active acne," she said. "Thirdly, some treatments like laser require heavy moisturising agents to aid healing of the skin barrier and putting greasy ointments on already acne-prone skin is just going to cause more acne."
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So what should you do? "It will save you time and money in the long-run to do things in a logical order," explains Dr. Maho. "You should ideally consider treating acne and scarring as a two step process. I personally do scar treatments such as laser but my patients know that I won’t even think about doing these until I am confident we are on top of the acne itself first. It takes time and requires patience and often a combination of different treatments to achieve realistic results."
You might also categorise hyperpigmentation or skin staining left behind by acne as 'scars', but these are easier to treat than deeper, pitted scarring. Your first port of call should be retinoids, thanks to their ability to speed up cell turnover and fade superficial scars in the process. That said, deeper, more indented scars are less likely to respond, according to Dr. Mahto, who rates The Ordinary's Granactive Retinoid 2% in Emulsion, £8. After cleansing, apply a retinoid cream or serum to dry skin. Remember to apply SPF daily, as retinoids can make skin sensitive to UV.
Applied topically, chemical exfoliators like glycolic, lactic and azelaic acid also work to minimise marks by sloughing away dead cells on the surface of the skin, uncovering brighter, clearer skin underneath and fading marks. Again, if you're using acids in your skincare routine, applying a daily SPF is a must to avoid skin damage caused by UV rays.
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