Skin may be the latest addition to the body positivity movement, but acne is still a confidence-sucking skin issue for many people. It plagues the best of us (even Justin Bieber). And, just when we finally think it's gone, a new problem — the dreaded acne scar — rears its ugly little head (or just lingers around so we never forget). They tend to turn up after that pesky pimple has finally subsided and can hang around for months before fading. Some even require more advanced treatment for relief.
So, we turned to board-certified dermatologists, Dr. Ted Lain and Dr. Julia Tzu to give us the inside scoop on acne scars. "Acne scarring develops when recurrent inflammation from deeper cystic lesions damages the collagen in your skin," explains Dr. Tzu. "Normal healthy tissue is then replaced by thinned-out scar tissue, which can manifest itself as depressions along the contour of the skin."
Not all acne scars are created equal. In fact, there are three specific kinds: Pitted or "ice pick" scars (these are deep, but small in diameter), boxcar scars (these tend to be rectangular), and rolling scars (these resemble hills and valleys).
The longevity of an acne scar can also vary depending on your skin type. "For people with darker skin tones like Indian, African American, and Asian people, the skin produces more pigment," says Dr. Lain. "When their skin gets inflamed, the natural response of their skin is to produce more pigment."
Age also plays a factor. "When the diminishing collagen and subcutaneous fat levels of our body can no longer help provide the structural support it used to in our earlier years, acne scars can become more pronounced," Dr. Tzu adds.
There is some good news, however. Many people believe that the red marks (scientifically known as post-inflammatory redness) are acne scars when they really aren't. Dr. Lain is quick to point out that "if the acne bump is gone but the persistent redness stayed, it may not be an acne scar, it's just redness and it will get better," he says.
Another thing some people may not realise is that certain things may be exacerbating the issue. With the help of Dr. Lain and Dr. Tzu, we've compiled a list of things you need to stop doing, stat, in addition to tips for preventing acne scars in the future. Read on for the juicy details:
You Aren't Solving The Problem At Its Source
The best thing you can do to keep scarring at bay is to effectively treat any existing acne. "If you're dealing with mild to moderate acne which isn't associated with hormones, using an over-the-counter system will work for over 50% of people," says Dr. Lain. "Acne systems that use benzoyl peroxide or an alpha hydroxy acid tend to work well. But, if those don't work or stop working, you need to see a dermatologist."
A good skin care system is a must when combatting acne. "Poor skin care regimens may bring out more acne and cause future scarring and irritation," says Dr. Tzu. "Using harsh bar soaps to cleanse the face, using irritating facial washes, washing too frequently, or using comedogenic (pore clogging) products to hydrate the skin [can make things worse, too]."
You Pick The Pimple
We all know that picking your pimples is a huge no-no, but who hasn't done it at some point or another? Well, no more, and for real this time. Both Dr. Tzu and Dr. Lain urge patients to avoid it at all costs. "Picking leads to a secondary infection or more inflammation, both of which can lead to scarring," Dr. Lain warns. "It's so important that people keep their hands off their faces and get treatment for the acne instead of trying to pop their pimples."
You Aren't Wearing SPF
"Sun exposure of any type can make scarring worse," says Dr. Lain. "A lot of women in particular rely on the sunscreen in their moisturiser or makeup rather than using a dedicated sunscreen on their face." If you haven't already, he suggests adding an SPF into your skin care routine ASAP. "I like Elta MD's UV Clear Broad Spectrum SPF 46. It has a very high SPF with other ingredients that help reduce redness," he says. "I also like Cetaphil's DermaControl Oil Control Moisturiser SPF 30, which is great for teenagers."
Your DIYs Are Doing You More Harm Than Good
Turns out your at-home recipes might be making your skin worse. "I've seen people apply lemon juice to their scars, only to develop a reaction to the lemon juice," Dr. Tzu says. Do-it-yourself masks and treatments can do wonders for your skin, but hopeful DIYers can go overboard causing their skin to become irritated and inflamed.
Dr. Lain warns that the most common at-home treatment that he has seen go wrong are chemical peels. "Due to a lack of knowledge and experience, I have seen many of these 'treatments' result in chemical burns," he says. "Despite their best efforts to help reduce acne, scarring, or pigmentation, people then have an additional issue to deal with that is just as difficult to improve."
How To Prevent and Reduce The Appearance Of Acne Scarring
Apart from keeping your hands off your face, wearing a dedicated SPF, and introducing a good acne-fighting system into your skincare routine, there are a few products and procedures that can help make your acne scars less visible.
Over-the-counter scar fading creams tend to work on hyper-pigmented scars that aren't too deep. Dr. Lain normally prescribes a fading cream like Retin-A, in combination with hydroquinone, kojic acid, or liquorice, to those looking to lighten scars. "Retinoids can help build collagen under the cells and build them up [to fill in scars]," says Dr. Lain. But, both Dr. Lain and Dr. Tzu make sure to point out that topical treatments don't always provide the miraculous results most patients are looking for.
This is where treatments like lasers, chemical peels, or subcision (which involves the use of a needle to sweep under the scar and break the "tethers" of the scar to the underlying tissue) come into play. These procedures can be costly, but patients are usually happy with the results.
But, if lasers aren't up your alley, there are some less-intensive treatments available. Micro-needling, for example, is a technique that builds collagen underneath the scar and costs much less than the traditional laser, however, multiple sessions are normally needed to get scars to become more shallow.
Corrective makeup can also help keep acne scars out of sight and out of mind. If you just want to cover up a few minor scars, "green-tinted makeup can conceal some of the red," says Dr. Tzu. Our favourite redness-reducing concealer? Urban Decay's Correcting Fluid in Green.
Acne scarring can happen to anyone and everyone, so rest easy knowing you are in good company. All skin is different and no treatment is one-size-fits-all, but hopefully, with a little more information, we'll all be one step closer to clearer, scar-free, skin.