What’s worse than a bad acne breakout? The scars of course. Getting an acne problem under control is just the first part of the battle won. Unsightly scars left behind after a breakout can deal a serious blow to our self-esteem and they are often more complicated and costly to treat than the actual acne itself. Thankfully, not all marks that appear post-breakout are scars. If you are lucky, you may be dealing with acne marks that are much easier to treat. However, if you are not so lucky, there are still plenty of treatment options that can lighten and remove acne scars. Let’s find out how you can differentiate between acne marks and acne scars, and what treatments and procedures you can do to regain a smoother and clearer complexion.
What Are Acne Marks?
Also known as Post-Inflammatory Hyperpigmentation (PIH), these dark or light-coloured flats marks may appear on the skin after a mild to moderate acne breakout. They are the result of melanin, the pigment that gives your hair and skin its colour, being excessively produced by the body when the skin is healing itself. If you pick at or pop a pimple, you also increase the chances of getting PIH because you are causing the skin to be more inflamed.
The good news is that most acne marks are merely superficial and will naturally fade away with time as no damage has been done to the follicles. However, if the acne marks are caused by inflammatory acne such as cystic lesions and nodules, they will not disappear so quickly. It may take anywhere from 3 months up to 24 months for the marks to fade away completely.
How Do I Remove Acne Marks?
You can use over the counter or prescription topical medicated products to lighten marks that are not so visible. Products using ingredients such as Alpha Hydroxy Acids (AHA), retinoids, azelaic acid and hydroquinone can help to brighten the skin and treat hyperpigmentation. For darker marks, you can consider doing chemical peels and microdermabrasion. It may take a few sessions before you start seeing results. You should also make sure that you apply sunscreen every day to prevent the marks from getting darker.
What Are Acne Scars?
While acne marks are merely found on the skin’s surface, acne scars are formed when a breakout penetrates the skin deeply and causes the support structure in the layers beneath the surface of the skin to be broken. A loss of skin tissue causes a pitted or depressed area, while an overgrowth of tissue creates a raised scar. Scarring occurs after moderate to severe acne breakouts and actions such as popping a pimple will injure your skin and leave a scar. These indented scars can slightly fade away with time but are usually permanent. You will need to visit a dermatologist to undergo medical treatments to reduce the scarring completely.
The Different Types Of Acne Scars
Ice Pick Scars
These V-shaped column-like scars have jagged edges and may also resemble large, scooped out pores. They are the result of severe acne lesions and can develop after an infection from cysts that are lodged deep inside the skin. They look narrower than boxcar and rolling scars, but are deeper and more obvious looking. It can be challenging to treat these scars as they run deep beneath the surface of the skin.
These rectangular depressions are wider than ice pick scars and have defined steep edges, resembling round craters with sharp edges. They give the skin a pitted and uneven appearance and can be shallow or deep. They occur due to inflammatory breakouts that destroy collagen causing loss of tissue. This causes the skin in the affected area to be left without support, leading to the creation of depressions in the skin.
These are broad, wave-like looking depressions with rounded, sloping edges that make the skin look irregular and uneven. They appear when multiple bands of tissue develop in the deeper layers of the skin. If left untreated, they can look more obvious with age.
Hypertrophic and Keloid Scars
These scars are raised above the surface of the skin and occur because of excess tissue in the area where the lesion had developed. A keloid scar is a more severe form of a raised scar as it can grow much larger than the original wound. It can keep growing even after the wound has healed.
How Do I Treat Acne Scars?
There are a range of medical treatments that can be used to treat acne scars. The best treatment for you will depend on the type of scars that you have, and the severity of their condition.
This is a good option for shallow scars but might not work as well for deeper scars. A chemical peel can reduce discolouration and scarring, prevent breakouts and smoothen the skin. It works by removing the top layer of the skin to rejuvenate the skin.
Micro-needling or Rolling
This process involves inserting micro-needles around the scars to stimulate the body to produce more collagen. It can cause temporary side-effects like inflammation, pain and redness. Besides helping to reduce scars, wrinkles, stretch-marks and discolouration, it can also promote skin rejuvenation and improve skin texture.
Hypertrophic scars or keloids can be treated with corticosteroid injections. These injections have anti-inflammatory properties and can be injected directly into the scar to soften and shrink it. It can also be done together with other treatments that treat keloid scars such as laser removal treatments or removal surgery to prevent reoccurrence of the scar.
Dermal fillers might often be confused with Botox, but the difference is that the former type smoothens out the skin by filling scars or wrinkles, while the latter “freezes” muscles. Dermal fillers are usually temporary and can last between six and 18 months after treatment. They work the best on indented scars. Other commercial fillers like polymethylmethacrylate (PMMA), hyaluronic acid (HA) and poly-L-lactic acid (PLLA) can also be used to treat scars.
This highly popular method is one of the most preferred methods used by dermatologists to remove acne scars. It helps reduce scars by removing the uppermost layer of the skin using focused light therapy and doesn’t involve any chemicals. However, it may not be suitable for those with sensitive skin as potential side-effects include swelling, itching, redness and temporary oozing. If your scars are severe, you might need to be sedated before going through the treatment.
This procedure uses a rapidly rotating device to sand the outer layers of the skin, allowing new skin that is smoother and younger-looking to grow back. It is used to treat acne scars, wrinkles, patchy skin and dark areas. This procedure can be conducted on its own or in combination with other cosmetic procedures. It can cause temporary redness.
If you have deep scars, a dermatologist may recommend that you go for surgery to remove the scars or make it less visible. Different types of scars require different methods of removal such as skin grafting or excision.
Punch techniques are surgical techniques that use small punch tools instead of scalpels to treat ice pick and boxcar scars. There are three types of techniques:
Punch Excision (for mild acne scars)
The scar is surgically removed and the wound is stitched flat to achieve a smooth texture.
Punch Elevation (to treat boxcar scars)
The bottom part of the scar is cut out and then lifted up so that the scarred skin can be at the same height as the surrounding skin, giving it a smoother appearance.
Punch Grafting (for deep ice pick scars)
The scar is removed and the wound is filled with a skin graft that is taken from another part of the body, usually from the back of the ear.
This procedure works best on rolling scars and involves the use of a sharp instrument such as a needle to break apart scar tissues that pull down the skin. This triggers the production of collagen which will help the affected area to heal and improve the appearance of the scar at the same time.