Is there anything more triumphant than battling a bad bout of acne and coming out with almost clear skin? I think not. Unfortunately, acne can be tough to tame, and treating acne scarring can sometimes be a whole other feat in and of itself—ignoring treatment for your acne scarring may leave you with scars for years.
There are multiple types of acne scars and many ways to treat acne scarring, both in and out of your dermatologist’s office. Below, we give you the rundown on everything you need to know for how to combat acne scarring.
Multiple types of acne scarring can develop on someone’s skin, including atrophic acne scars, post-inflammatory hyperpigmentation (PIH), and post-inflammatory erythema (PIE). The most common type of acne scarring is atrophic acne scars. “Atrophic scars are depressions left behind after acne is long gone and are common along the temples and cheeks,” explains Dr. Aimee Paik, a board-certified dermatologist and Medical Director of Apostrophe. “These scars sink below the skin’s surface with gentle sloping borders.”
Another type of acne scarring under the atrophic acne scar umbrella includes ice pick scars. “These are usually located on the central cheeks, tend to be very small, and have a punched out appearance with sharp cliff-like borders,” says Dr. Paik. “This type of scarring is the most difficult to treat.” The third type of atrophic acne scar includes hypertrophic scars, which are raised, thick, firm scars that can sometimes be itchy or painful—these tend to occur along the jawline. “In general, scarring is defined as a permanent change that does not go away on its own,” explains Dr. Paik.
You may not have pits of scarring left after a difficult breakout, but you could experience PIH or PIE, which are dark spots or marks that remain after an acne lesion heals. PIH results in spots that are brown or dark, while PIE spots are usually pink, red, or purplish. “Fortunately, [these types of scars] are not a real scar—this surface discoloration resolves on its own but takes about 6-12 months to fade,” explains Dr. Paik.
Similar to treating active acne breakouts, Dr. Paik argues that tretinoin, a star ingredient found in Apostrophe’s acne-fighting formulations, is the best topical agent to combat acne scarring. “[Tretinoin] can improve atrophic scars and also helps post-inflammatory hyperpigmentation fade more quickly,” she says. “Importantly, tretinoin is an important acne treatment that also prevents new breakouts from forming, thereby preventing more scarring.”
Another solid option includes azelaic acid, which is a gentle topical agent that helps fade PIH and is also used in Apostrophe’s formulas to treat acne. “Azelaic acid has anti-inflammatory and antimicrobial effects, targets comedones, and even inhibits pigment production,” says Dr. Paik. Finally, hydroquinone is the gold standard in treating multiple types of hyperpigmentation and is used in Apostrophe’s formulations for treating acne scarring.
Between microneedling, lasers, chemical peels, and many more, there are multiple types of in-office treatments that can help speed along the healing process, but they all come with a pretty hefty price tag. “In-office procedures such as microneedling and laser treatments will be more effective for acne scars, but unfortunately, are a lot more expensive—it’s best to make sure your acne is under very good control first before making such an investment,” explains Dr. Paik. “Topical prescriptions are most effective at keeping acne under control long-term.”
The length of time it takes to heal really depends on how severe your acne scarring is, along with which type of scarring you’re dealing with. “If your acne is severe, it can take 6-12 months to get your acne under control using prescription medications,” says Dr. Paik. “Once your acne is under control, you may have scarring that remains—tretinoin helps build up collagen over 1-2 years, over which time it can improve the appearance of atrophic scars.” Hypertrophic scars may improve and flatten out on their own over 1-2 years, while ice pick scars require in-office procedures to treat. PIE and PIH will take about 6-12 months to fade.
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