First things first: treat the acne, and get it under good control. There are a number of procedures that will treat acne scars. There is little to no benefit from any existing topical creams to treat acne scars, however a number of procedural treatments exist. The choice of procedure varies by the severity of the acne scarring, cost and skin type. In darker pigmented skin, any skin procedure can lead to a change in skin color, or pigment, and like all procedures should be performed by a qualified individual who is familiar with treating darker skin types. Procedures may include chemical peels and laser resurfacing procedures. Discuss which treatments are right for you with your dermatologist, dermatologic or plastic surgeon.
Acne Treatment
Acne treatments vary, depending on the severity of your acne. Many teenagers and adults can control mild acne with over-the-counter topical solutions, like acne cream and salicylic acid products that loosen blackheads and whiteheads, clearing clogged pores. For more severe acne, dermatologists may recommend prescription medications, or even an in-office procedure such as a chemical peel or laser treatment. Learn more about acne treatment with expert advice from Sharecare.
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Dr. Cybele Fishman, MD , Dermatology, answered
A wonderful, natural supplement for treating acne is fermented cod liver oil. Watch dermatologist Cybele Fishman, MD, explain why this supplement is so beneficial for acne symptoms, the different forms it comes in, and how much you should take. -
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See All 2 AnswersOily skin is due to over-active oil (sebaceous) glands that secret sebum into the hair shaft for lubrication and for protection from infection by micro-organisms. Sebum is a complex and variable blend of lipids that are mostly oils (triglycerides), fatty acids, and waxy materials and the composition of sebum varies from person to person. Sebum flows from the hair follicle and spreads on the surface to provide a barrier against moisture loss. Skin also has other lipids that are part of the skin's moisture barrier. These are different types of materials, and they are essential to keeping water in the skin and keeping unwanted irritants, allergens, and microbes out. When cleansing oily skin the trick is to remove the offending sebum but without disturbing the skin's natural moisture barrier. Harsh surfactant-based cleansers should be avoided because they cannot distinguish between the good and the bad lipids. Over cleansing of the skin can make skin dry and causes the oil (sebaceous) glands to start producing more sebum. The best way to cleanse oily skin is to use either a very mild cleanser or a solvent based cleanser. The latter dissolves the sebaceous oils without harming the lipids of the skin's moisture barrier. They can be either rinsed with water or removed with a tissue or cotton pad. The skin is not left dry so the sebaceous glands do not have to go into production of more sebum. Proper cleansing of the skin is essential for the control of the rate of sebum production and to minimize acne formation.
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Dr. Audrey G. Kunin, MD , Dermatology, answeredIce pick acne scars have hard, irregular jagged borders and often the depth is irregular as well. Simple excision of these scars with a sutured closure allows the dermatologist to bring the dermis back together, get rid of the ragged margins, and close the area with a fine, uniform line. The tiny linear scar may be allowed to fade on its own or the procedure may be performed before a more generalized resurfacing is performed such as dermabrasion, microdermabrasion, chemical peel or laser resurfacing. -
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Dr. Audrey G. Kunin, MD , Dermatology, answeredEveryone always wants to know what topicals can help resolve acne scars. Certainly anything that has been shown to help stimulate collagen bundle formation, such as the use of topical vitamin A creams (which help with exfoliation as well as stimulate collagen) or antioxidant-packed rejuvenating creams (often containing vitamin C), seem like logical choices.
These are certainly options I do encourage those with acne scars to take. I do think that the reality is that a procedure is going to maximize your results, whether done alone or incorporated with a topical agent. -
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Dr. Audrey G. Kunin, MD , Dermatology, answeredIn subcision, the dermatologist undermines the acne scar with a sharp instrument such as a tiny scalpel or needle. Subcision helps break fibrous bands of scar tissue that are creating tension between the epidermis and deeper structures and also helps induce new collagen formation.
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Dr. Audrey G. Kunin, MD , Dermatology, answeredA chemical peel involves the application of a high-potency acid upon the skin. The more potent the acid, the deeper the penetration into the skin. Personally, I find this more beneficial for post inflammatory skin color changes and the most minor of acne scars.
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Dr. Audrey G. Kunin, MD , Dermatology, answeredNon-ablative lasers for acne therapy trigger changes within the dermis without injuring the epidermis. Smoothbeam is an approved laser for this treatment. Smoothbeam targets and heats the sebaceous gland, helping reduce oil production and acne formation. Heating the collagen helps tighten the dermis, resulting in less visible scarring.
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Dr. Audrey G. Kunin, MD , Dermatology, answeredPrevention may sound like a glib answer to how to handle acne scars. But since an estimated 10 million Americans become scarred to some extent by acne each year, intervention is by far the best solution.
Who will develop acne scars and how severe will scarring be? Short of a crystal ball, much of that is left to chance. What we do know is that genetics play a definite role in the likelihood of acne severity and consequent scar formation. Also, the severity of preteen acne lesions is linked to a more severe form of scarring later in adolescence or adulthood.
Because 95% of acne patients will develop scarring to some degree, the earlier the treatment appropriate for the severity of the outbreak is initiated, the better the odds are that scar formation will be mild. Delaying acne therapy by 3 or more years is likely to increase one's risk of more significant acne scarring. -
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Dr. Audrey G. Kunin, MD , Dermatology, answeredAblative lasers for acne therapy literally remove the outer layers of the skin, burning away scar tissue and stimulating the dermal collagen to tighten, reducing the amount of scar visibility. The ultrapulsed carbon dioxide laser and erbium yttrium-aluminum garnet (YAG) laser are most frequently used in laser resurfacing. The recently introduced Fraxel Dual combines an erbium laser with a more superficial light to simultaneously improve both acne scars and the associated discoloration. Downtime from these types of treatments is approximately one week. Typically, three to five treatment sessions are necessary.
Because the skin is injured and unprotected tissue exposed, great effort must be put into wound care and infection prevention. The skin may remain reddened for several months or a year afterwards.