June is Acne Awareness Month, and something that isn’t often talked about after having acne is the residual scarring. Acne can be a long and challenging battle. The relief of finally clearing your skin after months or years of struggling is akin to completing the Boston Marathon. You’ve spent a copious amount of time receiving facials and lasers; you slogged through months of creams and prescriptions and maybe piled on a gallon of concealer. You deserve to enjoy your newly cleared skin! However, just because you’ve finished the race doesn’t mean you won’t feel sore and tired. Once you’ve cleared your skin, you’re often left with the texture or pigmentation of acne scars.
Why does this happen? Acne, caused by clogged pores and bacteria, causes inflammation in the skin. This inflammation can alter collagen, a protein that gives our skin its structure. When collagen is modified, it changes the skin’s overall appearance, leading to the formation of scars. Unfortunately, these scars can be a lasting reminder of our acne journey.
Types of Acne Scars
There are several types of acne scars, and they are all treated differently. Knowing what you have is essential for receiving the proper treatment.
Atrophic Scars
Atrophic scars cause depressions in the skin because of the destroyed collagen I mentioned earlier. There are ice pick scars, which are narrow, deep pits; broader boxcar scars with sharp edges; or rolling scars, which appear as wavy depressions in the skin.
Hypertrophic Scars
Also known as keloids, are scars that form when too much collagen is produced. They can continue to grow laterally even after the acne site is healed because the body is unaware that the acne wound has healed and continues to produce collagen, leaving a raised scar. Although they are less common, they can happen to anyone, especially if they are prone to inflammatory reactions or have an autoimmune disease.
Pigmented Scars
Pigmented scars are more like marks than actual, textural scars. These marks are called post-inflammatory hyperpigmentation (PIH) or post-inflammatory erythema (PIE). They appear like flat discoloration marks and can range in color from pink to red (PIE) and brown to black (PIH), depending on the skin tone and depth of discoloration. PIH and PIE are caused by increased melanin production. Melanin is the pigment that defines the color of a person’s skin, and the increase in melanin is triggered by how skin heals after inflammation or injury. You may see these marks alongside atrophic and hypertrophic scars.
How to Treat Scars
Treatments for acne scarring differentiate because not all scarring is the same. Deeper scarring, like ice pick and boxcar scars, can be more challenging to treat than shallow scars like rolling scars or PIH and PIE. You typically need to go to a dermatologist for hypertrophic scarring to receive corticosteroid injections.
Traditional and Radiofrequency Microneedling
These treatments benefit atrophic scars by boosting collagen production and encouraging tissue regeneration. This makes the skin smoother and firmer and improves its tone and texture. The difference between traditional and radiofrequency is that when the RF waves are delivered beneath the skin, they increase collagen stimulation and have a skin-tightening effect. The added benefit of PRP is that using one’s own platelet-rich plasma (obtained by a quick blood draw) will create dramatic, faster results when combined with microneedling by using your body’s growth factors to promote healing and cell regeneration.
Chemical Peels
Peels are excellent for lightening post-inflammatory hyperpigmentation marks and softening atrophic scars. There are many peels to choose from, ranging in strength from very superficial to deep. At Boss Gal, we love the VI Peels for treating PIH, PIE, and acne scars because they are medium-depth peels that penetrate the papillary dermis. This is the layer where collagen is forming. The peel will help stimulate that production to lessen the appearance of atrophic scarring. VI Peel uses ingredients like ascorbic acid, kojic acid, and hydroquinone to help lighten PIH and PIE. We recommend VI Purify with Precision Plus Peel. This was designed to help treat active acne, acne scarring, post-inflammatory hyperpigmentation, and post-inflammatory erythema and reduce excess oil.
Ultimately, doing a combination of treatments and home care products will be best at getting you to your skin goals.
Home Care
There are some great products for fading pigmentation and lessening more brutal atrophic and hypertrophic scars. Ingredients like retinol and alpha-hydroxy acids can aid cell turnover and smooth skin texture, potentially softening the look of rolling and boxcar scars. We recommend SkinBetter’s AlphRet Exfoliating Peel Pads because of their exclusive AlphaRet Technology. Formulated with retinol, glycolic, and lactic acid to increase cell turnover while hydrating skin, the peel pads also include salicylic acid to fight congestion and smooth skin texture.
Post-inflammatory hyperpigmentation and post-inflammatory erythema can be treated with ingredients such as alpha-hydroxy acids, vitamin C, and niacinamide. We love ZO Skin Health’s Brightalive Skin Brightener because it not only inhibits future pigments from forming but also lightens existing pigmentation.
Still trying to figure out where to start? If you have questions about what you can do to correct your acne scars, book a FREE consultation at any one of our locations located in Clintonville, Grandview, Easton, or Powell today! We can’t wait to see your face!