Wondering how to get rid of acne scars? An unexpected pimple (or five) is annoying enough, but the acne scars and dark marks it leaves behind are often worse. While there isn't a magic wand that can get rid of them overnight, top dermatologists from across the country share how to handle marks and bumps, from prevention to treatment (including home remedies).
In order to treat acne marks and scars, it's helpful to learn how to distinguish between the two. "What many people don’t realize is that a dark or pink mark on the skin is not actually an acne scar. Inflammation in the skin often leaves behind a stain as part of the natural healing process. The inflammation revs up pigment production, creating the mark that fades on its own over several weeks to months," says Dr. Joshua Zeichner, the director of Cosmetic and Clinical Research in Dermatology at Mount Sinai Hospital in New York City. Unlike scars, these are smooth to the touch (AKA, not raised or indented), and signify that there is no permanent collagen damage to the skin.
Acne scars, on the other hand, are formed when there is damage to the skin which leads to abnormal collagen production, and usually appear raised or bumpy. "There are two types of acne scars: depressed and raised. Depressed scars may look like pits or craters, and raised scars may be firm and tender," explains Dr. Zeichner, who notes that unfortunately, these are permanent.
According to dermatologist Dr. Whitney Bowe, some scars are thick, raised hypertrophic scars that stick out above the skin; others are keloid, which are scars that have over-healed, and manifest as dense rubbery skin tissue. Then, there are atrophic scars that appear as depressions in the skin — they're the most challenging to treat. The three main categories of atrophic scars are:
Ice pick scars: Deeper than they are wide, with jagged edges. Sometimes they resemble a large, scooped out pore.
Boxcar scars: Broad, rectangular depressions with steep, defined edges.
Rolling scars: Broad depressions that have rounded, sloping edges, hence the name.
What causes acne scars and dark marks?
The spots that linger after a pimple has healed are caused by inflammation that has disrupted the skin's natural healing process. "When your skin is opened up (like when you pop a pimple) and then closes back together, you can get abnormal pigmentation, texture, and tone that looks different from the rest of your skin. Sometimes the broken blood vessels that remain after an acne lesion fades can result in a mark," says Dr. Bowe. For a number of people who are able to refrain from picking, inflamed pimples or blemishes can still leave a dark brown or red mark — but these naturally fade over the course of a few months, notes dermatologist Heather C. Woolery-Lloyd, MD.
Since it's pretty difficult to determine what causes one person to scar more than another, the best way to avoid scarring is to treat acne with a great skin care routine — and that means you need to resist picking, poking, or touching a pimple.
But, sometimes a particularly aggressive blemish is truly on a mission to leave its permanent mark. "Acne scars occur when normal tissue in the skin is destroyed and replaced with fibrous tissue. You can think of an acne lesion as a wound. When the damage caused by acne is severe, the body can respond by creating too much tissue or too little tissue. The production of too much tissue forms a keloid or a hypertrophic scar, and too little tissue leads to that depression in the skin or atrophic scar. The deeper and more inflamed the acne lesion, or the more that it is picked or squeezed, the more likely it is to scar," says Dr. Bowe.
Some acne marks and scars are completely within your control while others are pre-determined. Aside from genetics, there are several lifestyle habits that can make dark marks and scars worse. Spending time in the sun is a big one, and, to reiterate one last time, every dermatologist agrees that picking or squeezing pimples creates further inflammation and can ultimately lead to more damage.
Now that we know where acne scars and dark spots come from, let's dive into how to treat them—starting with acne scars.
How to Get Rid of Acne Scars
Acne scar treatments are best handled with special attention and care from your dermatologist since they require more intense procedures than over-the-counter options. The downside: Treatments tend to be expensive. If you aren't quite ready to put a dent in your savings, know that you aren't alone in your struggle with acne scars. Just by reframing your way of thinking, you may even learn to feel much more comfortable with them.
1. Steroid Injections
If you feel a stress pimple rearing its ugly head, a steroid shot can be administered the same day you call your derm because the process is very fast. Not only does it immediately reduce the inflammation of an existing zit, but cortisone can also help thick scars (keloids) appear softer and flatter. "These are specifically for raised scars, however," says Dr. Shah. "It'll help flatten out the scar, but it won't do anything to any discrepancies in the texture."
2. Dermal Fillers
"Certain scars can be filled with a substance that elevates the depressed areas, like hyaluronic acid. This can make the surface of the skin more even and get rid of shadows," says Dr. Bowe. Until recently, fillers weren't a lasting solution. But now, if you're over 21 years old, Bellafill is the first FDA-approved dermal filler designed for permanently correcting moderate to severely dented acne scars. Unlike other fillers, it contains two different ingredients to help improve acne scarring. "It's 20% polymethylmethacrylate (PMMA), which helps your body make more protein to allow itself to heal," says Dr. Shah. "PMMA are tiny balls that sort of act as a scaffolding. Most fillers degrade over time, but since PMMA cannot be absorbed into the body, this offers a permanent result," she says. The other 80% is collagen. The procedure takes about 20-30 minutes, and while you may need a touchup a couple of months later, some people just need the single treatment, says Dr. Shah.
3. Scar Filler
This scar filler from Dermaflage is basically a temporary dermal filler. It's a great low-cost, temporary solution if you're dealing with acne scars. You apply the scar filler like makeup, and it comes off easily when you're ready to remove it.
4. Laser Treatments
Dermatologists often remodel collagen using lasers, "which do not completely eliminate acne scars but can improve them by 30% or more," according to Dr. Woolery-Lloyd. "These can be helpful in reducing the redness associated with acne marks and scars. I use a pulse-dye laser called the V-Beam for red scars. When treating older scars that are no longer red, I like to use the Fraxel laser. When lasers are used to treat acne scars, the results can differ dramatically based on two things: how many treatments you have done, and how much social downtime you're willing to accept as part of the recovery process," says Dr. Bowe. "Erbium laser resurfacing is also another option and it's more aggressive than Fraxel," says Dr. Shah. "It's a minimal burning of surrounding tissues and has fewer side effects like less swelling and redness, but it won't work for those with darker skin tones."
5. Punch Excisions
"This procedure is best for those with icepick scars, which aren't as wide as rolling or boxcar scars," says Dr. Shah. "If you use a punch excision on a scar that's wide at the surface, you're making a bigger punch and trading in one scar for another," she says. "Your dermatologist will numb up the area and use a tiny cookie-cutter like device to cut out the scar, and then sew it closed with a tiny stitch. The stitch is removed in less than a week," says Dr. Bowe. However, Dr. Idriss cautions against this method for those with darker skin or undertones who are prone to hyperpigmentation.
6. Mix & Match Treatments
"Since acne scars vary, so do treatments. Depending on the individual, I often use a multimodal approach to treating acne scars. First, I might use Fraxel treatments to smooth out the skin texture. Then, I often use a combination of the fillers Restylane and Belotero to lift the depressed scars. Finally, I perform a few punch excisions to surgically remove any deep scars that may remain," says Dr. Bowe. There are also topical treatment options for active breakouts that help prevent scarring, which can be used to get out ahead of things.
How to Get Rid of Dark Spots from Acne
"The discoloration from dark marks will usually fade over time," says dermatologist Sejal Shah, MD, who notes that they tend to take between 3-6 months to go away on their own. "But, there are a number of treatment options to help speed up the process."
From sunscreens and vitamin C to retinoids and exfoliating, find out how to treat dark marks, officially known as hyperpigmentation, here.
Here are some of the best at-home treatments:
7. Retinoidl Cream
Count on this budget-friendly retinoid cream to effectively treats your acne while it also restores your skin’s natural tone and texture.
This baby is like a chemical peel right at home. It's a peeling solution made with glycolic acid and salicylic. Use it twice a week to exfoliate your skin and improve acne scars, stat.
9. Foam Cleanser
Prepare your face for all the serums and moisturizers you'll apply by using a great cleanser first. This foaming cleanser from Dr. barbara Sturm contains salicylic acid to gently soften dead skin cells and deeply cleanse the skin.
This 99.5% natural acne toner gently exfoliates your skin with so that your pores stay clean and clear and skin cells turn over quickly for a more radiant complexion.
11. Lightening Serum
Corsrx Triple C Lightning Liquid is made with 20.5% pure vitamin C. Vitamin C attacks dark spots and acne scars, making this serum a valuable addition to your acne treatment regimen.
$27.00, Soko Glam
12. Body Lotion
Murad's Skin Perfecting Lotion might be lightweight but its ingredients are effective and perfect to tackle any bacne scars.
13. Brightening Face Mask
Add this brightening face mask from Glamglow to your routine to see even the dullest spots of hyperpigmentation be evened out in no time.
14. Dark Spot Patches
You already have (and love) acne patches for those pesky zits that appear and you want to tackle overnight, but have you tried dark spot patches? It's the same concept but not they are formulated to help lighten the appearance of dark spots with their microneedle technology.
15. Detox Scrub
Tried and true by our own EIC, this detox scrub from Urban Skin Rx is will minimize your pores and even out your skin tone when you use it over time.
16. Sheet Mask
This sheet mask is worth every penny thanks to its unique formulation. By combining ingredients like tranexamic acid and 4MSK you get a mask that targets the different causes of discoloration on your face.
Sunscreen is actually your first line of defense against acne spots, acne scars, fine lines, wrinkles, skin damage, and skin cancer. Invest in a high-quality sunscreen with an SPF of 30 or more.
There you have it! As with any skin concern (such as how to get rid of acne scars) it's best to consult your regular dermatologist to see which option is best for you. And while technology has come a long way in making dark marks and acne scars treatable, remember that most of us will experience them at some point. So while these are all feasible options for fading your acne scars, don't forget that you always have the choice of pimple positivity, too.
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Originally Appeared on Teen Vogue