Acne scar treatment: Energy-based skin resurfacing with a laser, radiofrequency, or an ultrasound device can help treat boxcar scars, according to Nada Elbuluk, MD, an assistant professor at the Ronald O. Perelman Department of Dermatology at New York University Langone Medical Center in New York City. “They all work by creating new collagen beneath the surface of the skin.” A series of treatments is likely needed based on the extent of scarring, she says. Chemical peels can also help but to a lesser extent. With either procedure, using a retinoid to increase cell turnover and further boost collagen can help improve results, Dr. Elbuluk adds.
Scarring from severe cystic acne can have harmful effects on a person's self esteem, happiness and mental health. Thankfully, there are many different acne scar treatment options available, ranging from chemical peels and skin fillers to dermabrasion and laser resurfacing. According to the American Academy of Dermatology, these are all safe and effective acne scar treatment methods. However, Baldwin says it's important to first clarify what you mean by 'scar.' “Many people point to red or brown spots leftover from old zits and call them scars," she says. “These are marks, not scars and they'll fade with time. Scars have textural changes and are not flush with the surface of the skin. There are several types of acne scars – innies and outies. Outies can be injected with corticosteroids and flattened. Innies can be either deep and narrow or broad, sloping and relatively shallow. Deep and narrow scars need to be cut out, but broader sloping scars can be made better by fillers, laser resurfacing and dermabrasion."
A new, big trend in acne treatments over the past year has been stick-on dots. Some brands, like Nexcare Acne Absorbing Covers, aren't medicated; instead, the clear, absorbent, sterile patches (which feel more like gel than a Band-Aid) dry out the zit like a sponge. Bonus: They'll keep you from picking at it! Despite the fact that they contain no actual medicine, the Nexcare covers have a perfect five-star rating on drugstore.com and a cult following. Meanwhile, many brands do medicate their acne dots, like Peter Thomas Roth's new Acne-Clear Invisible Dots. These invisible stick-on patches contain salicylic acid, tea tree oil, and hyaluronic acid to disinfect and clear clogged pores.
Blackheads are, essentially, open comedones. "Comedone refers to plugging of the follicular opening," explains NYC dermatologist Elizabeth Hale, M.D., referring to hair follicles that technically cover your entire face and body (hi, peach fuzz). "Every hair follicle appears in a sebaceous gland." So a blackhead is the mixture of dead cells, bacteria, and grime that builds up and hardens in the follicular opening—but it's open to the world, which is why blackheads are so easy (read: tempting) to push out.

"I have seen many patients develop a tolerance to prescription acne treatments, and when they stop working, it’s devastating. Treating acne demands a more holistic approach that includes lifestyle, nutrition, and advances in topical skincare. I developed Outsmart Acne™ Clarifying Treatment to be used as part of a whole-person regimen to help skin stay consistently clear."—Howard Murad, M.D., FAAD


Many theories about diet and acne abound; Anolik is most convinced by the ones surrounding sugar and dairy. “Dermatologists really didn’t believe in all the dietary restrictions for acne, but studies in the past ten years have convinced us a bit,” he says. “Dairy and high-glycemic foods do seem to play a part.” High-sugar diets are known to feed bacteria; any diet that increases overall inflammation in the body doubtlessly plays a part. Specific diets—from Ayurveda to low-carb to veganism—definitely work for some people.

First thing's first: prevention. "Getting on a good skincare regimen, avoiding picking, popping, or traumatizing the skin, and protecting it with SPF so it does not darken are important ways to avoid acne scarring," dermatologist Annie Chiu advises. For day-to-day coverage, try this SPF 45 option from Dr. Jart. It's a four-in-one primer, moisturizer, sunscreen, and treatment serum that evens out skin tone from within and offers mild coverage.


Shower twice a day. Take a shower or bath in the morning and at night. Alternatively, take a shower in the morning and then again after physical activity, like exercise, or sweating. Wash your entire body with a mild cleanser and use shampoos that limit oil production in your hair. Be sure to always shower after exercising to remove the dead skin cells your body has sloughed off through sweating.

When answering the question "why does stress cause acne?", it is important to note that stress is not the definitive catalyst for breakouts, but rather a factor that worsens a previously existing condition. When stress levels are consistently heightened, adrenal glands signal the production of the male hormone androgen, which signals sebaceous oil glands to secrete more sebum. As this excess oil builds up, acne is more likely to develop. As women produce a larger percentage of androgens in the adrenal gland than men, stress more commonly has an affectation on acne frequency in women.
48. Clean your makeup brushes every two weeks or so. The amount of product and bacteria build up that happens within two weeks is frightening, and the longer you wait to clean the brushes the longer you’re putting the bacteria right on your skin, causing breakouts. Use warm water and a mild anti-bacterial soap to clean your brushes, laying flat to dry to avoid any warping that can happen.

In dermatology, PDT with the photosensitizer Levulan Kerastick (20% delta-aminolevulinic acid HCl) is used for the treatment of very early, thin skin cancers called actinic keratoses (AK). The initial approval was specifically for the treatment of actinic keratosis of the face and scalp with a combination of an application of the photosensitizer followed by a timed exposure to a special blue light source. PDT is also used for acne, rosacea, skin cancer, sun damage, cosmetic skin improvement, oily skin, enlarged sebaceous glands, wrinkles, rejuvenation (anti-aging), warts, hidradenitis suppurativa, psoriasis, and many other skin conditions.
Unfortunately, if you have a scar on the skin then it will for lifelong but the good news is that you can reduce its size, color and appearance on the skin by lightening them up to the point of undetectable. In general, there are 5 types of acne scars like an ice pick, boxcar, rolling, hyperpigmentation, and keloid scars. So, consult your dermatologist for proper treatment.
What you can do differently: For starters, stop going to tanning beds. Period. And if you are in the sun, make sure to slather on a titanium dioxide- or zinc-based sunscreen (these are natural sun protectants and their formulations usually contain fewer chemicals, so they won't break you out as easily), and wear a sun hat or ball cap to shield your facial skin from harsh rays.

9. You're not releasing pent-up stress properly. Stress triggers acne and acne results in more stress, so it's a very vicious cycle. Basically, when you're under pressure, your skin produces stress hormones, including cortisol, that can stimulate your oil glands to make testosterone that then increases oil production and clogs pores. (Tip via Dr. Downie.)
Acne scar treatment: “You have to take all of these factors into account, and I always advise people that multiple treatments will be needed, and even after a year or two, a 50 percent improvement may be all they get,” Dr. Levine says. Still, it’s important to remember that less visible or deep scars can still make a difference to a person’s self-esteem. “It takes patience, but every scar can be improved, and even if the results are not perfect,” says Dr. Hellman.
Doctors can treat telangiectasias with a small electric needle, a laser, intense pulsed light, or minor surgery to close off the dilated blood vessels. Usually, multiple treatments are required for best results, and only a portion of the blood vessels improve with each treatment. Not everyone responds the same to these types of treatments, and a physician can help someone decide which treatment is best for his or her skin type, condition, and size of blood vessels.
Isotretinoin: Accutane was the original brand name; there are now several generic versions in common use, including Sotret, Claravis, and Amnesteem. Isotretinoin is an excellent treatment for severe, scarring, persistent acne and has been used on millions of patients since it was introduced in Europe in 1971 and in the U.S. in 1982. It should be used for people with severe acne, chiefly of the cystic variety, that has been unresponsive to conventional therapies like those listed above. If taken in sufficient dosage, it should eliminate the need to continue the use of prescription drugs in most patients. The drug has many potential serious side effects and requires a number of unique controls before it is prescribed. This means that isotretinoin is not a good choice for people whose acne is not that severe but who are frustrated and want "something that will knock acne out once and for all." In order to use the drug, the prescribing physician, the patient, and the supplying pharmacy must be enrolled in the online "iPLEDGE PROGRAM." Used properly, isotretinoin is safe and produces few side effects beyond dry lips and occasional muscle aches. This drug is prescribed for five to six months at a dosage that has a high likelihood of preventing the return of acne. Fasting blood tests are monitored monthly to check liver function and the level of triglycerides, substances related to cholesterol, which often rise a bit during treatment but rarely to the point at which treatment has to be modified or stopped.
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