Patients first receive a topical anesthetic, which works for about an hour before the device goes on. "When you’re done," she explains, "it looks like your skin has tiny holes — almost pixelated or grid-like — and I follow with SkinCeuticals CE Ferulic Acid, a hyaluronic acid serum, and Luxamend (a prescription wound-healing cream that speeds up healing). Finally, we apply Aquaphor to create a barrier for the skin." Depending on the intensity of the laser, patients can expect anywhere from a few days of ruddiness to up to 10 to 14 for very high-intensity treatment. There is a risk of bleeding, infection, or scarring. As always, you'll need to consult with your dermatologist about whether this treatment is right for you.
"I often recommend PCA Skin Pigment Gel to patients looking to treat scars left behind from acne," explains Rebecca Kazin, a dermatologist at Washington Institute of Dermatologic Laser Surgery and Johns Hopkins department of dermatology. "This gel contains 2 percent hydroquinone blended with other skin brighteners, like kojic acid, resorcinol, and azeleic acid, which work to lighten the pigmentation without irritating the skin," she says. The addition of lactic acid helps maintain moisture to prevent overdrying, which can worsen pigmentation.
So if popping pimples doesn't cause scarring, what does? Long-lasting scars typically turn up after a recurring bout with cystic acne. Cystic acne is a breakout that burrows deep into the skin. These red, painful nodules occur when clogged pores are filled with pus and bacteria, which causes inflammation. Cystic breakouts are often tied to an internal fluctuation of hormones like testosterone (that's why they're common during puberty, monthly menstruation, and perimenopause). "If there is a cyst in the skin, it's going to cause a scar the longer it sits there because pus or bacteria deeper inside the pores cause surrounding inflammation," says Dr. Karolak. And as a result, the inflammation affects the collagen production as well as the fat stores under the skin, creating a visible scar on the surface.
Moderation and regularity are good things, but not everyone can sleep eight hours, eat three healthy meals per day, and drink plenty of water a day. Probably the most useful lifestyle changes one can make is to never to pick or squeeze pimples. Playing with or popping pimples, no matter how careful and clean one is, nearly always makes bumps stay redder and bumpier longer. People often refer to redness as "scarring," but fortunately, it usually isn't permanent. It's just a mark that takes months to fade if left entirely alone.