Skin-care geeks rejoiced when the formerly Rx-only Differin gel became available over the counter, in 2016. A prescription-strength retinoid, Differin also affects cell turnover faster than OTC retinols to prevent the formation of new acne. Avram recommends it for those dealing with a lot of small pimples and only the occasional monster cyst. Because Nagler says retinoids “encouraging collagen remodeling,” a well-tolerated formula like Differin can also reduce the appearance of deeper scars.
Bellafill is a dermal filler approved for the correction of moderate to severe, atrophic, distensible facial acne scars on the cheeks in patients over the age of 21. This injection provides immediate improvement — like, your skin is improved by the time you leave the office. Once it's injected, the collagen goes to work immediately, adding natural-looking volume and lift to soften acne scars. Over time, your body naturally metabolizes the collagen — but the results remain intact. In fact, Z. Paul Lorenc, a New York City-based plastic surgeon, explains, “90 percent of patients who used Bellafill to treat their acne scars were still satisfied with the results at the one-year mark." The best part? There is no downtime and you can return to normal activities right away.
Lasers: 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's won't work for those with darker skin tones."
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.
There are a number of mild chemical peels available over the counter, but acne scar removal requires a stronger peel typically administered by a doctor or dermatologist. Trichloroacetic acid (TCA) peels are slightly stronger than alpha hydroxy acid (AHA) peels and may be used for acne scar treatment. The strongest type, phenol peels, may cause significant swelling and require up to two weeks of recovery time at home. Neither are recommended for people with active severe acne.
Treating acne requires patience and perseverance. Any of the treatments listed above may take two or three months to start working (even isotretinoin). Unless there are side effects such as excessive dryness or allergy, it is important to give each regimen or drug enough time to work before giving up on it and moving on to other methods. Using modern methods, doctors can help clear up the skin of just about everyone.
"Put it this way: It is so common that pimples are meeting wrinkles," dermatologist Neal Schultz, M.D., creator of Beauty Rx Skincare, tells SELF. "For the last 10 to 20 years, adult acne has been increasing. It can even go into your 50s, right to menopause." If you had acne as a teen, chances are, you've got oily skin that's prone to breakouts. But even if you didn't, it's still possible you'll end up with adult acne.
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.
There you have it! As with any skin condition, 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.
Since lemon juice has a pH of 2 and skin's pH is 4.0-7.0, this method needs to be used carefully. If left on too long, or not diluted this can lead to significant chemical burns. Citrus juices also contains a chemical called Bergapten, which binds to DNA and allows UV radiation to damage skin more easily, so you need to watch your sun exposure if you have any citrus juice on your skin. Rinse it off before going into the sun, and wear sunscreen.
Ablative lasers deliver an intense wavelength of light to the skin, removing thin outer layers of the skin (epidermis). In addition, collagen production is stimulated in the underlying layer (the dermis). Patients are typically numbed with local anesthetic and the ablation is done as an outpatient procedure. CO2 and erbium are the ablative lasers most often used for acne scar treatment.
Sometimes even though they wash properly and try lotions and oil-free makeup, people get acne anyway — and this is totally normal. In fact, some girls who normally have a handle on their acne may find that it comes out a few days before they get their period. This is called premenstrual acne, and about 7 out of 10 women get it from changes in hormones in the body.
"Hyperpigmentation is an increase of melanin, which is the substance that colors the skin," says Dr. Sobel. Hyperpigmentation often clears up on its own. However if you want to speed up the process, you can use topical treatments with ingredients like retinol, vitamin C, and kojic acid, which can help brighten skin overall. We like Sunday Riley Sleeping Night Oil ($105, sephora.com) and InstaNatural Vitamin C Serum ($17, amazon.com). The most important thing is to stay out of the sun to keep the dark spots from getting even deeper in color.
While you’re waiting on all those active ingredients to kick in, Tzu says it’s best to use “makeup or foundation with a green tint to neutralize the redness.” She likes the Clinique Redness Solutions line, designed to color-correct red marks or spots. While this foundation includes SPF, it’s still best to layer over a dedicated sunscreen for maximum protection.
Strat beauty editor Rio Viera-Newton mentioned this paraben- and fragrance-free concealer in her post on makeup for broken-out skin. “This has helped me conceal even the worst of the worst,” she wrote. Designed for buildable coverage, it will also work on masking those acne marks until they gradually fade away, and the gentle formula means it won’t cause additional irritation.
Both Avram and Tzu recommend looking for products with mark-fading hydroquinone. Ambi Fade Cream includes 2 percent hydroquinone, the highest concentration allowed without a prescription. “It also contains soy, which is well known for treating pigmentation issues, and vitamin E which helps with scarring,” says Tzu. While the FDA considers hydroquinone safe, it is banned in Europe and can potentially cause irritation or further discoloration, so remember to patch-test and check with a dermatologist whether it’s right for you.
Isotretinoin (previously known as Accutane) is the most effective form of acne therapy and the only one that can actually result in a cure for your acne. After finishing a course 80% of people never see acne again. It works so well because it unclogs pores, kills bacteria, reduces oil production and reduces inflammation. It is taken as a daily pill. Isotretinoin has numerous rare and potential side effects that has made it a controversial choice, but for patients with severe acne there is often no other option. Patients taking isotretinoin must also be on highly effective birth control as the drug can cause birth defects. Isotretinoin can only be taken under close medical supervision.
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