Even if you have amazing willpower—like the willpower of a Girl Scout with a full inventory of Thin Mints under her bed—and never, ever mess with your acne, you can still scar. "Acne scars result from damage to the skin following repeated inflammation from acne cysts," says Judith Hellman, M.D., a board-certified dermatologist in New York City. "Pimple popping can make the process worse, but acne can cause scarring even without pimple popping."
Acne scars take many different forms. You might see tiny pockmarks, a swollen keloid, or a discolored area on the skin. And just like the types of scars vary, there isn't a one-size-fits-all fix. Your dermatologist can use a combination of treatments including lasers, chemical peels, or fillers to minimize the spots. "Once there is scarring you can't get the skin back to the way it was before," says Dr. Karolak. "But we can get it to look significantly better, so that [clients] feel more comfortable in social environments."
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In occasional cases, patients may use short-term topical cortisone (steroid) preparations of minimal strength to reduce local inflammation. Some mild steroids include desonide lotion or hydrocortisone 1% cream applied sparingly once or twice a day just to the irritated areas. There is a risk of causing a rosacea flare by using topical steroids. Prolonged use of topical steroids on the face can also cause irritated skin around the mouth (perioral dermatitis).
Washing your face with regular soap is not enough to make acne better. The best face wash for acne is effective at removing oil and dirt, but still gentle enough to use regularly without overdrying your skin. Look for topical acne medication ingredients salicylic acid and/or benzoyl peroxide in your face wash and use gentle, nonabrasive cleansing techniques.
Laser resurfacing involves directing concentrated pulsating beams of light at irregular skin. This procedure may be used to reduce wrinkles, blemished, or acne scars. There are two types of lasers commonly used in laser resurfacing: carbon dioxide and erbium. Treated areas heal in 10-21 days. Possible complications include milia, hyperpigmentation, and swelling.
This is Dr. Schultz's number-one piece of advice. "Exfoliation is the most important thing you can do on a regular basis to be fighting acne both in terms of preventing it and treating it." His go-to ingredient? Glycolic acid. While a glycolic cleanser will help, a treatment that really soaks into your skin is what will give you the results you want. Try BeautyRx Advanced 10% Exfoliating Pads or Drunk Elephant T.L.C. Framboos Glycolic Night Serum.
Comedo (whiteheads or blackheads) or papules. The comedo is the basic acne lesion, which is a plugged pore. If the plugged pore stays under the skin, it's called a closed comedo and forms a white bump or whitehead. Blackheads are comedos that open up and appear blackish on the surface of the skin. This black color is not due to dirt, but because the air reacts with the excess oil.
Blackheads are a mild form of acne that appear as unsightly, open pores that appear darker than the skin surrounding them. They get their dark appearance from a skin pigment called melanin, which oxidizes and turns black when it's exposed to the air. Blackheads aren't caused by dirt, but by sebum (oil) and dead skin cells blocking the pore. If the pore remains open, it becomes a blackhead; if it's completely blocked and closed, it turns into a whitehead.
Spot treatments are key for treating a pimple ASAP. Benzoyl peroxide is often vilified for being harsh, but when it comes to really zapping a zit, it should be your best friend. Just dab it on the trouble spot to dry it out and kill bacteria. For heavy-duty action, try Neutrogena Rapid Clear Stubborn Acne Spot Gel; for something gentler, we like Arithmetic Acne Control Complex, which has soothing ingredients to counter the drying effects and is made with adult skin in mind.
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.
Although cow's milk has a low glycaemic index, it contains androgens, oestrogen, progesterone and glucocorticoids, which also provoke keratinisation and sebum production. Milk also contains amino acids (eg arginine, leucine, and phenylalanine) that produce insulin when combined with carbohydrates. Other components of milk that might induce comedones include whey proteins and iodine.
Retinol is a vitamin A derivative, which the skin absorbs and converts to retinoic acid. Retin-A is the prescription form. "Topical retinoids are fortunately one of the most effective treatments for acne, and also happens to be a highly effective antiaging ingredient, because of its collagen-building properties," Dr. Tzu notes. The biggest downside is they're harsh and can sometimes be too much for sensitive skin. For an elegant OTC option, try Dr. Dennis Gross Skincare Ferulic Acid + Retinol Brightening Solution.
Rouleau also enlightened me about another culprit making my skin care routine less effective: using oil-based products at the beginning of my skin care routine. As Rouleau explained, oils have a large molecule size and, therefore, should go at the end of a skin care routine because it almost acts like a sealant. When you use a cleansing oil or balm first (as I used to do along with makeup wipes), you're basically creating a barrier that makes it more difficult for other skin care products to penetrate and do their job.
Acne scars are usually the result of inflamed blemishes caused by skin pores engorged with excess oil, dead skin cells and bacteria. The pore swells, causing a break in the follicle wall. Shallow lesions are usually minor and heal quickly. But if there is a deep break in the wall of the pore, infected material can spill out into surrounding tissue, creating deeper lesions. The skin attempts to repair these lesions by forming new collagen fibers. These repairs usually aren't as smooth and flawless as the original skin.
A game changer in the skincare industry, the Acne Pad delivers medical-grade glycolic acid that retextures the surface of the skin to reveal what Cane + Austin likes to call that "glycolic glow"all just with one product. After years of treating thousands of patients with glycolic acid, Dr. Austin knew he had to share this miracle ingredient with everyone. While in development, Dr. Austin shared the pre-production samples in Ziploc bags and gave to friends and family to try. He knew he had something special when a friend had to choose between being on time for her flight, or running back to get more of "those pads". She missed her flight. Cane + Austin had a cult following before even being distributed in stores.
Facials can be an effective way to get rid of non-inflammatory or comedonal acne (whiteheads and blackheads). Comedones occur when pores get clogged with oil and dead skin cells. Facial exfoliation takes off the top layer of skin, which unclogs pores and helps oil flow naturally through the follicles, thus avoiding future breakouts. Extractions remove the existing comedones, which both helps your appearance and also lessens the likelihood developing a pimple (which occurs when a comedone becomes inflamed).
As the name suggests, ice pick scars are very deep acne scars that look like the skin has been punctured with… an ice pick. When the body produces too little collagen in response to an injury, depressed scars such as ice picks can form. “Ice pick scars represent the result of infected sebaceous gland openings on the skin. They are usually the most difficult to correct,” says New York City plastic surgeon Gerald Imber, MD.
Experiment with aloe vera. The sap of the aloe vera plant is a soothing natural substance which can be used to relieve many ailments, from burns to wounds to acne scars. Aloe vera helps to rejuvenate and moisturize the skin, encouraging acne scars to fade. It is possible to buy aloe vera products in the drugstore, but the best thing to do is buy an aloe vera plant and use the sap from a broken leaf. This gel-like sap can be applied directly on the scarring, and there is no need to wash off.
Hormone changes as an adult. The menstrual cycle is one of the most common acne triggers. Acne lesions tend to form a few days before the cycle begins and go away after the cycle is completed. Other hormone changes, such as pregnancy and menopause, improve acne in some women. But some women have worse acne during these times. Stopping use of birth control pills can play a role as well.
It starts out as a powder (a blend of raw cacao, bamboo charcoal, soil nutrients, and spices), only releasing its potent healing elements when mixed with water. The resulting mousse heals blemishes, fights inflammation, encourages circulation, and visibly tightens pores pretty much instantly. Use Lindstrom’s facial treatment bowl and brush to mix the paste.
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.