As far as combination scars go, Dr. Levine’s go-to acne scar treatment for combination-type scars include a series of treatments with picosecond lasers such as the Picosure or use of the FRAX 1550* Fractional non-ablative laser. “These are newer technologies, and they have less downtime than older lasers, so for me this means I can be more aggressive and see results with fewer treatments.” Older ablative lasers blast off the skin’s top layers, which requires significant downtime, but these newer non-ablative lasers pass through the skin’s upper layers to harmlessly heat the deeper tissues, stimulating collagen and smoothing the scar’s appearance.
2. You're OD'ing on spot treatments. Overusing topical salicylic acid, benzoyl peroxide, or sulphur over-the-counter treatments can dry out your skin, causing it to produce more oil and possibly blemishes. Those ingredients can actually make the appearance of your pimples look worse, since the active ingredients can slightly burn the top layer of your skin if used too often, making the pimple appear even redder and harder to conceal than if you had just left it alone. (Tip via Samantha Wright, a licensed aesthetician and Skinovator at the Dangene Institute.)
"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.
"You want to calm the inflammation right away," Chiu says of treating newly popped pimples prone to scarring. She suggested asking your dermatologist to prescribe an anti-inflammatory acne medication like Aczone Gel. For a prescription-free solution, dermatologist Ronald Moy suggests treating newer scars with a product containing innovative growth factors that "stimulate collagen production immediately" and "should prevent any new scars from becoming old scars." This serum from Moy's product line, DNA EGF, uses growth factors clinically proven to speed up the growth of healthy skin cells. Both hyperpigmentation (not true scarring, but the spotty aftermath of a breakout) and atrophic scars (those crater marks more deep and sunken) benefit from a stimulating collagen boost because thickening the skin leads to less visibility of existing scars, Moy says.
Avoid getting sunburned. Many medicines used to treat acne can make you more prone to sunburn. Many people think that the sun helps acne, because the redness from sunburn may make acne lesions less visible. But, too much sun can also increase your risk of skin cancer and early aging of the skin. When you're going to be outside, use sunscreen of at least SPF 15. Also, try to stay in the shade as much as you can.
“After sweating, immediately use an exfoliating cleanser to help keep your pores clear and remove excess oil,” says Dr. Zein Obagi of ZO Skin Health. Try keeping Neutrogena Rapid Clear Treatment Pads in your gym bag or locker for those times you need an on-the-go cleanse. These will remove any leftover dirt while treating your skin with acne-fighting salicylic acid.
There are many who recommend that those with acne-prone skin use non-comedogenic ingredients, that is, cosmetics designed to avoid clogging the pores. It’s best to use products that are labeled hypoallergenic and oil free, and some find that makeup products with salicylic acid help the skin remain clear. It’s also important to avoid applying layer upon layer of makeup.
Hormones are ruthless, and all the topical treatments in the world won't make a difference if yours are seriously out of whack. In that case, you need to fix things internally first. "Medications that manipulate hormonal levels, such as oral contraceptives and spironolactone, are helpful in curbing hormonal chin and lower face outbreaks," Dr. Tzu says. Ask your derm about what might work for you.
Those who consume a bevy of seafood, seaweed, and iodized salt experience high iodine levels. These iodine levels have also been purported to trigger acne flare ups. Word spread about iodine’s potential for causing skin issues in the 1960s, and it’s had a bad rap ever since. However, recent studies have fought against this pervasive thought, as some studies have seen no difference between acne in those who were given iodine and those who weren’t. It’s important to take these studies with a grain of salt, and understand that depleting your diet of iodine can have negative effects on holistic health. Iodine is essential for proper thyroid function, and is responsible for the manufacture of T3 and T4 thyroid hormones and it’s important to maintain proper levels of iodine in your diet.
Oral contraceptives: Oral contraceptives (birth control pills), which are low in estrogen to promote safety, have little effect on acne one way or the other. Some contraceptive pills have been shown to have modest effectiveness in treating acne. Those that have been U.S. FDA approved for treating acne are Estrostep, Ortho Tri-Cyclen, and Yaz. Most dermatologists work together with primary care physicians or gynecologists when recommending these medications.