"If you occupy the area [under the skin] with a cyst, it destroys fat around it. Once the cyst goes away, the loss causes indentation," Dr. Karolak explains. A boxcar scar is a depression that has hidden scar tissue, which acts like an accordion pulling the scar downward. Subsicion is one solution for these deeper scars. Subsicion uses a sharp needle to go under the surface and break up that scar tissue. Then, you can fill it in with fillers made specifically for acne scars like Bellafill. Or you can do a fat transfer. "One of my favorite treatments for volume loss is fat transfer, which allows me to take inject a patient's own body fat instead of synthetic filler," says Dr. Karolak. Another treatment for boxcar scars is punch excision where the indented area of the scar is removed and the edges are pulled together with a suture. These treatments are often followed up with a collagen-boosting laser treatment.
When it comes to skin care, we're not usually ones for hard and fast rules. Everyone has unique skin types, skin tones, lifestyles, and genetic histories that make it impossible to have a single piece of one-size-fits-all advice. It can take years — and dozens of trips to the dermatologist — to discover how to treat acne effectively on your unique skin. But here at Teen Vogue, we've pretty much made it our life mission to figure out the best tips from the pros to point you in the right direction. They've seen it all and won't recommend it unless it's backed up by experience and science,.
Acne is a condition of the skin that shows up as different types of bumps. These bumps can be blackheads, whiteheads, pimples, or cysts. Teens get acne because of the hormonal changes that come with puberty. If your parents had acne as teens, it's more likely that you will, too. The good news is that, for most people, acne goes away almost completely by the time they are out of their teens.
Acne refers to pimples, blemishes, blackheads, zits or whiteheads. While this problem is commonly associated with teenagers, many adults suffer from acne as well. Stress, hormones, environmental factors and more can lead to acne problems, causing individuals embarrassment and slashing their confidence. Outlined below are tips for eliminating acne once and for all so you can have healthy, glowing skin.
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.

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.)
The spots that linger after a pimple has healed are caused by inflammation that has disrupted the skin's natural healing process. "When your skin is opened up (like when you pop a pimple) and then closes back together, you can get abnormal pigmentation, texture, and tone that looks different from the rest of your skin. Sometimes the broken blood vessels that remain after an acne lesion fades can result in a mark," says Dr. Bowe. For a number of people who are able to refrain from picking, inflamed pimples or blemishes can still leave a dark brown or red mark — but these naturally fade over the course of a few months, notes dermatologist Heather C. Woolery-Lloyd, MD.

Contrary to popular belief, acne isn't caused by a harmful diet, poor hygiene, or an uncontrolled sex drive. The simple truth is that heredity and hormones are behind most forms of acne. Swearing off chocolate or scrubbing your face 10 times a day won't change your predisposition to this unsightly, sometimes painful, and often embarrassing skin problem.
"Jessner Peels help to reduce acne lesions overnight by drying them out. They also help to remove the top layers of the skin that cause dry skin and acne flareups. It's important to note that the use of retin-A may cause the acids in the peel to intensify, so if you are using a prescription retin-A it's important to stop using it one week prior to getting the peel," says Dr. Bank. For those with less severe acne or occasional breakouts, there are other types of chemical peels your derm can give you to exfoliate your skin, dry up acne, and help create an instant glow (great for if you're trying to remove a few lingering pimples before a big event in a few days).
"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.

Moderate to moderately severe acne. This type of acne consists of several whiteheads, blackheads, papules and pustules that cover from ¼ to ¾ of the face and/or other parts of the body. It can be treated with antibiotic lotions or gels, as well as retinoic acid. Retinoic acid is an altered form of vitamin A. It helps prevent whiteheads and blackheads. Your doctor may also prescribe an antibiotic pill, such as erythromycin. If you take birth control pills to prevent pregnancy, antibiotics can affect how well they work. Be sure to use a second method of birth control with the pill, such as a condom. Retinoic acid and antibiotic pills can make the skin sensitive to the sun. So, wear sunscreen and stay in the shade while using them.


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.
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