How to Treat (and Avoid) Acne Scars

Pimples can be an unwelcome blemish, but acne is more than just a few pimples. For some people, acne can leave their skin scarred and pocked. So whether you have acne now or had acne in the past and have acne scars today, you’ll want to find out how to treat and avoid acne scars.

What Causes Acne Scars

Acne occurs when glands in the skin produce too much oil, and the pores get clogged with the extra oil. The buildup of natural skin oils creates a favorable environment for certain bacteria, which can grow in the clogged pore. Small pores usually develop into whiteheads, a small bump in the skin. Larger pores often develop into blackheads, a flat mark with a black dot in the center. If the clog is close to the surface of the skin, it usually heals pretty well on its own. But when the clog is deeper down, it can take longer to heal and be more destructive. The clog can actually cause the wall of the pore to burst, and secretions can kill off skin tissue in the immediate area, leaving your body to heal. The deeper clogs kill off more tissue and are more likely to become scars.

When the clog finally clears, the body rushes in to repair the damage, as it would with any injury. It produces new skin tissue to replace what was killed. But when the body repairs the dead skin cells, it may not always match the original skin perfectly. Sometimes the body produces too much new skin. That creates a raised scar, usually a small bump. Other times, the body produces too little skin, which can leave a pockmark, a small depression in the skin. These imperfect reconstructions of damaged tissue are what we call acne scars.

In addition to scars, acne can leave dark spots. When a pimple is opened up, either by intentional popping or some other mechanism, new skin grows over the open lesion to close the wound. But that skin may not match the surrounding skin. It can be darker. Technically, this is not a scar. It is referred to as hyperpigmentation. But the result is the same, irreparably uneven skin that lasts long after the acne is gone.

Preventing Acne Scars

The very best way to avoid acne scars is to avoid disturbing the acne pimples. Popping pimples causes worse damage and increases the chance of scarring. On the other hand, medical treatments for acne, typically topical applications, can help prevent scarring. If the clogged pores are treated, there is less dead tissue to replace, so fewer opportunities for scarring.

Who Is at Risk for Acne Scars

Thankfully, acne is mostly a disease of adolescence. It typically arises in the mid-teenaged years and subsides by the mid-twenties. This age-specific acne is due to the effects of hormones that increase during puberty and decrease with age. For a similar reason, men are more likely to suffer severe acne than women. Androgen, a hormone that is present in men at much higher levels than in women, is one key culprit.

Despite the association of acne with young people, about 20% of acne cases are in adults past their mid-twenties. Unlike during puberty, women are more likely than men to experience acne as adults.

Anyone with moderate to severe acne is at risk of scarring. Some scarring can be avoided with a little willpower to keep your hands away from your face, combined with timely medical treatment. Still, in more severe cases, scarring can be unavoidable. Genetics also plays a role in acne scarring. Some people are just more prone to scarring. So if your parents have acne scars, you are at higher risk of developing them yourself.

Treatment for Acne Scars

There are plenty of products out there that claim to restore skin damaged by acne scars. In many cases, these products actually don’t do much to help. However, some in-office medical procedures are pretty effective at restoring the damage done by scars caused by acne and reducing their visibility.

One treatment involves basically filling in the depressions left by acne scarring. Bellafill is the proprietary name of a treatment that injects collagen into the depressions on the cheeks and helps to create natural volume. The collagen fills in the depressions, making them much less visible. Even though the collagen is naturally broken down over time, the results last. 

Another in-office procedure actually involves damaging the skin slightly to induce healing and growth of new skin cells. Microneedling is a process that creates many tiny holes in the skin that penetrate the epidermis to the papillary dermis. As the skin heals, it produces new collagen, which can help smooth out the scars from acne. The procedure is done in-office with topical anesthetic and may take a half hour to an hour. When the procedure is completed, the skin can be raw and red, similar to a sunburn. The skin is treated with ointments to heal the damage and coated with another type of ointment to help seal the skin and keep moisture in and debris out.

Fractional Laser Resurfacing

Fractional laser resurfacing works by the same mechanism as microneedling. A laser creates tiny holes in the surface layer of skin that penetrate into the layer below. As the skin naturally heals, new collagen forms and reduces the appearance of acne scars. After fractional laser resurfacing, the skin is raw and easily damaged. Ointments need to be applied to keep the skin moist, encourage healing, and keep the area clean. Within 3-7 days, the primary healing has taken place, but a sunburn-like irritation can last up to a few weeks.

Where to Go for Acne Scar Treatment

There are numerous home remedies and over-the-counter products that claim to diminish the appearance of acne scars. However, the best and most effective treatments are in-office treatments by expert doctors. With an in-office procedure, people with acne scars can be treated non-surgically with minimal downtime. The solutions we mentioned, Bellafill, microneedling, and fractional laser resurfacing can be done with only a local anesthetic, and patients can walk right out of the office and return to most regular activities immediately. However, before you undergo any acne treatment, consult with a dermatologist or specialized plastic surgeon to find out which treatments are best for you.

If you’re thinking about treating your acne scars, or if you have any other concerns about scars, wrinkles, or hard-to-beat fat deposits, TrustDALE has a great doctor to recommend. Dr. Elizabeth Whitaker is one of the region’s best facial plastic surgeons. She was named Top Atlanta Plastic Surgeon for 2018 by Atlanta Magazine. In addition to her practice, she has authored articles and book chapters and served as Chief of the Facial Plastic and Reconstructive Surgery Division at the Medical College of Georgia.

After a thorough investigation, TrustDALE is proud to include Dr. Whitaker’s practice, Atlanta Face & Body, in the TrustDALE circle of trust. And as with all of our certified businesses, we stand behind Atlanta Face & Body with Dale’s $10,000 Make-It-Right™ Guarantee.