With a whopping 40 to 54 percent of today’s adult population experiencing persistent breakouts, acne is a more common for adults than you’d think. This means if you’re experiencing acne (or its scars), you’re definitely not alone.
The good news is that there are better face wash options, medications, and topicals available today than back in your high school days. The downside? You may have some leftover scars.
We’re all for embracing skin textures in all forms, so you may be totally cool with them. But if not, there are ways to minimize the look of those scars.
Here’s more on the various types of acne scars and what treatments are available.
“Acne scars are very challenging to treat and are even more challenging to treat once they’ve been given time to age,” says Joel Schlessinger, MD, a board certified dermatologist in Omaha, Nebraska.
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 pop or mess with your acne, your skin can still scar.
“Acne scars result from damage to the skin following repeated inflammation from acne cysts,” says Judith Hellman, MD, a board certified dermatologist in New York City. “Pimple popping can make the process worse, but acne can cause scarring even without pimple popping.”
How big of a scar you’ll be left with after a blemish (if any at all) depends on the depth of the breakout, Schlessinger says. “As our pores become engorged with oil and form a blemish, the pore may swell and collapse the follicle wall,” he says.
“The depth of the resulting lesion determines the severity of the scar. Shallow lesions usually heal quickly and leave little-to-no scarring, while deeper lesions spread to nearby tissue, causing a more pronounced scar.”
If you see scars form, Hellman says they’re likely one of the following types.
The first three types of scars are called “atrophic” because they’re depressions in the skin as opposed to raised up from the skin.
Ice pick acne scars
Ice pick scars are usually narrow, deep indentations common in the cheeks. They may look like a scar made from a tiny ice pick. They’re one of the more challenging scars to treat (but it can be done!).
Boxcar acne scars
Boxcar scars aren’t as narrow as ice pick scars. They’re usually a wider depression in your skin that can have more defined edges. They can resemble a chicken pox scar.
Wider scars may be harder to treat than more narrow scars.
Rolling acne scars
Rolling scars are often the widest of the atrophic scars and may not have distinct edges. Instead, they’ll likely have varying depths, curved edges, and a more irregular look.
Treatment options for atrophic acne scars
Addressing this type of scar usually involves reducing the depth of the scar and then treating any discoloration.
There are a number of treatments that range from mild to clinical-level, so speak with your dermatologist to see what’s right for you and your skin tone and type. Treatments include:
- Chemical peels. Used to removed top layers of the skin and encourage new skin growth in mild scarring.
- Laser resurfacing. Uses lasers to treat layers of the skin and encourage new skin growth.
- Dermabrasion. Removes the top-most layer of skin to encourage a smoother layer to grow in its place.
- Dermal fillers. Substances such as hyaluronic acid can be injected to fill in the scar temporarily.
- Microneedling. Tiny needles are used to encourage collagen production and reduce the depth of scars.
- Punch excision. The scar is cut out and then stitched together to create a less noticeable scar.
- Punch grafting. The scar is cut out and replaced with skin from elsewhere, usually from behind the ear.
- Subcision. Scar tissue is broken away from the skin so that it can raise up and look less noticeable.
- TCA CROSS peels. Trichloroacetic acid (TCA) is used on a scar to encourage collagen growth.
Instead of indentations in the skin, hypertrophic scars are raised up from the skin due to too much collagen produced while healing. These are less common than the other kind and are mostly associated with body acne. Damn you, bacne!
Hypertrophic scars are the same size as the acne that caused it, but keloid scars are larger than the original spot.
Treatment options for hypertrophic acne scars
Treatment for raised scars is all about reducing the height of the scar. Treatments include:
- laser resurfacing
- steroid injections to soften the scar tissue and reduce its size
- surgical removal
- over-the counter (OTC) scar treatments like silicone sheets or oils
There are lots of OTC treatments that claim to reduce the appearance of scars, so definitely check with your doctor or derm before wasting any money on products that may not work.
Your acne may have healed, but that inflammation may leave behind a signature: Some extra pigment from the skin producing extra melanin during healing.
Hyperpigmentation can happen to anyone, but is especially common in those with darker skin tones sporting more melanin in their skin.
Treatment options for post-inflammatory hyperpigmentation
Consistent use of the forever superhero, SPF 30+ sunscreen, is key. Use it daily, even indoors, and reapply every couple of hours.
Other treatments include:
- OTC or prescription-level topical treatments like vitamin C, azelaic acid, and retinoids
- chemical peels
- laser resurfacing
Sunscreen pro tip
If you wear makeup, powder or spray sunscreens can be applied on top throughout the day.
If your scars are bugging you and you don’t want to wait for an OTC remedy to make some progress, working with a dermatologist is the most effective way to tackle your texture.
Your treatment plan depends on the type of scars you have. And treatments can be spendy and take a long time to start working, so know that going in.
Schlessinger recommends seeing your dermatologist as soon as your skin starts breaking out to help prevent scarring. He says medication and topical acne treatments are less pricey than expensive treatments for scars.