With so many people experiencing breakouts during the pandemic (hi, maskne [1]), the concern around blemishes and the unwanted parting gifts — aka acne scars [2] or marks — they leave behind has only grown. First, the bad news: once a spot has scarred, the damage is done (which is why most dermatologists advise against picking [3]).
Now for the good: what you might think is scarring is often just post-inflammatory hyperpigmentation or erythema (brown or red spots), rather than a textual change of the skin. Plus, even if they are in fact scars, there are ways to minimise the appearance of acne marks. All it takes is using the right products and treatments [4] in your skin-care routine.
That's where we come in. We spoke with a handful of experts — including two board-certified dermatologists (the equivalent of consultant dermatologists in the UK), Anna Guanche [5], MD, and Dendy Engelman [6], MD, and New York City aesthetician Taylor Worden [7] — to get their recommendations for treating, preventing, and minimising the appearance of acne scars and marks. Keep reading for more.
What Are Acne Scars, and What Causes Them?
Before we get into how to treat acne scars, it's important to understand what they are: visible raised marks and indentations left behind due to skin damage from a pimple or serious acne.
"Acne scars are when the blemish damages the top layer of skin as well as the deeper levels of the skin," Worden told POPSUGAR. "It damages the skin and leaves you with an indentation like a pockmark or crater in the skin."
Acne can be caused by a multitude of factors: genetics, environment, hormones, diet, sebum production, pH of skin, bacteria buildup, medication, and inflammation. As the inflammation subsides and the skin attempts to heal itself, scar tissue can form. Scars could look different depending on skin type and skin tone. Light-colour skin tones will often produce red marks after acne, whereas darker complexions show brown marks [8] after acne.
What's the Difference Between Acne Scars and Acne Marks?
The main difference is the level of permanence. "Acne marks are red (erythema) or brown (hyperpigmentation) discoloured marks that are temporary, taking just a few months to fade and heal," Worden said. Acne scars, however, can be permanent if not treated early on.
According to Dr. Engelman, acne marks can include dark marks or hyperpigmentation, which are not raised. One telltale way to know the difference: acne scars have a texture. "They are raised or depressed marks that are able to be felt on the skin," she said.
What Are the Types of Acne Scars?
Generally speaking, there are two types of scarring: superficial and deep indented scars.
"If you feel a divot or textural irregularities in the skin, those are referred to as deep or indented scars," Dr. Guanche said. "Superficial scars are often referred to as post-inflammatory erythema and do not typically have textural indentations in the skin. This type of scarring will heal over time without treatment."
Although oily skin tends to be more acne prone, all skin types are susceptible to acne and acne scars. There are differences in the way skin will heal: "Some can have deep cystic breakouts that look disfiguring but then heal with perfectly smooth skin," Dr. Guanche said. "Others can have a mild breakout that results in permanent noticeable scars. The difference is likely genetics."
Then, to get more granular, there are four main types of acne scarring: boxcar (broad depressions with sharply defined edges); icepick (deep, narrow, pitted scars); rolling scars (broad depression with a sloping edge); and hypertrophic scars or keloids (raised thick lumpy scars).
Can I Get Rid of Acne Scarring at Home?
When working to treat acne scarring at home, topical formulas can help lighten the areas. "Treat dark marks with salicylic acid or glycolic acid, and peels containing these acids, to promote cell turnover and remove the top layers of the skin," Dr. Engelman said. Since dark scars are superficial blemishes, they can also be treated with LED light therapy [9] masks or Rhofade [10], a topical prescription cream.
On the flip side, textured scars can be treated by "resurfacing the skin and promoting cell turnover and collagen production," Dr. Engelman said. When doing this at home, you can use a gentle microneedling [11] tool, the process of creating micro-injuries in the skin that trigger its natural healing process.
Worden encourages her clients to stay up on their vitamins (vitamins A, B, C, and E) and mineral supplements (pomegranate seed oil, zinc, fish oil) to help the process of wound healing. You can also invest in products that contain lightening ingredients: niacinamide, azelaic acid, rosehip oil, retinoids, lactic acid, turmeric, AHAs, salicylic acid, and liquorice root.
What In-Office Treatments Are Best For Acne Scarring?
When in doubt, see a dermatologist. Dr. Guanche recommends a pulse dye layer for superficial red scars. "VBeam is best to reduce the redness and remodel collagen," she said. For indented scars, you can commit to pro-grade microneedling, fraxel resurfacing [12], fillers (which are injected to plump up skin and fill the scar), chemical peels [13] (for collagen buildup to fill texture scars from within), or radiofrequency microneedling.
How to Prevent Acne Scarring
All three experts agree that controlling and treating acne is the first step. Otherwise, you may just be chasing more scars. "Use a nourishing oil cleanser to remove makeup, dirt, and grime, then use a face wash to deeply cleanse," Dr. Engleman said. It's also important to focus on hydrating the skin to promote a healthy skin barrier that is less vulnerable to acne.
Again, as tempting as it is, the best advice to prevent scarring is not to pick pimples. "Picking worsens the problem and increases the risk of scarring," Dr. Guanche said. Instead of picking, you can apply a targeted spot treatment, or better yet, spot patches to help you fight the urge.
The second best line of defence is to wear sunscreen no matter what. "SPF will help fade the scars and prevent post-inflammatory pigmentation," Worden said.