MDacne
There are two main types of acne scars. Physical scars that can be felt with the hand and pigmented flat spots are color changes. The most common physical scars will look like depressions in your skin or deep holes, also called ice-pick scars.
What are the best treatments for flat hyperpigmented acne "scars"?
The treatment of hyperpigmentation should always start with good oil-free sunscreen. SPF 30 is optimal; higher SPFs contain more chemicals and increase the risk of allergies.
The second step is to use a dark spot remover. The best ingredients to look for in skin-brightening creams are hydroquinone in the USA and arbutin outside the USA. Arbutin is a natural substance that transforms into hydroquinone in the skin. In combination with other ingredients, it can help fade hyperpigmentation.
What are the best surgical treatments for physical acne scars?
Surgical procedures performed in a dermatologist's office are the most effective treatments for this type of scar. Cutting the collagen fibers under the scars (undermining) is the most common surgical treatment for depressed acne scars. A less invasive procedure is microneedle radiofrequency, which can significantly improve physical acne scars and make the skin smoother and less bumpy.
What are the best non-surgical treatments for physical acne scars?
Some improvements can also be achieved with non-surgical methods.
Retinol is the most effective topical treatment for existing textured scars. If used correctly for at least six months, it gradually exfoliates the skin and produces new collagen fibers in the dermis. These effects can decrease the depths and the appearance of depressed acne scars and provide a healthier, brighter look for the skin. Combined with niacinamide and dimethicone, high-quality retinol will cause less redness and irritation than the simple "one size fits all" prescription retinoids.
A topical scar cream with peptides and ceramides can speed up healing of blemishes, strengthen skin barrier, reduce inflammation, and improve texture in newer scars.
How to use exfoliation for the treatment of depressed acne scars?
Using particle scrubs or electric spin brushes is not good for people with physical scars. If they damage the skin's protective barrier layer, they can cause more dark spots and acne breakouts. The correct way to exfoliate the skin is with several well-researched topical agents: retinol and alpha and beta hydroxy acids (AHA/BHA).
The most effective of those would be retinol. Used in the adequate percentage of 0.25%-0.5%, it causes a mild, invisible exfoliation of the skin's upper layer. With time it renews the epidermis and makes the skin smoother and brighter. More importantly, retinol penetrates deeper into the dermis and triggers the production of new collagen. If used for at least six months, these effects will reduce the appearance of physical scars and provide a smoother, glowing look to the skin. Combining niacinamide with retinol will enhance the beneficial effects of retinol while reducing skin redness and irritation.
Alpha and beta hydroxy acids are also effective peeling agents for the epidermis. However, AHAs and BHAs will not have the same effect as retinol on the dermis and will not help with collagen production, depressed scars, or fine wrinkles.
What is the effect of silicone anti-scar sheets, creams, and gels?
Silicone sheets can sometimes help with hypertrophic, raised scars. The best choice for depressed scars is dimethicone, a type of silicone used in a high-end moisturizing cream. Combined with active peptides, ceramides, and other ingredients, Dimethicone reduces the appearance of depressed scars.
Shop:
Peptide Scar Cream
Retinol + Niacinamide Treatment Cream
References:
- Goodman GJ, Baron JA. Post acne scarring: a qualitative global scarring grading system. Dermatol Surg. 2006;32(12):1458-1466.
- Layton AM. Optimal management of acne to prevent scarring and psychological sequelae. Am J Clin Dermatol. 2011;12(5):283-294.
- Fabbrocini G, Annunziata MC, D'Arco V, et al. Acne scars: pathogenesis, classification, and treatment. Dermatol Res Pract. 2010;2010:893080.
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