Now that we're all up to snuff on dealing with hyperpigmentation (and if you're not, click here), it's high time to tackle a slightly more stubborn issue: acne scars. Is the anticipation killing you? Good.
First thing: Determine if what you're dealing with is actually an acne scar. “A lot of people come and say they have acne scars, but actually what they have is either hyperpigmentation or residual redness,” said Cybele Fishman, a dermatologist in New York City. “For that, we can use hydroquinone, chemical peels, or even just wait the redness out. However, if the dermis has been disrupted, there are other options,” Boxcar, rolling, and ice pick scars are some of the most common—talking to a doctor or consulting Google Images can help you figure out what you're dealing with.
The next step is to assess your options. We'll go through the “can't do at home' ones first.
Lasers
'The best data,” Fishman said, “recommends fractional ablative lasers versus non-ablative. This basically causes injury to the epidermis and the dermis, stimulating collagen production to remodel how the skin looks,” Again, seeing that this is very much an in-office procedure, your doctor can guide you better on which brand of laser treatment to consider.
Microneedling
'This is a less expensive, less aggressive way of causing injury to the skin to promote healing,” Fishman said. “I just ordered the Eclipse MicroPen for my office and am super-psyched based on the patients I treated as demos, who were thrilled with results. Not everyone can afford fractional lasers and there's no downtime with microneedling,”
Injectables and Fillers
'Sometimes people have such deep scars, they need them filled,” Fishman explained. “I use Belotero and Radiesse for this. Basically, you are adding volume where it is missing,” Conversely, liquid cortisone injections can be used to treat keloid or hypertrophic scars that appear overgrown on the skin.
As for the at-home alternatives, most products are going to treat the discoloration associated with acne scars, as well as keeping any recent injuries hydrated—anything that keeps the wound moist is going to promote healing. Fishman recommends prescription-strength Retin-A for shallow scars and potentially silicone sheets or gels to minimize scarring after surgery. “They are not trendy or sexy, but they work,” she said.
Also, anything that stimulates collagen production and cell turnover is your friend. Yüli Cell Perfecto PM is a particularly effective all-in-one cure for scrapes and cuts (true acne scars might need something a little bit more hardcore)—it speeds up the healing process while regulating pigmentation and relieving undue stress on the injury. Bio-Oil is another standby. It's used it in burn units around the world, so you know it's good.
What else is good? Your acne scar recommendations. Lay 'em down below.
Photographed by Tom Newton. For more on acne, click here.