We all have experienced some sort of blemish, pimple or blackhead at some point of our lives because no one's skin is perfect. Everyone has pores even though most filters these days tend to tell us otherwise. Skin is perfectly imperfect and it's okay to have pores, it's normal to get blackheads and/or congestion, and acne scarring to some degree happens more often than you'd think.
Textured Acne Scarring
There are many kinds of acne scarring and they vary in degree of severity from one person to another. Textured acne scarring comes from the damage, loss or overgrowth of tissue to the follicle resulting in an indentation or raised scar. Icepick, rolling or boxcar scarring would be considered atrophic scarring meaning there is loss of collagen and tissue creating a pitted or indented scar. Keloid scarring would be the opposite type of scarring where there is an overgrowth of scar tissue leaving a raised scar.
Treatments for Textured Scarring
Acne scars that are indented like icepick, rolling or boxcar need treatments that are going to help regenerate collagen or resurface the skin to reduce the appearance. Professional strength peels like the VI Peel, is a medium depth peel to help make scarring go from deep to shallow smoothing out the harsh texture. Professional depth Microneedling would be another option for this type of scarring however, I say professional as the over the counter dermarollers and at home microneedling is not the same thing! The depth of the needle that is required to effectively, safely and hygienically treat scar tissue will require topical numbing and the skin will require some down time. This type of healing is making changes to the skin unlike the shallow depth and risk for infection that you would get at home. More aggressive treatments like Fractionated CO2 or Pixel Resurfacing have more downtime but faster results. These deeper laser treatments make tiny little pin-point holes in the skin to stimulate collagen production helping in smoothing out the texture. Subcision is another lesser known treatment done with a needle under numbed skin, moved back and forth to break up that scar tissue.
Post-Inflammatory Hyperpigmentation Scarring
PIH is the overproduction of melanin in the skin triggered by the skin’s natural response to inflammation. Common causes are acne, a cut, cold sores, a rash, sunburn and heat/hot weather. Discoloration that forms can range from light to deep, pink to brown or even black.
Treatments for PIH Scarring
First and foremost sunscreen! I cannot stress the importance of sunscreen enough. Not only will it prevent future PIH from popping up, it also prevents the current PIH on the skin from getting darker. SPF = BFF every day! Another way to speed up the recovery time for PIH is to speed up your cellular turnover. Cell turnover starts to slow down at the early age of 25! Exfoliation is important to keeping our skin glowy and thriving. Products like retinols, tretinoin and AHA’s (glycolic/lactic acid) will help aid in cell turnover and can get rid of that unwanted PIH a little faster.
Professional strength peels are great for both PIH and textural scarring. VI Peels will help resurface the skin eliminating pigment while restoring collagen. If you are concerned with just the PIH, peels involving less downtime like glycolic acid peels can be very beneficial as well. Laser treatments such as IPL Photofacials would be another treatment I would recommend for PIH as it can quickly diminish both the red and brown pigment left behind from an old acne blemish. The heat from laser treatment can also aid in killing bacteria for any current acne marks. Professional Microneedling would be a great treatment for those who have both PIH and textural scarring. Since microneedling is resurfacing the skin it can help reduce the appearance of both pigment and divots left behind from acne.
What Treatment Would be Best for Me
Finding out which type of acne scarring you have, either textural or PIH, would be the first step. Some of the treatments mentioned above can be beneficial for both active acne and scarring while other treatments would be best if all active acne was cleared up first. Here at ZONA we would love to sit down and discuss your skin concerns to guide you in the right direction. The skin you’ve always wanted does take time. When dealing with acne scarring know that improvements can definitely be made but patience is key. Stay diligent with your at home care as well as your in office care and you’ll have smoother, brighter skin before you know it!