Teach Me

How You Can Prevent and Treat Unsightly Acne Scars

Fighting acne is bad enough—you try to keep your skin clear, but you can’t seem to stay ahead of the breakouts. And to make matters worse, those breakouts can lead to unsightly scars.

Fortunately, there are ways to prevent breakouts and keep those scars from cropping up. And if you’re already seeing some scars, new treatments can help minimize their appearance.

How to prevent acne scars

Joshua Tournas, MD, a dermatologist with Banner Health Center in Sun City West, AZ, said to reduce the risk of scarring you want to aggressively control the acne. “It pains me sometimes to see kids, parents, young adults, and even doctors sometimes who think you’ll just grow out of acne,” he said. “Keeping your skin clear is how you prevent scars.”

If your acne is mild, you might be able to treat it at home with over-the-counter medications like benzoyl peroxide or retinoids. If over-the-counter treatments aren’t working or you’re starting to see signs of scarring, see your physician or a dermatologist. “If you’re questioning whether your acne is severe enough to see a doctor, you should probably see a doctor,” Dr. Tournas said.

About one-quarter of people with acne develop what’s called cystic acne, which is more aggressive and inflammatory. It’s most common on the face, chest, and back and develops when acne gets severe. “It can be devastating,” Dr. Tournas said.

How to treat acne scars

Before you treat your acne scars, step one is to get your acne under control. “If people come to me for treatment for their scars and they’re still breaking out, I will often send them back to the dermatologist,” Dr. Tournas said.

Once your acne clears up, you have different treatment options to consider depending on how much scarring you have.

For very mild scarring, Retin-A, microdermabrasion, dermaplaning, chemical peels, or filler injections can work.

But for most acne scarring, laser therapy is the gold standard. With acne scarring, it’s often the transition between the scar and the normal skin that’s more visible, and laser treatments can smooth that transition. “If you can blunt it—soften the transition between the scar and normal skin—you can see some real improvement in people’s complexions, especially on the cheeks, chin, and jawline,” Dr. Tournas said.

There are two types of laser treatments—non-ablative and ablative. The non-ablative laser treatment is less aggressive. It heats up small columns of tissue and leaves normal tissue in between the columns. The more aggressive ablative laser treatment uses a carbon dioxide laser to vaporize the columns of tissue.

With both treatment options, new, healthy skin grows in to replace the scar tissue. “It’s like aerating your lawn,” Dr. Tournas said.  He typically uses the less-aggressive laser treatment on milder cases of acne scarring and the more-aggressive carbon dioxide laser on moderate and severe cases.

For sunken acne scars, microneedling could be an option. That’s a technique where a doctor uses a needle to loosen the tissue underneath the scar and break down the scar tissue.

Scars on the chest and back can be more difficult to treat, and for them you might need steroid injections.

Treating your acne scars takes time. “Scars didn’t appear overnight, and they don’t disappear overnight, whether you use a topical treatment, a chemical peel, or a laser,” Dr. Tournas said. With laser treatments, you should see a slight improvement with each session and as you progress you can decide how many treatments are necessary.

Once your treatment is completed, you want to keep your acne under control. “The last thing I want is to treat someone, then have them come back for more treatments. That can be discouraging,” Dr Tournas said.

The bottom line

Acne scars are preventable, and if they do develop, they’re treatable. If you’re unhappy with the appearance of your skin because of acne scars, talk to an expert who can outline the pros and cons of your treatment options. For a referral to a Banner Health dermatologist, visit bannerhealth.com.

And don’t assume your acne scars are permanent. “We have really good laser treatments now. They aren’t magic erasers, but they reduce the appearance of scars. Some people think there’s nothing they can do—that they have to live with acne scars. That’s not true anymore,” Dr. Tournas said.

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