Acne scars on the face, chest and back are very common. Some 80% of people between ages 11 and 30 will get acne, and one out of five of those people will develop scars. Reducing the scars requires treatment either over-the-counter medications or one or more procedures performed by a dermatologist.
Who gets acne scars?
Some people are more likely to see scars when their acne clears. The risk increases when a person:
- Has inflammatory (swollen, reddish, and painful) acne
These often include acne cysts and nodules. This type of acne tends to penetrate deep into the skin, which damages the skin. - Delays or does not treat inflammatory acne
The longer a person has inflammatory acne, the greater the risk of scarring. - Picks, squeezes, or pops acne
This increases inflammation, which increases the risk of scarring. - Has a blood relative who developed acne scars
Genes play a large role.
Although we know what increases a person’s risk of developing acne scars, it is not possible to predict who will develop acne scars. Even people who have all the risk factors may not scar.
It is, however, possible to prevent acne scars with effective acne treatment.
Waiting to treat acne until it becomes severe can lead to extensive scarring.
What causes acne scars?
When acne breakouts penetrate the skin deeply, they damage the skin and the tissue beneath it. As the acne clears, the body tries to repair this damage.
During the healing process, the body produces collagen—a substance that gives the skin support. If the body produces too little or too much collagen, you will see a scar.
The type of scar depends on how much collagen your body makes.
Depressed acne scars: If the body produces too little collagen, depressions or pits form as the skin heals.
Raised acne scars: Sometimes the body produces too much collagen as it tries to heal the skin and underlying tissue. When this happens, a person develops a raised acne scar. This type of acne scar is more common in people who have skin of color like African Americans, Hispanics, and Asians.
Even when we do our best to prevent acne scars, some people scar. There are many treatment options, which can significantly diminish depressed and raised acne scars.
Are acne scars permanent?
Now time for some good news. Christenson says there are definitely things you can do to reduce acne scarring once you have it.
“The best course of treatment depends on the type of scarring you have, with indentation scarring often requiring more advanced treatment,” says Christenson.
For discoloration acne scarring, start by trying the at-home retail topicals aimed at counteracting hyperpigmentation, such as brightening serums or retinol-containing products.
“The one watch-out about using retinol is that it can make your skin more sun-sensitive. It’s always important to use sunscreen to protect your skin, but be even more diligent about applying sunscreen while using a retinol product,” warns Christenson.
For hyperpigmentation that doesn’t respond to retail products, and for the deeper indentation scarring, Christenson recommends the more advanced treatment options a medical aesthetician can provide, including:
- Chemical peels
- Microneedling
- Prescription brightening products
“Chemical peels are great for both discoloration and indentation scarring, and these peels can also help with what’s called ice pick scarring — very deep indentations that form due to severe acne lesions,” explains Christenson. “Microneedling, which uses tiny needles to stimulate your skin’s healing process, works incredibly well to reduce indentation scarring and make your skin look smoother.”
Lastly, for discoloration scarring, a skin-brightening product containing 4% hydroquinone typically offers the best results. However, it must be purchased in a medical office.
5 tips for preventing acne scars
While there are treatments for acne scarring, you might also consider the following tips for preventing scarring in the first place.
1. Avoid the urge to pop a pimple
As mentioned, serious squeezing, pinching and scraping of pimples causes more harm than help, making it more likely for you to scar. In addition, popping a pimple may result in a small, local infection or result in you inadvertently spreading acne elsewhere on your skin — again, more chance for scarring.
2. Know the different types of acne
You see the whiteheads, blackheads and pimples, but have you ever wondered about those acne bumps that never actually seem to surface. They’re hard, red bumps that can really hurt, but, unlike other types of acne, they remain under the surface of your skin.
“Cystic acne is a type of acne characterized by inflammation underneath the skin with no pore to the surface. Since there’s nowhere for the fluid to actually come out, you really want to avoid trying to apply pressure to cystic acne. Attempting to pinch or pop this type of acne will just lead to the inflammation spreading underneath the skin, creating a larger area of damage and, ultimately, a larger area of discoloration scarring,” explains Christenson.
For cystic acne, Christenson recommends applying ice to help relieve the inflammation — and leaving it at that.
3. If you really want to handle a whitehead or blackhead, don’t overdo it
Whiteheads and blackheads are unsightly, so — naturally — you want them gone.
If you want to take action on a whitehead, Christenson recommends following these steps:
- Wash your hands
- Gently apply light pressure to remove the whitehead
- Wipe the area with alcohol
- Apple an acne serum
- Wash your hands again
“If removing the whitehead takes anything more than gentle pressure, stop what you’re doing and try again the next day,” recommends Christenson.
And while blackhead removers can help clear your pores, Christenson adds that you should only use these devices if (and only if) you know how to do so correctly.
“It’s very easy to get carried away while using a blackhead extractor, especially if you have a heavy hand. These devices can be dangerous if not used correctly,” warns Christenson.
4. Start acne treatment ahead of time
If you break out once a month or in a predictable cycle, start treating your skin early.
The type of acne treatment that works best varies from person to person, but consider applying your acne serum, retinol product or antibacterial topical before the breakout even begins.
“In addition to these topicals, wearing sunscreen can help prevent any hyperpigmentation that may occur as a result of acne,” adds Christenson. “Just be sure to choose a sunscreen that’s appropriate for your skin. A sunscreen that clogs your pores can make your acne worse, causing more chance for scarring.”
5. See a skin care specialist
If you feel like you’re using all the right at-home preventive measures but still can’t control your acne or acne scarring, consider seeing a medical aesthetician.
“In our medical spa, we offer many advanced, effective treatments for acne and acne scarring, including chemical peels, microneedling, hydrafacials and prescription skin products,” adds Christenson. “We can also help you understand your skin and recommend the retail topical products we trust.”
In particular, Christenson recommends visiting a medical aesthetician for help with treatments and choosing the correct products for your skin if you’re prone to acne and/or acne scarring.
“Having monthly maintenance skin care retreatments, including facials, can be very helpful. It can also help with anti-aging in the long run!” adds Christenson.