Acne is a skin condition that affects up to 80% of people in their teens and twenties, and up to 5% of older adults. While many people recover from acne without any permanent effects, some people are left with disfiguring acne scars. There are some topical skin care products and medications that can improve mild scarring, but most acne scars are treated with a combination of surgical procedures and skin resurfacing.


Early Acne Scars

After an acne lesion has healed, it can leave a red or hyperpigmented mark on the skin. This is actually not a scar, but rather a post-inflammatory change. The redness or hyperpigmentation is seen as the skin goes through its healing and remodeling process, which takes approximately 6-12 months. If no more acne lesions develop in that area, the skin can heal normally. Any color change or skin defect still present after 1 year is considered to be a permanent defect or scar.


Preventing Early Acne Scars

The best way to prevent post-inflammatory changes caused by acne is to prevent acne lesions from occurring. This is done by understanding the factors that cause acne and using the appropriate treatments for the different acne types. See the following articles for more information about acne causes and treatments.


Treating Early Acne Scars

The post-inflammatory changes caused by acne are part of the skin's natural healing process. There are certain practices and medications that can help facilitate this healing process.

  • Unprotected exposure to the sun causes more skin damage and delays healing, therefore wearing a good sunscreen is important.
  • Using tretinoin (Retin-A, Renova, Avita) speeds up the skin's remodeling process and helps heal post-inflammatory changes.
  • Appropriate formulations of Alpha-Hydroxy Acids (AHAs) and Beta-Hydroxy Acid (BHA) that contain the correct concentrations and are at the appropriate pH also help the skin's remodeling process.
  • Picking at scabs should be avoided at all costs. Scabs form to protect the healing process that is going on underneath them. Pulling a scab off before it is ready interferes with the healing and remodeling process, prolonging the time that post-inflammatory changes will be visible.

    Antioxidants and Post-Inflammatory Changes

    As we understand more about skin damage from free-radicals, it seems that using an antioxidant would help treat post-inflammatory changes or even permanent scars. Unfortunately no good scientific studies have shown that any oral or topical antioxidant prevents or heals skin damage. As a matter of fact, Vitamin E, when applied topically to healing wounds, has been shown to cause more harm than good. As antioxidant research continues, scientists may find a formulation that effectively reverses skin damage, but until then any claims of skin rejuvenation through the use of antioxidants are merely hype.


    Acne Scars - Icepick

    Icepick scars are narrow, sharp scars that make the skin appear it has been punctured with an icepick. They are usually narrower than 2 mm and extend into the deep dermis or subcutaneous layer. Icepick scars are usually too deep to correct with skin resurfacing treatments such as dermabrasion or laser resurfacing.


    Acne Scars - Boxcar

    Boxcar scars are round to oval depressions that have sharp vertical edges. Unlike icepick scars they do not taper to a point at the base. Shallow boxcar scars are 0.1-0.5 mm in depth and can usually be treated with conventional skin resurfacing techniques. Deep boxcar scars are >0.5 mm in depth and require full-thickness treatment techniques.


    Acne Scars - Rolling

    Rolling scars occur as a result of tethering of otherwise normal-appearing skin to the subcutaneous tissue below. This process gives the skin a rolling or undulating appearance. Conventional skin resurfacing techniques do not work on rolling scars. They must be corrected by breaking up the subcutaneous fibrous bands.


    Acne Scar Treatment After Accutane

    An important consideration in the treatment of acne scars is the past use of accutane. There are numerous procedures that can be used to correct acne scars. Each procedure has its own risks and benefits, and several procedures are normally combined to create the smoothest appearing skin. Here is a brief discussion of the more effective acne treatment procedures.


    Dermal Fillers

    There are many types of dermal fillers that can be injected into acne scars to raise the surface of the skin and give a smoother look. Examples of dermal fillers are fat, bovine collagen, human collagen, hyaluronic acid derivatives, and polytheyl-methacrylate microspheres with collagen. The injection of these materials does not permanently correct acne scars, so further injections are necessary.


    Punch Excision

    This method of surgically correcting acne scars is used on deep scars such as icepick and deep boxcar scars. This procedure uses a punch biopsy tool which is basically a round, sharp "cookie-cutter" tool that comes in diameters ranging from 1.5 mm to 3.5 mm. The size of the tool is matched to the size of the scar to include the walls of the scar. Under local anesthesia the scar is excised with the punch tool and the skin edges are sutured together. The newly produced scar eventually fades and may not be noticeable. If it is noticeable, it is more amenable now to resurfacing techniques.


    If you’re on a constant hunt for industrial strength concealer, have spent more money than sense on eye cream and you hear the phrase “You look tired today” more than your own name some weeks, then I can empathise.


    Under eye bags and dark circles have been the bane of my beauty life since I traded in leisurely university lie-ins, for late nights and early mornings. But recently, no matter how much sleep I seemed to get, those two bags packed for a week-long vacay didn’t want to budge.


    Sadly, cosmetic products aren’t legitimate miracle workers (despite what it says on the tube) and there are no quick fixes. But there are ways to reduce your under eye bags, even almost completely, you just a little help from the experts...


    The Nutritionist

    According to Chelsea-based nutritionist Petronella Ravenshear, it’s not so much about which foods to eat than which foods to avoid. She told HuffPost UK Style: “Wheat is the main culprit for dark circles - sometimes called ‘allergic shiners’! Very often when people stop eating wheat the black bags magically disappear. “Other than food allergy or intolerance, dark circles can also be a sign of poor detoxification and lymphatic congestion.”


    If you’re feeling sluggish, plenty of water, a healthy diet with lots of fresh fruit and veg, regular exercise and dry body brushing are all brilliant ways to boost your lymphatic system.


    The Facialist

    Lymphatic congestion can also be eased with targeted massage techniques, as loved by facialist Antonia Burrell (who’s famed in celeb circles for her de-puffing facials) Burrell shared her method with HuffPost UK Style, “I recommend gently placing your ring fingers in the corners of your eyes nearest your nose, and gently rotating them along your eye line. “This technique helps to improve circulation. You might feel a dull ache in some areas, but this is actually a good sign as it means you are easing congestion.” You might need to do this more in the summer season as hay fever is a big cause of congested sinuses and swollen eyes (and the pollen count is soaring right now!). Beauty blogger and facialist Caroline Hirons has also shared an imperative piece of beauty wisdom when it comes to selecting an eye cream. In her eye cream “cheat sheet” blog post, Hirons recommends sticking to serums and lighter formulas so as not to cause further puffiness.

    Make a Reservation