What causes acne scars?
Acne scars can happen for every skin type and skin tone. As the acne pimple heals, the skin tries to repair this damage. During the healing process, the fibroblasts in the lower layer of the skin (dermis) produce collagen fibers — the rope-like fibers that support the skin. If the fibroblasts produce too little or too much collagen, a scar will form. The type of scar depends on how much collagen your body makes. Current research shows that having the correct levels of nutrients can enhance wound healing improve current scars, and prevent future scars.
What are the types of acne scars?
There are three main types of post-acne signs. Brown spots, pink spots, and real acne scars—also referred to as "ice-pick," "boxcar," or "rolling" scars.
Pink Spots: Post-acne pink spots are caused by dilated skin capillaries and will usually fade away on their own within about 2-3 months (once the active acne is controlled).
Brown Spots: A post-acne brown spot (dark spot) is a round flat brown lesion - similar to a sunspot or freckles. As your acne heals and inflammation decreases, a dark spot can appear in its place. You see a mix of dead skin cells and an excess of brown pigment (melanin).
Real Acne Scars: Real depressed acne scars are caused by poor healing of the acne pimples. Instead of healing the skin thoroughly, the skin's healing mechanisms produce an excessive amount of collagen fibers that pull down the skin and cause the typical sunken of ice-pick like acne scars.
How to prevent acne scars?
The best way to prevent acne scars is with early and effective treatment of active acne. Every active acne pimple can leave a scar behind. As a rule, people that have more acne breakouts with deeper acne pimples will have more acne scars. Untreated acne causes damage to the skin tissues, which can frequently heal in a non-optimal way, leaving a depression in the skin or post-acne brown spots (hyperpigmentation).
Fortunately, effective personalized acne treatment is more affordable than ever. In most cases, Using the correct over the counter medications can help with acne without the need for pricey Dermatologist prescribed medications.
Popping up pimples is also a cause for more acne scars. When one tries to pop the pimple, the finger causes mechanical trauma to the skin, increasing the scars' risk.
Using an oil-free sunscreen and the right skincare products can help prevent the development of post-acne dark spots. Keeping the skin moisturized during acne treatment can the skin healing processes and reduce acne scars' risk and severity. Active acne-prone skin moisturizers with niacinamide can help protect the natural skin barrier and reduce the tissue damage that active acne causes.
What are the best supplements for acne scars?
Taking acne supplements can help the wound healing process and reduce the risk of scarring. The most important vitamins and minerals that play a role in wound healing and treatment of existing scars are the vitamins from the B family, Vitamins A, the minerals zinc and selenium, and to a lesser extent vitamins C and D.
Regular "one size fits all" skin and hair multivitamins are not the best choice for people with acne scars. They will usually contain a large amount s of biotin and vitamin E, which can counteract the beneficial effect of vitamins A and B5 on active acne and acne scars. A better choice is that vitamin and mineral supplements are specially formulated for acne and acne scars. This vitamins and mineral formulation contain the correct amount of vitamins (especially A and B5) and the correct amount of Zinc, with less Biotin and Vitamin E.
Vitamin A supplements for Acne Scars
As acne pimples are healing, vitamin A is responsible for forming new blood vessels and new connective tissue production. One study has shown that Vitamin A can modulate the renewal of damaged skin capillaries, melanocytes, and fibroblasts by binding to retinoic acid receptors. A recent study of researchers found that deficiency of Vitamin A is related to more skin inflammation and decreased capacity to renew the upper layer of the skin (epithelialization) and to produce new collagen in the dermis. Another study has found that vitamin A supplements counteract the delay in wound healing caused by corticosteroids.
Vitamin B Supplements for Acne Scars
B vitamins help with wound healing by increasing protein synthesis and enabling more repair cells to the site. B1 and B5 are essential for promoting skin health by strengthening scar tissue and increasing the number of fibroblasts that help secrete collagen. Vitamins B1, B2, B6, B9 (folic acid), Vitamin B5 (pantothenic acid), and Vitamin B12 (cobalamins) are essential factors in the enzyme reactions involved in wound healing. Research has also shown that Thiamine (B1), riboflavin (B2), pyridoxine (B6), and cobalamins (B12) are also required for the synthesis of collagen. Vitamin B12 (Methylcobalamin) enhances protein synthesis and increases the number of repair cells at the surgical or injured site.
Zinc for Acne Scars
Zinc serves as a cofactor for numerous reactions vital to healing wounds and reducing scar tissue. Zinc helps in the synthesis of new collagen. One study has shown that Zinc can reduce the healing time of surgical wounds by 43 percent. Zinc deficiencies have been associated with delayed or slowed healing and reduced wound strength. Other studies have shown that Zinc is a micronutrient essential for the human skin's development and functioning. It is bacteriostatic against Propionibacterium acnes, inhibits chemotaxis, and reduces pro-inflammatory cytokine production.
Selenium for Acne Scars
Selenium (l-selenomethionine) increases cell movement and wound healing by preventing hydrogen peroxide accumulation in tissues.
Vitamin C for Acne Scars
Vitamin C (ascorbic acid) improves wound strength and aids the production of collagen. It is also vital for developing new blood vessels that help to transport nutrients to the wound. It was found that Vitamin C has a role in cell migration, collagen synthesis, antioxidant response, and angiogenesis. Research has shown that vitamin C forms extra-bounds between collagen fibers that increase the dermis' stability and strength during collagen synthesis. In another study, it was found that Vitamin C also helps counteract free radicals in damaged cells, while its deficiency might increase new vessels' fragility.
Vitamin E for Acne Scars
Although most vitamins help in wound healing, vitamin E oral supplements might negatively affect collagen synthesis and counteract the benefits of vitamin A supplementation in wound management. Some people believe that applying vitamin E oil onto your acne scars can help them heal. Unfortunately, the proof for these effects is anecdotal.
What is the best cream for acne scars?
Topical creams can not eliminate real depressed (atrophic) acne scars. That said, using topical retinoids for long periods can help smooth the skin. Retinol, a derivative of vitamin A, is one of the best options available over the counter and does not require a dermatologist prescription. Acting as topical vitamin A, retinol was shown to promote skin cell turnover and renewal and increase new collagen fiber production in the dermis. High-quality retinol will also cause mild exfoliating to the upper surface of the skin, providing a fresher natural glow to the skin. If your concern is mainly post-acne dark spots, you may also want to check out the Medicated Dark Spot Remover, which can be used alongside your acne treatment (on alternating nights) to help treat dark spots more quickly.
What is the best in-office surgical treatment for acne scars?
Chemical peels can help with superficial acne scarring and hyperpigmentation. Deeper acne scars should be usually treated by surgery or minimally invasive procedures (micro-needling with RF or laser treatment).
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More info on pantothenic acid for people with acne.
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