The 10 most common acne scars questions

15% of the People with untreated acne are left with acne scars. The best treatment for acne scars is to prevent them. Early acne treatment is now much more effective easy and affordable than ever. People that will use a good set of anti-acne products, that are customized to their skin type and acne severity can expect great results, even without oral medications. What should one do if she/he is left with red spots, brown or depressed scars (=valleys in the skin)? Here are the 10 most common acne scars questions people with acne are interested in.

[1] How do I get rid of acne scars? What is the best solution?

Acne scars are caused by damage to the deeper part of the skin (Dermis). 

Post acne "scars"  can be divided into 3 groups:

1. Flat, pink, reddish spots:  Flat, pinkish colored dots. These spots are caused by the enlargement of microscopic capillaries. These capillaries which will actually fade by themselves in a few weeks to months even without treatment.

2. Flat brown spots: Some of these will fade by themselves while others will need further treatment. Treatment for these spots is usually quite easy and will include whitening creams (prescribed to you by your doctor) or superficial chemical peels.

3. Persistent pink and brown spots: Can be treated with light sources, called Intense Pulse light (IPL). These IPL’s produce intense pulses of light very similar to a camera flash. The light is absorbed in small capillaries, and the melanin globules in the spots cause them to fade.

4. Real Acne Scars: These are cases when skin texture is affected, depressed (like a crater), or elevated like a “hill.”

There are 5 main types of real acne scars:

1. Hypertrophic acne scars: elevated scars that are confined within the margins of an original pimple.

2. Keloid acne scars: elevated scars that are larger in size than the original pimple margins. Keloid post acne scars are commonly found on the chest, back, shoulders, and ears. These acne scars are very persistent and are found almost equally among male and female patients. Keloid acne scars are less common in the very young or old. The most popular treatment for keloid acne scars is a combination of intralesional injection of steroids into the scars combined with cryotherapy (liquid nitrogen freezing of the scar tissue). Another popular treatment is a silicon anti-scar sheet.  These silicon sheets should be kept on the scars for a few months.  Some of the users of these sheets report flatter and less red keloid scars.

Both hypertrophic scars and keloids demonstrate thicker, more abundant collagen that is stretched and aligned in the same plane as the epidermis. Both keloids and hypertrophic scars have an incidence of 5 to 15 times higher in African Americans and 3 to 5 times higher in Asians compared with Caucasians. It is estimated that they affect both the African American and Hispanic populations between 4.5% and 16%.

3. Icepick scars:  Usually smaller in diameter (1-2 mm) and deep with tracks to the dermis or subcutaneous tissue possible. Although the surface opening is smaller and steep-sided, there may be a wide base that could later evolve into depressed or boxcar scars. Icepick scars are commonly seen on the cheeks.

4. Depressed or boxcar scars: Shallow (0.5 mm) or deep (0.5 mm) and are often 1.5 to 4 mm in diameter. They have sharply defined edges with steep, almost vertical walls. Shallow scar treatment can be with resurfacing or possibly punch elevation whereas deep scar treatment is most often done by punch excision, elevation, or other modality.

5. Soft rolling scars: Can be circular or linear, are often greater than 4 mm in diameter, and have gently sloped edges that merge with normal-appearing skin. Treatment is commonly by subcision.

Acne scars can be improved by the minimally invasive treatments that are available today in many Dermatologists offices. Systems that use non-insulated fractional microneedle RF technologies (such as Endymed’s Intensif system) seem to be more efficient and safe than the fractional lasers, especially on darker skin types.

[2] Should I buy a Derma Roller for acne scars?

Derma rollers are not the best for people with acne. If you have active acne they can spread the bacteria, and cause more acne breakouts. In some cases, Derma rollers can also cause more brown spots. Derma roller is a good option for people with fair skin types that have depressed acne scars without active pimples. Using sun protection and whitening creams are more effective and much better option for brown spots.

[3] Is there a way to get rid of the red marks that acne spots leave after they go away?

Post-acne red marks are caused by enlargement of microscopic capillaries. Fortunately, pink spots will usually fade without special treatment in a few weeks after your active Acne is over. All you need to is prevent new pimples with a good mild anti-acne cream and use an oil-free sunscreen each morning. If needed, persistent pink can be also treated with light sources, called Intense Pulse light (IPL). These IPL’s produce intense pulses of light very similar to camera flash. The light is absorbed in small capillaries in the spots causing them to fade faster.

[4] How to get rid of post-acne dark spots?

Treatment for brown post acne spots is usually quite easy and will include over the counter lightening agents or stronger prescription based whitening creams that contain hydroquinone. The best dark spots treatment ingredients available over the counter are hydroquinone, arbutin, kojic acid, licorice, and green tea. Licorice and green tea are natural ingredients that have been shown to be very safe and can help face post acne brown spots if used for at least 3 months. (a good example for anti-acne products that contain Licorice and green tea are MDacne products). Arbutin is a natural derivative of hydroquinone derived from plants, including bearberry, blueberry, and cranberry. Some cosmetic products contain 3% concentrations, which studies show can significantly lighten the skin. Kojic Acid is an antioxidant derived from a fungus. It works by breaking down melanin in the skin and preventing its production in the skin. Kojic Acid is found in cosmeceuticals in 1% to 4% concentrations either combined with other skin-lightening agents or by itself.

[5] Is there anything I can do to clear up my post-acne marks faster? Does benzoyl peroxide work?

Benzoyl peroxide (BP) is the best single topical ingredient to prevent and treat red active acne pimples. Unfortunately, BP does not help with existing post acne brown spots. To fade these post-acne marks, you need to look for whitening creams. Some of the new anti-acne products contain ingredients that also help face brown acne spots.

[6] I have some red spots (But there actually isn't anything there, like underneath the skin, they're just red) — how do I get rid of them?

The treatments for red/pink spots are different than the ones for brown spots. The flat pink reddish spots that remain on your skin after the pimples heal are actually enlarged blood capillaries. In most cases, these pink spots will fade in a few weeks to months without special treatment. If these pink spots do not fade, they can be treated with lasers or Intense Pulse light (IPL). These lasers, used by many Dermatologists. produce intense pulses of light that absorbed in these small capillaries. The heat produced by the laser coagulates these capillaries eliminating the pink spots. Treatment for brown post acne spots is usually quite easy and will include over the counter whitening creams or stronger prescription whitening creams that contain hydroquinone. The more persistent brown spots can be treated by special superficial chemical peels (Jessner’s solution) or by the same lasers or IPLs used to treat red spots. These lasers destruct the excess melanin in the skin fading the brown spots.

[7] I have school in 2 weeks. What can I do to get rid of my acne scars and acne?

Even the most powerful anti-acne drugs, like accuatne, will need 3-5 months to control active acne. To get rid of your acne you need some patience and commitment. If your acne is mild-moderate, you can expect to see some improvement after 4-6 weeks and get much better in 8-12 weeks.

The best way to make your acne go away is; 1. Learn what causes your acne breakouts and learn how to avoid these factors. 2. Use your MDacne app to understand what is the severity of your acne and which products you need to use. 3. Commit to your treatment and track your skin improvement with the app at least twice a day. It was shown that people that track their skin improve faster.

[8] Is there any way to stop foundation creasing around depressed scars on the forehead?

Here some tips for reducing foundation creasing around depressed acne scars:

  • Use less foundation: the more you use, the more there will be available to migrate into the creases.
  • Translucent setting powder with a damp sponge: applying the powder with a damp sponge makes the powder cling more tightly to the foundation, and therefore sets it better.
  • Use a setting spray: setting spray can make all the difference as to whether the makeup creases over time. The best part is that if you apply it after you set the area with powder then it helps everything to look more natural and skin-like as well.
  • Try a sticky glycerine based primer: glycerine helps makeup stick to the skin, but it is not heavy or thick so it’s perfect to keep things looking natural and keeping your makeup in place. Good options are Laura Mercier hydrating foundation primer or the Nivea men’s sensitive after shave balm. These are cheap and works well.Try not to make facial expressions until the foundation sets: Just try not to scrunch your face up for a minute or two after you apply your base. It will save you some trouble later.     




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[9] Why are my acne scars red? What can I use to make the scars disappear?

Acne scars are red due to of enlarged capillaries in the newly formed scar tissue. Fortunately, this redness will decrease by itself with time, even without any special treatment. Nevertheless, you need to be patient. This process can take 3-9 months. Till then you need to continue with your anti-acne treatment to prevent new pimples and to apply every morning an oil-free sunscreen to protect your skin from the sun. If your red spots do not disappear after 9 months it’s possible to fade them with lasers.

[10] I've had a couple of spots for over six months now - they were large and red, but now they're flat (But still red). Are they scars? What can I do to get rid of them?

If the spots are flat - they probably post-acne marks. These will fade by themselves 2-3 months after active acne is controlled. In some cases, it may take up to 6 months. Till then you need to keep on using a mild anti-acne cream in the evening and an oil-free sunscreen in the morning. If these spots do not fade in 3 months, it's possible to fade them faster with a laser.

10 unknown facts about acne scars

15% of people with acne are left with acne scars. Dermatologists use many tools to try to get rid of these scars.  

There are 2 main types of post acne signs.  Flat pink or brown spots and real acne scars that include also a change in skin texture.

Acne dark scars - best treatments 2018
The best way to get rid of post-acne dark spots

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