Acne marks & scars

Acne marks & scars

Acne sucks. But what sucks even more is having your skin clear up, only to find you’ve got to deal with what’s left behind (as if pimples aren’t enough). You might have a few small pink spots, crater-like dents or raised skin toned bumps. To understand how to treat your acne marks & scars, you must first understand what type they are.

There’s more than one type?

Many people don’t know that there are actually several distinct types of residual damage left behind after acne has gone away. It’s important to learn and recognise the difference between Post-Inflammatory Erythema, Post-Inflammatory Hyperpigmentation and true scarring. Each needs a different approach to treatment. Read on to find out how to determine what you have and deal with it.

PIE

No, not the delicious dessert. PIE stands for Post-Inflammatory Erythema. That’s a fancy term for ‘angry blood vessels after damage’. Your skin tried and succeeded in destroying the offending pimple, but unfortunately that heightened blood flow means excess and damaged capillaries. This results in a pinkish flat mark that blanches (disappears) under pressure. To test whether your marks are PIE, press the bottom of a clear glass against your skin. If you see them disappear, then it’s probably PIE. If they stay visible even under pressure, it’s more likely you’re looking at PIH.

How do I treat PIE?

PIE is tough to treat and it’s slow battle. There are certain kinds of treatments like pulsed dye laser (V-Beam) that can be effective against PIE, but unfortunately it’s one of those things where for most it’s a waiting game. There is not a lot else you can do to deliberately fade PIE marks fast. Your body will naturally sort these out over time – over the period of a few months to a year.

PIH

PIH stands for Post-Inflammatory Hyperpigmentation. Unlike PIE, PIH has to do with melanin levels in your skin. After trauma, our skin tries to protect itself and sometimes this is via a heightened production of melanin. Melanin makes freckles and tans turn brown. It is also what gives colour to their skin of those who are naturally dark. As such, people with naturally deeper skin are more likely to suffer from PIH, due to their tendency to produce melanin. PIH is also flat and can be dark red or brown. It’s sometimes hard to tell apart from PIE. A simple solution is the glass test from above – PIH will not blanch (disappear) under pressure.

How do I treat PIH?

As with PIE, treating PIH is a process requiring lots of dedication and patience. The most effective system is two-fold – pigmentation removal and pigmentation prevention.

You can remove pigment with lightening ingredients and exfoliation. Lightening ingredients reverse the pigmentation in the skin. These include Hydroquinone, Vitamin C, Arbutin, Niacinamide and more. These will slowly lighten the marks over time until they completely disappear. Exfoliants like Alpha Hydroxy Acids remove the hyper-pigmented skin. You can use products containing small amounts of these daily or weekly, like Derma E Overnight Peel or Nip + Fab Glycolic Fix Pads. Alternatively you can go the peel route at a dermatologist.

However, these methods only work when using a high SPF sunscreen every day. That’s right – every day. Not wearing SPF will cause PIH to darken further and ruin any progress you’ve made. Think of them like freckles – every time you go out unprotected they will get darker. You will not be able to successfully get rid of PIH without sunscreen. I use Sunplay Superblock SPF 50+ PA++++.

Scarring

Acne scarring is damaged tissue left behind after the trauma of acne. You’ll know if you suffer from actual acne scars since your skin will have a change in texture and/or shape. Acne scarring is very difficult to treat yourself, and will require the help of a dermatologist to administer treatments that will resurface and re-level your skin. There are two main sub-types to know.

Atrophic scars

Atrophic are caused by abnormally low collagen production in the skin after trauma. This creates areas that sink down, leaving holes or dents behind. Atrophic scarring comes in several forms – icepick, boxcar and rolling.

Hypertrophic scars

Hypertrophic scars are caused by excess collagen/scar tissue produced after trauma. This then leaves a raised bump above the skin.

How do I treat scarring?

Removing acne scarring is often more expensive, time consuming and invasive than treating acne marks. But it is certainly possible! You will have to consult a dermatologist or aesthetician for the following services:

PEELS

Chemical peels are done in an aesthetician or dermatologist’s office. Lactic, Glycolic, or Salicylic acid are more gentle peels that encourage your skin to turn its outer layers. More intense peels such as Jessner’s or TCA are available for drastic scarring. These will cause your skin to dry up then peel off over the course of a week or so. The new skin underneath will be smoother in texture, and free from scars. In especially bad cases, multiple peels might be needed.

LASER

Fractional CO2 Laser is another very effective treatment for all kinds of acne scars. This treatment essentialy ‘burns’ tiny dots into your skin in a grid-like fashion. This triggers a healing process where new collagen is produced, filling in or smoothing out the scar. While there can be some notable downtime for this procedure, the results are very impressive.

FILLERS

For some atrophic scars, dermal fillers can be skilfully injected to fill up the divots in the skin and create an even skin surface again. These last anywhere from a few months to many years.

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That’s it for today! Acne and what it leaves behind are totally normal, but people can be deeply affected by it. I think that learning more about something that affects you empowers you to change it.

Did you learn something new about acne marks and scars? What kind do you suffer with? Thanks for reading and I look forward to seeing you here again soon.

S.



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