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Your acne may be gone, but what about the dark spots and uneven texture left behind? Blemishes can leave their mark for far longer than you’d like. The elusive acne scar is stubborn and hard to treat, but not impossible. Whether you deal with pink spots that linger for weeks or months, or indented, pitted scars, there are the best treatments and solutions for regaining smooth, soft, bright skin.

The Different Types of Acne Scars

Not all acne scars are the same. Kimberly Lee explains that acne scars usually result from damage to the dermis layer, whereas post-inflammatory hyperpigmentation (PIH) refers to the temporary darkening of the skin due to increased melanin production after an inflammatory acne lesion. "Acne scars appear as indentations or raised areas, while PIH is a flat, discolored patch ranging from pink to dark brown." Unlike acne scars, PIH often fades with time and doesn't leave a permanent mark on the skin. However, an acne scar often does.

Meet the expert

Some acne scars may look like post-inflammatory hyperpigmentation, but Erica Marie Gatt explains that acne scars are typically elevated or pitted and fall into one of the following categories:

• Atrophic scars, which are flat, rounded, depressed pits caused by severe cystic acne
• Boxcar scars appear as dents or craters in the skin with sharp edges
• Ice pick scars are deep yet narrow indents in the skin
• Rolling scars, a type of ill-defined atrophic scar often with a wavy or rolling appearance
• Hypertrophic scars are raised, thick, and discolored
• Keloid scars surface as a thick raised scar that extends beyond the size of the original acne lesion

Ways to Improve Acne Scars at Home

You can improve acne scars and PIH with a well-devised at-home skincare routine. Dr. Lee says treating acne scars and post-inflammatory hyperpigmentation can be challenging, but using the right skincare ingredients can help. The sooner you can treat any acne scar or leftover pigmentation, the better.

Focus on Brightening

Dr. Lee says brightening products and ingredients help fade dark spots and even out the skin tone for a smoother, more radiant complexion. Effective skin-brightening ingredients include vitamin C and niacinamide, which boasts anti-inflammatory properties and can help fade PIH. If your skin needs more help, consider prescription-strength hydroquinone, a bleaching agent Dr. Lee says can effectively lighten dark spots and hyperpigmentation.

Improve Texture

Alpha hydroxy acids (AHAs) like glycolic or lactic acid exfoliate the skin and improve the texture of acne scars. "Exfoliation can play a role in improving acne scars by removing dead skin cells and promoting skin cell turnover," Dr. Lee shares. "Gentle exfoliation methods like chemical or enzymatic exfoliators can also improve the appearance of scars, but it's important to avoid excessive or harsh exfoliation, as it can lead to irritation or further damage to the skin." Equally as effective are safe-to-use at-home chemical peels that incorporate glycolic or salicylic acid.

Increase Collagen

Collagen production is vital for skin that bears the signs of uneven texture due to scarring. Gatt explains that increasing collagen stimulation within the skin makes it smoother, thicker, and more elastic, which can help to reduce the appearance of a deep scar. Dr. Lee shares that effective ways to stimulate collagen at home include using retinoids and incorporating collagen-boosting ingredients like peptides and growth factors into your skincare routine.

Don't Discount Hydration

While it may not seem like moisturizing would be a top priority when combating acne scars, it is. "It's important to hydrate the skin, especially if it is acne-prone," Gatt says. Hydrating the skin helps to maintain its natural skin cell renewal process.

Protect the Skin From the Sun

One of the most critical steps is protecting the skin from the sun. "Wearing sunscreen daily is important because the sun can darken existing hyperpigmentation and acne scarring," Gatt shares. "I recommend wearing an SPF zinc oxide, if possible, and reapplying it evenly throughout the day."

In-Office Acne Scar Treatments

If active acne is present alongside acne scars, Chris G. Adigun says to clear up the breakouts first. "When active acne persists, we are limited in the modalities we can use to treat the acne scars, reducing the outcome."

Microdermabrasion, which resurfaces the skin by removing dead skin cells with a vacuum-like wand with an abrasive tip, is an option for mild PIH and scars. Chemical peels, which range in intensity, are also helpful in lightening pigment-heavy scars since they exfoliate away the top layer of skin.

The key to improving stubborn acne scars is to create new collagen. Divots indicate a loss of collagen. "Stimulating new collagen at the base of the scar, no matter the type of acne scar raises it to meet the rest of the skin," Dr. Adigun explains. She says the most effective in-office laser treatments for pitted and texture-related acne scars use heat.

"My go-to for this is the Sciton HALO laser because it provides ablative and non-ablative wavelengths in one treatment. As a result, we can stimulate multiple healing processes for a better outcome." Other laser treatments, like Fraxel, deliver focused energy to the skin, which Dr. Lee says stimulates collagen production and resurfaces the skin to reduce the appearance of scars. However, most lasers require multiple treatments depending on the extent of the acne scars.

Treating PIH scars may also necessitate a laser to reduce redness and pigment in the skin. "I like the Sciton MOXI 1927 nanometer when there is a lot of leftover red and purple in the skin from acne," Dr. Adigun shares.

Like lasers, microneedling is also effective for fading acne scars since its end goal is collagen stimulation. Microneedling, often performed with platelet-rich plasma (PRP), uses small needles to create tiny controlled wounds in the skin that promote collagen synthesis to reduce the depth and appearance of acne scars. Radiofrequency (RF) microneedling is often recommended for more severe scars since it adds RF energy to the treatment, prompting the body to produce even more natural collagen.

For severe, unresponsive scarring, Dr. Lee recommends subcision. "It uses a needle to break up the fibrous scar bands that tether the scar tissue to deeper layers of the skin. By releasing these attachments, subcision helps elevate depressed scars and improve their appearance."

The Bottom Line: It Takes Time

No matter which routes you choose, expect to invest time and money since these treatments won't improve scars overnight. "It may seem like your skin will never get better, just be patient and don't give up," Gatt says. "Consistency is key when achieving clearer, brighter, and more even skin tone."

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