Know what to use, when to use & how to use to fight acne scars!

As if acne was not a problem in itself, the scars it leaves behind can be very frustrating. You may have emerged victorious in bidding adieu to your acne, but the stubborn marks they left behind can linger on months. However, fear not - there are simple methods and changes to your lifestyle you can make to treat and fade these scars for smoother, clearer and even-toned skin! 

What are acne scars? Why do we get them?

When the skin's pores get clogged with dirt, bacteria, dead skin cells or impurities, acne tends to form. When our pores get blocked, they swell up and cause the follicle wall of the skin to break, creating both deep and shallow lesions that remain of the skin afterward. These scars are usually a byproduct of inflamed lesions, which penetrate through the skin's tissue under and leave behind marks. Since acne is an inflammatory condition, its scars have a lot to do with the severity of inflammation as well as its duration, which is why the scars usually differ from time to time as well as person to person. Delaying the treatment of acne can increase the potential risk of scarring, which is why it is best to take action soon.

Acne scarring increases over time, as our skin tends to lose collagen as we grow older. As we all know, collagen plays a vital role in the skin's healing process. However, after a breakout the skin needs to produce more collagen to repair itself and if it is not enough, it causes a scar to form. 

What are the different types of acne scars?

Before trying to find the right ingredient or medical treatment to treat your scars, it is essential to understand the different kinds of acne scars that can occur. Each scar responds differently to a certain treatment or ingredient, and some may be more beneficial than the others.

Here is a complete guide on the different types of acne scars:

• Atrophic/ Depressed acne scars

These are the most common scars which create depressed, hollow indentations on the face and are formed when the skin lacks fibroblasts in the healing process. Fibroblasts are skin cells that play a pivotal role in the healing of wounds as well as the production of collagen.

The three types of atrophic scars are:

 - Boxcar: These are wide U shaped scars with sharp edges that can be deep or shallow. The shallower they are, the faster they react to any skin treatments. They are formed due to an inflammatory breakout that destroys the natural collagen, leading to the loss of skin tissue and forming depressions in the skin.

- Ice pick: These are narrow, V-shaped scars that extend far under the skin's surface, whose appearance resembles small circular or oval-shaped holes or chickenpox scars. These are the hardest scars to treat as they go deep under the skin's surface and are the most prominent to the naked eye. 

- Rolling: These have an irregular appearance with wide depressions in the skin's surface with round edges. They occur due to the fibrous bands of skin tissue that develop in the middle of the skin's surface and the tissue below and pull off the epidermis, giving the scars an uneven and irregular appearance.

• Hypertrophic scars

On the contrary, the skin may create too many fibroblasts as the acne spot heals, which creates a raised scar that stands above the surface of the skin. These are commonly noticed on the chest and the back.

•  Keloid scars

Similar to hypertrophic scars, these are thicker in comparison to the original acne spot. They are darker than the skin in the surrounding areas, and are red or brown in colour. They cause itchiness or pain sometimes.

What is the difference between acne scars and marks? 

Acne marks are usually experienced by those having darker complexions, and they may experience brown marks whereas those with lighter complexions develop purple or red marks called post-inflammatory erythema. These tend to fade faster over time.

On the other hand, scars are deep indentations in the skin which are formed when pimples are picked on. They take longer to heal in comparison to marks and may even be permanent sometimes. In order to completely reduce your scars, medical treatment may be required on certain occasions.

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What are the ingredients that help reduce acne scars?

Vitamin C

A potent antioxidant, Vitamin C helps neutralise free radicals and reduce redness, swelling and significantly improve the appearance of acne lesions. Its healing properties accelerate collagen production and help in rebuilding the skin's structure, especially for Atrophic scars. Furthermore, it is effective in treating and reducing hyperpigmentation and dark spots and sun damage too.

Salicylic Acid

Salicylic Acid is a common BHA in skincare that has been used to treat acne since years, in different forms such as spot treatments, exfoliators, cleansers, etc and works effectively for all kinds of acne scars as it clears out the pores and reduces swelling and redness. It exfoliates the skin gently to remove dead skin cells, dirt and other debris that tends to accumulate and clog the pores. Products containing Salicylic Acid can be added into your daily skincare regime, or used in the form of a chemical peel at the dermatologist. 

Note: If you have sensitive skin, it is best to do a patch test to avoid experiencing any dryness or irritation.

AHAs

Alpha Hydroxy Acids are wonder ingredients to treat acne as well as acne scars. They work on all kinds of acne scars to draw out impurities, toxins and dead skin cells that can plug the pores and provide mild exfoliation to the outer layer to remove roughness, unevenness and discolouration.

We recommend: Martiderm Night Renew

Lactic Acid

A super mild and gentle acid for the skin, it is usually found in moisturisers and lotions in over the counter products. It gently peels away dead skin cells and improves the skin texture and smoothness. Again, it works for all types of acne scars and is available in the form of peels, serums, ointments for spot treatment and exfoliators.

Retinoids

Topical Retinoids help to get rid of acne scars by blocking inflammation, decreasing acne lesions and speeding up cell regeneration. This can be very effective to manage and lighten post-inflammatory hyperpigmentation scars for those with darker skin tones. It is imperative to apply sunscreen during a Retinoid treatment, as the sensitivity to the sun can increase.

We recommend: Over Dermis Skin Alphabet Vitamin A Serum

Rosehip

Apart from being an anti-ageing goldmine, it helps in reducing redness, inflammation and acne scars due to the high Linoleic Acid content and bioactive form of Vitamin A (Retinoic Acid) which aid in boosting both collagen and elastin production. This helps speed up cell regeneration which minimises the appearance of all kinds of scars, including those from hyperpigmentation.

 

Niacinamide 

A form of Vitamin B3, it helps in the neutralisation of free radicals and to keep the skin healthy. Its anti-inflammatory properties reduce skin damage, repair the protective outer layer of the skin and help manage hyperpigmentation when topically applied.

We recommend: Suganda 10% Niacinamide Serum

Azelaic Acid

Naturally occuring in food grains such as Rye, Wheat and Barley, it has both antimicrobial and anti-inflammatory properties, making it an effective remedy for active breakouts and scars. It encourages the turnover of cells so the skin heals faster and scarring is minimised. It also reduces inflammation and treats redness to make the scars less visible and reduce irritation. Sometimes, inflammation can result in hyperpigmentation, where Azelaic Acid helps to stop the population of discoloured skin cells. 

We recommend: Deconstruct Breakout Control Serum

What are the different dermatological treatments you can undergo for acne scars?

In the case of severe acne scars, it is best to check with a dermatologist who can recommend different treatments and procedures based on the extent of scarring, any skin concerns and other conditions.

1) Chemical Peels

Unfortunately, there are not like the peeling face masks we love and indulge in on weekends. A chemical peel consists of a strong acid that helps shed the top layer of the skin in order to reduce the scars deep below. The acid of choice depends on the severity of the scars and individual skin type. Milder versions of these peels are available to use at home too, however it is best to consult a skin specialist if you wish to use a stronger formula for higher efficacy. Commonly used acids in peels are Glycolic Acid, Salicylic Acid or Trichloroacetic Acid.

2) Dermabrasion

This is frequently used to treat scars, and is an effective treatment for scars close to the skin and deep below. It works using the same mechanism as microdermabrasion kits, where a wire blush or wheel is used to provide deep exfoliation to the skin's top layer. It can be used to treat dark spots, wrinkles and patchiness on the skin too, so that the new skin that grows after the treatment is smoother looking.

3) Microneedling

One of the newer treatment techniques, it uses a handheld roller on the surface of the scars that is studded with small needles. These needles help to puncture the skin, and reduce the depth of the scars, especially depressed acne scars. It also stimulates collagen production which diminishes the scars by smoothening the skin. However, always ensure that this is done in a gentle manner to avoid redness, pain or inflammation later.

4) Laser treatments

Laser treatments aid in the removal of the top most layer of the skin to reveal newer, younger cells underneath without the usage of scrubs or chemicals. Upon undergoing laser resurfacing, you are likely to heal sooner in comparison to other treatments. This method helps in reducing scarring, but may not work for everyone, especially those having sensitive skin, dark skin tones or those prone to acne. 

5) LED or Red Light Therapy

Red Light therapy uses an LED, or Light Emitting Diode is similar to a computer chip that emits wavelengths of light energy. It was originally discovered by NASA to treat surgery scars and heal deep wounds, but is a new found favourite in the skincare world as it is a non-invasive and healing treatment. It works as the skin cells convert light energy into fuel to function effectively. Moreover, red wavelengths can penetrate deep into the skin, hit the bloodstream and increase the elasticity of collagen fibres.  

We recommend: Eclair Therapy Mask

6) Cryotherapy

A treatment that is gaining popularity, Cryotherapy involves the freezing of the skin's scar tissue. Upon freezing, the scar tissue gradually dies and falls off. For better results, dermatologists recommend doing a series of cryotherapy sessions. This is more effective in diminishing scars for those with lighter complexions. Moreover, a downside is that a few light spots may form and remain permanently on the skin.

What other remedies or habits we can one inculcate to prevent the appearance of acne scars?

Simple dos & don'ts such as:

• Wearing sunscreen: There is a reason dermatologists swear by sunscreens and recommend wearing them 365 days of the year! Sunscreen helps in the maintenance of skin health as it decreases the risk of damage from harmful UV rays and most importantly prevents dark spots and discolouration from sun damage for a smoother, even skin tone.

• Never popping pimples: Squeezing a pimple may be tempting in the moment, but this is something we should consciously avoid, as when done incorrectly, it increases the risk of infection and scarring. It could end up breaking your skin barrier, spreading bacteria into the pores and hair follicles and clogging the pores. It also triggers inflammation and makes the acne last longer and more visible.

• Use gentle products on the skin and exfoliate gently: Never scrub too hard or use powerful chemicals to get rid of scars as it may lead to redness, itchiness or inflammation. Always use mild products and gentle movements to apply them.

• Use a facial massage tool to clarify the skin from within: Ancient Chinese techniques such as Gua Shas and face rollers not only re-energise the skin and promote lymphatic drainage, but also clarify the skin from within. They aid in the removal of harmful toxins, soothe inflammation and regenerate the skin's tissue.

Read more on how Face Rollers and Gua Shas help clear acne here.

• Hydrate the skin internally and externally: Water is the elixir of life and plays a vital role in preventing acne and its scars. Drink up to hydrate your skin internally to avoid excess oil production that can clog pores and cause acne and its scars. 

• Be patient: Even though we wish there was a quick fix for acne scars, sometimes patiently waiting and allowing them to heal gradually is the best option.

Always remember, you have come out triumphant and won half the battle when you tackled your acne issues. With proper care, a diligent routine and effective remedies, acne scars too can be treated and said goodbye to forever!

- By Krisha Jhaveri