It's not just spots that are getting us down – it's the aftermath, too. We asked an expert for her top tips for dealing with acne scars, plus the best treatments to try right now…
Acne affects eight out of ten teenagers, and many adults too. It’s so common it’s almost a rite of passage, but that doesn’t make it any less distressing during an outbreak – and if you’ve suffered with spots, you’ll remember the relief you felt when they started to fade away. But when you succeed in treating your acne, or simply grow out of it, you can find yourself facing another problem: acne scars that outlast those spots. They can come in the form of indents or lumps, or just pigmented marks on the surface of the skin.
The next challenge is how to treat and remove the scarring. We asked Dr Stefanie Williams, Dermatologist and Medical Director of European Dermatology London, to share her expertise on preventing and treating acne scarring.
What is acne scarring?
It can be either a depressed scar, or a lump in the skin. There are three main types of depressed scars: an ice pick scar (a triangle indent in the skin), a rolled scar (a soft edge, larger indent in the skin) and a box scar (a square indent in the skin).
Will everyone scar?
The simple answer is no. Some people have an individual tendency to scar more than others, but you can make it worse by picking or squeezing. Keep fingers away from the face.
Can you prevent acne scarring?
The best thing you can do to prevent scarring is not to pick at all. I know it’s tricky, but trust me on this one!
Will scarring be permanent?
A true scar cannot be reversed but it can be dramatically improved. This first thing to note is what kind of scar it is – if at all. What some people think is acne scarring is very often discolouration, which is reversible. If you have dark skin, and you squeeze it, it often leaves a dark mark. This can be treated, as it’s pigmentation, not an acne scar.
Does diet make a difference?
There are certain foods which have been shown to make acne and subsequently the acne scarring worse. These include anything that will bring your sugar level up, like sweets and starch foods (bread, pasta, white rice). Also, try to steer clear of polyunsaturated fats, like vegetable oil, sunflower oil and soya oil, as they can make inflammation worse.
What should you eat?
Vegetables. They are, quite simply, great for your skin. You also need a portion of protein, and some (good) fats. Olive oil, avocados, nuts, coconut oil, even animal fats are all fine for your skin.
Are there treatments I can try at home?
Before you treat acne scars, the active acne needs to be completely burnt out. If spots are still occurring you can’t start any treatment, so make sure your skin is clear of any new breakouts first. The prescriptive cream azelaic acid, brand name Skinoren – which helps prevent new spots from coming up, and has anti-pigment effects – works well on most skin types.
How about Bio-Oil?
Bio-Oil is advertised as a scar treatment, but this is best for surgical scars or stretch marks, not acne scars.
Are there medical treatments available?
Yes. There are different medical treatments are available for acne scar removal, depending on the type of scars you have.
For raised acne, try steroid injections. Your doctor will inject a diluted cortisol solution into each raised scar, which helps to break collagen overproduction down.
For rolled scars, try derma roller, which uses a head of nine needles and pierces the skin with tens of thousands of tiny punctures. This tricks the skin into thinking that there are thousands of tiny little wounds that need repairing, and it responds with more collagen and elastine production to remodel the skin.
For ice-pick acne scarring, try TCA acid. A high concentration of TCA acid will be applied to the scar. There will be some crusting, and gradually, as the scar heels, it will come up to the surface to even out the skin.
Are there different treatments for dark skin?
Yes. You have to be careful with darker skins – especially with lasers. Steer clear of aggressive peels or acids altogether, as these could pigment the skin further.