Did you know that a spot has a 6% risk of turning into a scar?
Acne scarring is miserable. It can take lots of treatment and expense to improve, and resolution isn’t always possible. And some individuals have genetics that mean they scar worse than other people. It’s just one of those things.
So the best thing is to focus on prevention. I want to teach you 4 easy things you can action today that’ll reduce your risk of your blemishes leaving a scar on your skin.
Firstly when I talk about scarring I don’t mean flat dark marks, I mean indentations. That means collagen loss in the dermis has occurred and also potentially some tethering, where the base of the scar is stuck to the surrounding tissues.
How Do You Get Rid Of Acne Scars?
Use a retinoid. And it’s often a reason I’ll consider titrating a retinoid dose up above and beyond that which simply controls the acne process.
By influencing enzymes called MMP and stimulating new collagen synthesis, they can truly help remodel your dermis and prevent scarring. It’s why they’re the first line in any treatment regime for breakouts. And it's why they’re an essential part of a long-term maintenance strategy for anyone who suffers from blemishes.
Are acne scars permanent?
This is the biggest concern for many. A large proportion are, hence we take scarring very seriously. So guess what - we’re HUGE advocates of treating early. This is especially true for those with more severe disease.
Prevention of scarring is one of the main goals when treating with oral isotretinoin, which is especially important with the nodulocystic pattern of acne which has a strong tendency to scar, due to the deeper dermal nature of the lesions. So don’t waste time if you’re experiencing this pattern of acne - it needs to be taken seriously. Even oral antibiotics have a role to play in reducing scarring - tetracyclines down-regulate those collagen chompers MMPs so remember their action extends beyond the antibacterial.
Does exfoliation help acne scars?
In a word. NO! Avoid physical exfoliation like the plague.
Does exfoliating make scars worse?
This has no place in your acne treatment plan - it’s irritating, it can physically lead to removal of ‘heads’ of pustular spots, as can any form of friction and should be avoided. And we recognise the role of friction in a condition called acne excoriée, where rubbing of something like a bicycle helmet can drive the acne process.
In fact the handling of acne-prone skin should be very much that of someone with sensitive skin.
Does picking acne cause scars?
DON’T pick or squeeze your spots. At the very least, it promotes more intense inflammation, which promotes more pigmentation. But it can potentially drive that inflammatory process deeper into your skin and that can lead to lost collagen and potentially even more scarring.
An important aspect of minimising soreness and discomfort from your scars is skin hydration.
I see lots of people who underuse moisturiser for fear it’ll block their pores. This means the drying effect of their topical treatment isn’t negated. This can impact compliance but can also make you much more aware of your spots, and more likely to fiddle with them. My advice - seek out a good days and a bad days non-comedogenic moisturiser so you can tailor hydration to your needs.
Will my acne scars go away?
The good news - 33% of scars do improve slowly with time, over the course of 3 years. There are of course many treatment options for improving acne scars and I’d always recommend seeing a derm who specialises in this area as it’s very nuanced and is most successful when different treatment modalities are combined. Dr Lim and Dr Patalay are both highly skilled in this area.
So hopefully I’ve given you some pointers that you can action today to start caring for your skin - remember I’m here to support you and help you on this journey so subscribe and check back in every week for more content. I’d love it if you could share this with someone who needs this content so we can keep spreading the word.