Nearly everyone has experienced a breakout at some point or another. Although pimples can be a really frustrating part of acne, the scars they leave behind affect your complexion in the long term.
“It may come as a surprise that there are several different types of acne scars — but all of them can be minimized.”
To best address acne scars, it’s important to understand different types of acne scars and what can cause them. The best way to treat acne scars is to avoid them in the first place.
What Causes Acne?
You’ve probably heard the old adage, “know your enemy.” This is especially true in skincare – it’s hard to treat a skincare problem you don’t understand. With that in mind, here are a few factors that can cause breakouts.
Although there’s quite a bit of gunk that can clog up your pores, bacteria is one of the main culprits of irritated pimples. Several strains of bacteria can cause acne, but some of the most common are Cutibacterium Acnes and Propionibacterium Acnes.
These bacterias draw energy from sebum, which they then use to cause irritation. Acne-causing bacteria also rely on environments with low levels of oxygen since adequate oxygenation can fight bacteria and prevent them from causing infections. These bacterias also rely on your skin’s pH and are most active when your skin’s pH is around 5.5.
If bacteria causes your acne, your dermatologist may prescribe harsh-yet-effective treatment options that will curb your sebum production and adjust your skin’s pH to help fight off this bacteria.
Dead Skin Cell Buildup
Pimples are normally associated with oily skin, but even those with dry skin can suffer from breakouts! Dry skin produces dead skin cells faster than oily skin, which is why dry skin can sometimes feel flaky and rough.
When you have an excess of dead skin cells, they can start to build up. These dead skin cells can clog up your pores and cause irritation as they build up. In fact, the plugs that you can see in the center of whiteheads and blackheads are often made largely of dead skin cells.
If you have dry skin and still suffer from breakouts, dead skin cells may be partly responsible. I recommend exfoliating regularly to avoid breakouts related to dry skin.
Sebum is created by your sebaceous glands, which live in the middle layer of the skin called the dermis. Sebum has a bad reputation, but it isn’t all bad – sebum is part of your skin’s natural hydration mechanism. Sebum helps keep your skin moisturized and supple, and it even helps your skin fight off premature signs of aging like fine lines and wrinkles.
However, sometimes your sebaceous glands can get overexcited and make too much sebum. When this happens, excess sebum can sometimes start to clog up pores.
As mentioned before, acne-causing bacteria feed on sebum – so your oil-clogged pores are the perfect home for this bacteria. This is why oily skin is often associated with breakouts.
If you struggle with acne and have oily skin, one way to address the root issue is to apply a topical treatment to help regulate your sebum production.
What Causes Pimples to Scar?
Acne scars occur when your pimples get too irritated. If you have acne scars, you’re not alone; one in five people who have acne also have acne scars.
When you get a scar from a pimple, it’s largely because the pimple swelled beyond what your pore could handle. This can result in a breakdown within the walls of your pore.
Some blemish-related scars are located on the surface of the skin and fade quickly over time. However, others extend deeper into the skin and require either clinical treatment or over-the-counter products to clear up.
Your skin uses collagen to try and repair these pore walls, which results in the different textures of scar tissue. This scar tissue is also often discolored due to melanin overproduction, especially for those with darker skin tones.
What Types of Acne Scars Are There?
If you struggle with acne, you’ve likely noticed that your scars can look different from each other. This is because your skin reacts differently in certain situations. Here are some of the main types of acne scars.
Atrophic Acne Scars
Atrophic scars are also called depressed scars, and they occur when your skin loses tissue during regeneration. They can result in an uneven or rough skin texture.
Atrophic scars extend into the dermis and are most commonly caused by a lack of collagen. Even within atrophic scars, there are a few sub-types of acne scars that you can have.
Boxcar scars have very defined edges and tend to go deeper into the skin. Their indentations are more noticeable, and you can find them more often around the jawline.
Ice Pick Scars
Ice pick scars look like a narrow hole in your skin that narrows as it goes further down. These scars are deep and are very challenging to heal.
They are narrower and much more defined than any other atrophic scar. This type of scar occurs more frequently along the forehead and upper cheeks.
Rolling scars are slight depressions in the skin that have sloping edges and can give the skin a wavy texture. You can find them more around the jaw, similar to boxcar scars.
Hypertrophic Scars and Keloid Scars
Hypertrophic and keloid scars are raised scars that occur when your skin overcorrects by producing too much collagen and fibrous tissue. Hypertrophic scars typically appear red and feel like small bumps on the skin. However, keloid scars are much larger and often darker in color.
Post-inflammatory hyperpigmentation appears as red, brown, or white spots when acne lesions or cysts finally subside. Although these spots may look like scars, they’re just leftover irritation. The best way to help your skin fully heal and clear up this type of hyperpigmentation is to wear sunscreen and use over-the-counter skin-brightening products.
How Can I Prevent Scarring?
Since blemishes often lead to scars, many skincare products are designed to combat both. While some scars may not ever fully heal, there are ways to reduce their appearance over time and prevent scars from occurring in the first place.
Talk to Your Dermatologist
The best way to keep your acne from marring your complexion with dark spots is to talk to your dermatologist. Your dermatologist has all the tools and information needed to find the source of your acne. As I discussed before, there could be many factors behind your breakouts.
If you have severe acne, your dermatologist may prescribe strong topical medications or creams to help combat the issue. For instance, your dermatologist may prescribe a super-strong topical retinoid such as tretinoin if you have cystic acne.
Your dermatologist can also prescribe other clinical acne scar treatments such as collagen dermal fillers, microneedling, laser resurfacing or laser treatments, microdermabrasion, or steroid injections. In severe cases, your dermatologist might recommend surgeries such as punch excisions, punch grafting, or subcisions.
Use the Right Moisturizer
Moisturized skin is better at bouncing back from stress, which means it’ll be much better at resisting scarring. Moisturizer can also help hydrate dry skin, which may even help address the source of your skin issue.
When choosing a moisturizer, it’s important to pick one formulated for your skin type. For instance, heavy-duty moisturizers that are perfect for dry skin may irritate oily skin and trigger more sebum production. On the other hand, lightweight moisturizers for oily skin may not provide enough hydration for dry skin.
Before moisturizing, I recommend applying a hydrating serum like iS Clinical Hydra-Cool Serum. This serum is formulated with natural humectant hyaluronic acid to help draw moisture to your skin, and it even contains mushroom extract to help reduce the appearance of dark spots.
Whether or not you have dry skin, it’s still important to exfoliate regularly. Even if your dead skin buildup isn’t causing your breakouts, exfoliating can help slowly polish away the damaged skin cells that cause discoloration over time.
I recommend an exfoliating cleanser like Cosmedix Clarify Salicylic Acid Foaming Cleanser. This cleanser features salicylic acid, a BHA known for exfoliating clogged pores. This cleanser also includes aloe vera to help hydrate and soothe irritated skin.
I also recommend supplementing your skincare routine with the occasional chemical peel. These peels use a mixture of time-tested skincare ingredients to polish away the outermost layer of skin that is home to your acne scars. With consistent peels, your scars may fade over time.
Prevent Blemishes at their Roots
Although some skincare products can soothe irritation, the best way to prevent scarring is to prevent blemishes at their roots. While the best treatment depends on your individual skin, I recommend starting with my Retinol Reform.
This award-winning formula combines retinol and lactic acid to exfoliate dead skin cells, support firmer skin, and help minimize the appearance of fine lines. Retinol is currently at the center of the dermatology stage, and you’ll see why after just a couple of weeks with this rockstar formula.
Even once you’ve tamed your breakouts, your pimples can often leave behind some frustrating reminders. Whether you have atrophic or hypertrophic acne scars, the best way to treat scars is to avoid them in the first place.
If you’re looking for over-the-counter skincare results, I recommend scheduling a consultation with one of my skin experts to find the routine that’s best for your skin.