Stylist speaks to skincare experts on the different types of acne scarring, hyperpigmentation, and how to safely and effectively treat them with treatments and at home.
Whether you’ve suffered a full-blown bout of adult acne, have leftover indentations from teenage years, or are continuously waiting for leftover dark spots to fade away, it all comes together in one skincare struggle we can all relate to.
Seeing whiteheads and red lumps rear their ugly juicy heads can cause enough dread, but having to bear their aftermath for what can be months on end adds salt to the wound. Everyone experiences acne in some shape or form, so it’s perfectly normal to see on ourselves and each other – but if you want to treat the leftover marks for whatever reason, then it’s definitely achievable.
Physical acne scars vs hyperpigmentation
Although the term ‘acne scar’ is often used to describe any disturbance to the skin post-spot, there are two main differences.
Actual acne scars strike up when the skin’s texture is physically altered, or hypotrophic. “Acne scarring has three main classifications – rolling (gives a wavy/undulating look to the skin), ice pick (pitted and looks like tiny holes in the skin) and boxcar (sharp and defined depressions in the skin),” explains Dija Ayodele, clinical aesthetician and founder of the Black Skin Directory.
When it comes to discolouration, it’s a different story. Leftover dark or red spots after spots is perfectly normal, and don’t technically count as scars as they don’t disrupt the skin’s texture. Commonly referred to as post-inflammatory hyperpigmentation (PIH) or hypopigmentation, which is lighter patches on darker skin tones, they’re the result of our melanocytes (melanin-producing cells) releasing too many melanosomes (pigment granules), leading to discolouration. Like with physical scars, hyperpigmented areas can also become worse with picking and a poor skincare routine.
What causes acne scars?
According to Pamela Marshall, clinical aesthetician and co-founder of Mortar and Milk, the severity of your scarring is largely down to picking. “The more we pick at our skin, the most likely we are to scar – my ‘picker’ clients get a lesson on how to do it properly to avoid scarring,” she says. “But also dehydrated skin doesn’t function or heal well, so the more dehydrated we are the more likely we are to scar.”
“As well as picking, skin health and quality, genetics, environmental and lifestyle factors, product choices and treatments will also all play a role in how well skin heals,” says Ayodele.
How can we avoid getting scars from acne?
“The first step is having a solid skincare routine that addresses your skin’s core needs,” advises Ayodele. “That way you can maintain your skin in optimum condition. Exfoliating regularly also helps to keep skin clear of potentially pore-clogging old skin cells and balances oil production – try and incorporate exfoliants in different products for a layered method, for example an AHA or enzyme cleanser, mild AHA pads, and an overnight retinol treatment.”
How to treat physical acne scars and hyperpigmentation
“It’s best to include a regular resurfacing/collagen inducing treatment from the onset, alongside a topical product like Vitamin A,” Ayodele explains. “Treatments such as dermal rolling and laser will stimulate collagen production in the skin to plump and smooth the acne depressions. The earlier this is done the better as it’s much more challenging to treat old scars.”
Here’s where it gets super scientific. “Dermal rolling works by forcing the skin into a controlled wound state,” adds Marshall. “The skin heals and remodels itself by releasing arachidonic acid (the controller of our healing mechanism), which then sends a signal to our glycosaminoglycans (carbohydrates that support collagen and elastin) to rebuild the skin.”
“As effective as this is, it’s important to remember that rolling too much and too often can actually work to the detriment of our skin,” Marshall warns.
Of course, these treatments aren’t currently possible in lockdown but can be looked into once beauty salons reopen.
It can be hard to treat physical scarring that’s formed underneath the upper layer of the skin. Laser can work really effectively to tackle both PIH and textured scar tissue, but best results often occur when used in combination with topical products and dermal rolling.
Although laser treatments differ, they most commonly work by pulsing laser light into the scar tissue to break it down, and encouraging new tissue to grow in its place. As with other methods, a course of treatments is needed to see proper results; healing almost never happens overnight.
We should all be exfoliating anyway to encourage cell turnover and keep dead skin at bay, but certain active ingredients can really make a difference when it comes to targeting hyperpigmented skin. For physical scars, dermal rolling and laser or LED treatments tend to be more effective.
“I always recommend PHAs: their molecules are smaller than those of AHAs, so don’t penetrate the skin so deeply, avoiding over-exfoliation and irritation,” says Marshall. PHAs work to dissolve the protein bonds that glue dead skin cells together. Whereas BHAs like salicylic acid target oil and spots, they tend to go deep into pores rather than improve skin texture overall. That’s where PHAs excel, and are great for even the most sensitive of skin types (eczema and rosacea sufferers included).
And other ingredients? “Anything that safely fades pigmentation should work, such as hydroquinone, but only under medical supervision,” advises Ayodele. “Ingredients like liquorice extract, vitamin C, niacinamide, bakuchiol and vitamin A (or retinol/retinaldehyde) inhibit and quell excess melanin pigment before it gets a chance to strike.”
AHAs like glycolic and mandelic acids are also a favourite for fading discolouration fast and effectively, but can sometimes make things worse. “On black skin, it’s best to do a series of superficial peels over a course of a few months as opposed to doing a single deep peel which can cause further PIH,” advises Ayodele. “As always, use an SPF whether you’re using exfoliant ingredients or not – unprotected sun exposure can definitely worsen dark marks.”
Although cosmeceutical and pharmaceutical products are often the go-to for fast, effective effects, the power of natural plant remedies can yield great results, too. Some favourites among those recovering from PIH, scarring and stretch marks are rosehip, omega 3 and vitamin E oils for their ability to nourish skin, which is often cited as the key to keeping recovering cells supple and healthy.
“Plant-based oils have a powerful effect at treating pigmentation because they have the ability to heal and rejuvenate the skin on a cellular level,” says Kristy Cimesa, founder of Botanico Vida. “They deliver essential fatty acids, vitamins, minerals, antioxidants and proteins directly into the skins cell membrane and help reduce inflammation while also boosting hydration.”
Sacha Inchi Oil contains the earth’s richest plant source of omega 3,6,9, high levels of vitamin E and protein, making it particularly good at curbing inflammation and minimising scar tissue and pigmentation,” Cimesa continues. “Look out for other omega rich oils such as rosehip seed oil, which is renowned for its high levels of omegas and vitamin A, making it an effective acne scar and dark spot remedy.”
Using plant oils after AHAs is also extremely effective, as the ingredients can go straight to the renewed skin and there’s less risk of dead skin cells becoming clogged with oil. As always, use AHAs at night and always wear an SPF in daylight hours.
The best products for acne scars
Nuhanciam Anti Dark Spot Power Factor 4 Serum
Dr Dennis Gross Skincare Alpha Beta Universal Daily Peel
Eucerin Anti-Pigment Dual Serum Thiamidol & Hyaluronic Acid
Murad Blemish Control InvisiScar Recovery Treatment
Botanico Vida Omega Oil
Shop Botanico Vida Omega Oil at Feelunique, £11.50
Main image: Getty