June 28th 2020
How to prevent and treat acne scarring: the dos and don’ts
September 11th 2018 / 0 comment
Whether it’s a hangover from a particularly nasty spot or a case of more widespread acne scarring, 72% of us report that scars affect our confidence. Here’s how to prevent spots from scarring, and what you can do to reduce the appearance of acne marks
According to a survey of 364 people conducted by the British Skin Foundation, 14 per cent of us admit that we feel uncomfortable if we see someone with scarring, yet seven in ten report having visible scars or a skin condition that’s obvious to the onlooker, 72 per cent of whom suffer from low self-esteem as a result. This disparity proves just how much skin diseases and facial scarring are commonplace, yet have the potential to crush our self-confidence due to fear of judgement.
First off, never feel ashamed or angry with your skin- it’s part of you, it needs looking after and anyone who makes you feel like less of a person due to your skin condition isn’t worth your consideration. What's more, for what it’s worth, acne and acne scarring are both incredibly common- 54 per cent of UK women report suffering with spots and acne according to a survey of 3409 women by Ipsos Beauty Track, while acne was the second most searched for skincare concern last year as revealed in Google reports. It’s an issue that has the potential to cause lasting wounds both physically and mentally, and speaking of acne scarring in particular, it’s a matter that confronts dermatologists every day, as consultant dermatologist Dr Justine Kluk confirms:
“I spend a lot of my time in the clinic helping my patients with the prevention and treatment of acne scarring- it’s a topic I take extremely seriously.”
Consultant dermatologist and fellow acne specialist (and former sufferer) Dr Anjali Mahto seconds Dr Kluk’s dedicated approach to treating acne and any resultant scarring:
“Acne is a treatable skin disease and it is important to seek help early. No one should have to suffer in silence and early access to your family doctor or dermatologist is key. Although not life-threatening, the damage that acne can cause should not be underestimated. It can lead to scarring of the skin in addition to having profound effects on self-esteem. It is important to deal with these at an early stage to prevent lasting physical and psychological effects.”
As such, here’s how to nip blemish scarring in the bud, and the treatments that can help if you’re already dealing with acne scars.
Address spots first, scarring later
Getting to the root of the issue is essential to avoiding scarring in the first place- treating active acne should be your first priority, as Dr Kluk explains:
“The first step in managing acne scarring is to treat the underlying cause and get your spots firmly under control. If this doesn’t happen, you can end up going round in circles, wasting a lot of time and energy at great cost. Anyone who tries to sell you a solution for acne scarring without controlling your spots first is not doing you a favour!
“Acne shouldn’t be swept under the carpet, especially if you have the nodular or cystic form which is characterised by deep, tender lumps. It is important that this type of acne is treated effectively, and as soon as possible, as it has the highest probability of leaving permanent scarring. Trying a bunch of different self-help methods at home unsuccessfully may simply delay the healing process- I would encourage anyone with these symptoms to seek professional medical help early on.”
Don’t pick your pimples
No matter how many pimple popping videos you watch on Youtube, never be tempted to do it DIY- taking acne treatment into your own hands in the most literal sense only increases the likelihood of scars forming according to Dr Kluk:
“One of the other common causes of acne scarring is picking or squeezing inflamed spots. As tempting as it can be, this needs to be avoided, as breaking the skin can introduce infection and push inflammation even deeper.”
“Scars are the result of an imperfect inflammatory healing process, designed to heal wounds as quickly as possible. The process, unlike regeneration, leaves marks in the tissues (scars).”
To avoid permanent pigmentation marks and skin damage, there are better DIY ways to put out the fire…
Add an acid
As counterintuitive as it might sound, a BHA acid in particular can help to ease inflammation and decrease the likelihood of scarring- Dr Kluk presents an acidic alternative to picking and scratching:
“Dabbing a bit of salicylic acid on a cotton bud or applying a hydrocolloid spot plaster onto spots can heal the blemish more speedily.”
A topical liquid exfoliant is far preferable to the physical variety for clearing the decks too...
Steer clear of scrubs
Like picking at spots, scrubbing them away isn’t conducive to the healing process, as Dr Kluk emphasises:
“Exfoliating with grainy scrubs isn’t to be recommended. These kinds of products are likely to irritate acne and increase inflammation which can result in scarring.”
Exfoliating acids over brillo pad style skincare, every time.
Try a retinol
Vitamin A derivatives have an impressive success rate when it comes to treating acne and fading lingering scars. They’re one of Dr Kluk’s first line treatments when it comes to addressing acne scarring at home:
“A topical retinoid or retinol can be an extremely useful and relatively budget-friendly way to treat any scarring that’s already present. When applied regularly to the skin over a period of months, it can improve the appearance of discolouration and lead to a smoother, more even skin texture. Skinceuticals and Medik8 do a great range of starter retinols.”
Skinceuticals Retinol 0.3, £55 for 30ml
Medik8 3TR, £29 for 15ml
Strengthen skin with niacinamide
Not only can skin barrier boosting niacinamide cushion skin against any adverse effects of retinol, but its anti-inflammatory action can help to soothe blemishes and any resultant scarring before things get heated. Consultant plastic surgeon Paul Banwell advocates niacinamide in any spot and scar treatment routine (he favours Rationale Immunologist Serum, £88 for 30ml). He also promotes “having regular extractions and facials over picking spots.” Which leads us neatly to the next scar minimising approach...
Severe scarring is a tricky issue to tackle effectively at home- a visit to a dermatologist leaves you with a wider array of options, although clearly there’s cost involved, not to mention a fair few sharp objects. Dr Kluk gives us a few potential acne fading approaches at the doc’s office:
“In terms of procedures that can be performed by a consultant dermatologist in clinic, acne scars can be managed with a combination of subcision (inserting a needle underneath a depressed scar to break up the scar tissue manually) and medical needling.
“Some indented scars can also be lifted with a small injection of hyaluronic acid.
“Meanwhile very deep and narrow scars, known as ice pick scars, can be removed by way of a surgical procedure known as punch excision.
“Lumpy scars can be treated with scar gels or injected with cortisone to flatten them. If acne scars are a concern of yours, it is certainly worthwhile booking an appointment with a consultant dermatologist, who will discuss the best treatment options that are suited to your skin.”
Consider a peel
Dr Kluk reports that TCA peels can be effective in treating scarring- dermatologist and aesthetic specialist Dr Sarah Shah illustrates how they work:
“More aggressive medium to deep peels such as a TCA Peel (trichloroacetic acid) can penetrate to the deeper layers of the skin which results in reorganisation of the skin and increased cell growth, leading to healthier skin layers.
“In clinic I often treat scarring with the Obagi Blue Peel, which is a medium to deep depth peel. It is a simple procedure lasting around twenty minutes with the skin starting to peel within two to three days that can last up to ten days. Not only is it highly effective in moving acne scars, after the skin has finished peeling a dramatic improvement in the complexion will be noticed and will continue to improve over four to six weeks.”
Not everyone can tolerate deep peels, however, and depending on your degree of scarring, Dr Shah assures that a course of light peels can still be very effective where fading is concerned:
“Light chemical peels such as glycolic peels are a quick and simple technique that can achieve dramatic results. A series of treatments is a great way to reverse and lessen the effects of pigmentation and scarring. This is because light chemical peels react with the very top layer of skin, causing it to come away, revealing a smoother and less noticeably blemished complexion underneath.”
Peels should always be carried out by a professionally trained and licenced skincare expert and preceded by a thorough bespoke skin consultation- don’t dive head first into a course of peels in a back-alley joint, as poorly formulated and administered peels could make scarring and inflammation worse.
To add to the gazillions of reasons why you should wear sunscreen on the daily, it’s particularly key if you’re looking to minimise acne scarring, as Dr Kluk impresses:
“I strongly encourage all of my patients who are having treatment for acne and acne scarring to protect their skin year round with SPF. UV rays can make discolouration from blemishes even darker and is known to lead to collagen damage, reducing the capacity that our skin has for repair, leading to further risk of scarring.”
Use makeup to cover scars during the day should you wish, but Dr Kluk advises checking your formulas first:
“Creating an even skin tone through the use of makeup can disguise redness and minimise the appearance of scarring day to day, but choose products that are oil-free, water-based and are clearly labelled as being ‘non-comedogenic’ - simply meaning that they won’t block the pores and further exacerbate acne.
Skin charity Changing Faces also offers a free skin camouflage service, run by trained skin camouflage practitioners and makeup artists in 80 clinics across the UK. You can ask your GP or healthcare specialist for a referral or self-refer in some areas, and specialist cover products may even be available on prescription, depending on your area. To find out more about the service, and locate a clinic near you, check out the Changing Faces website.