As if fighting acne wasn't difficult enough, after puberty you also have to deal with the scars and marks left by post-inflammatory erythema. However, know that And possible to get rid of all those blemishes: just find the right method for your skin. There are many techniques to manage and control scars and can range from simple creams to more invasive surgery.
Steps
Method 1 of 3: Get Rid of Scars
Step 1. Identify the type of scars on your skin
Those produced by acne are of four types and, if you know their nature, you can choose the most suitable treatment.
- Icepick or "pit" scars are the most common. They are characterized by deep holes on the surface.
- Boxcar scars mostly form on the temples or cheeks and are characterized by depressed areas with angled edges similar to the marks left by chickenpox.
- The "bowl" scars give the skin a rippled appearance, their walls gradually incline, the edges are superficial but become deeper in the center.
- Keloids (or hypertrophic scars) are thick, raised scars that form due to excess collagen synthesized to repair the original injury.
Step 2. Try topical treatment for atrophic scars
This term refers to all undetected scars that are not keloid. Typically this type of skin blemish responds well to topical treatments that aim to boost collagen production. Look for products that contain:
- An alpha hydroxy acid (AHA). Glycolic acid is one of many AHAs available. For the over-the-counter product to be effective, it must have a pH between 3 and 4. Remember to apply it in the evening, as alpha hydroxy acids cause photosensitivity. Apply sunscreen during the day and try to avoid exposure to the sun's rays when following this treatment. Glycolic acid is also safe in pregnancy, as long as it has a concentration of less than 10%.
- A beta-hydroxy acid (BHA). A BHA must have a pH between 3 and 4 for it to exfoliate the skin. An example is salicylic acid; this product should not be used by pregnant women.
- Retinoic acid or vitamin A. In some countries, such as the United States, you must have a prescription to purchase a tretinoin cream, as it can cause birth defects if the patient is pregnant. Ask your dermatologist what side effects this product can generate.
Step 3. Give microdermabrasion a try for atrophic scars
It is a procedure that makes the skin around the scars smooth, thus smoothing the surface and making small holes and imperfections less visible. Microdermabrasion exfoliates the skin using very fine crystals and is relatively painless and bloodless. The procedure stimulates the body to produce collagen under the skin; many dermatologists recommend it and practice it in their clinic.
- Inquire to find some advice. If possible, talk to someone who has already undergone this procedure to treat acne scars.
- Some individuals with deep scars avoid microdermabrasion and undergo dermabrasion directly, a more invasive process that affects the deep layers of the epidermis. Ask the dermatologist what is the best solution for your specific case.
- Prepare for convalescence. The skin will be red and sensitive after the treatment. Avoid direct sunlight for a few weeks and always apply sunscreen.
Step 4. Get a chemical peel
Thanks to this procedure it is possible to remove the first or the first layers of the skin so that a new skin is regenerated free of blemishes and blemishes. Chemical peel should be always performed by a dermatologist or his assistant, although it is not too painful a process - patients usually complain of a slight tingling or burning sensation.
- Ask the dermatologist which type of peel is best suited to your needs. There are several solutions designed for various types of skin problems and which act at different depths. Chemical peels lead to better results when used multiple times.
- Do not stay in the sun and always use a sun protection cream. The epidermis will be extremely sensitive after the treatment, do not ruin a good job with a sunburn!
Step 5. Consider laser treatments
These are suitable for both atrophic and keloid scars. There are several procedures and the dermatologist will choose the one that best suits your problem.
- Laser resurfacing for atrophic scars works in a similar way to microdermabrasion. Its goal is to smooth the skin around the scars to reduce their appearance and visibility.
- Pulsed dye laser treatments are effective against keloids and red scars. This procedure induces apoptosis (the death of individual cells) by smoothing raised scars and reducing redness.
- The Smooth Beam laser is not very common in Italy, but is able to improve the appearance of atrophic scars by helping the body to replenish collagen.
Step 6. Ask your doctor about fillers
Sometimes the scars are so deep that superficial treatments alone are not enough. In this case you have to consider the possibility of injecting "fillers", also called fillers, which lift the depressed areas making them less evident.
The only downside to fillers is that these materials are absorbed by the body over time and therefore more injections are needed every 6-12 months
Step 7. Try steroid injections
Steroids, i.e. cortisone drugs, are able to soften and then shrink hard scars. This treatment is very effective against keloids. The doctor will inject the drug into the scar tissue thereby reducing the redness, itching or burning sensation. at the same time the cortisone softens and narrows the scar.
Step 8. As a last resort you can consider surgery
The surgery is effective but obviously involves risks.
- Excision with a cylindrical scalpel involves incision of the skin around the scar. The wound is then sutured to remove the original scar tissue.
- If the scars are very small, the suture will most likely be just a thin line above the excision area; on the other hand, when large areas are treated, a skin transplant is required which is removed from another area of the body, usually behind the ear.
Method 2 of 3: Treating Post-Inflammatory Eritema
Step 1. Understand the terminology
Although they are caused by acne, post-inflammatory erythema and post-inflammatory hyperpigmentation are not scars, but a change in skin color.
- Erythema manifests as pink and red areas caused by inflammation and acne lesions. Hyperpigmentation, on the other hand, generates brown spots that result from an excess of melanin.
- You can distinguish the two problems by looking at the color, but also by doing a simple test: erythematous spots disappear when you apply pressure to the skin, while hyperpigmented spots do not.
- The term "scar" only describes the holes and imperfections found caused by acne; people who suffer from very severe skin rashes are also interested in reducing the visibility of erythema and hyperpigmentation.
Step 2. Treat both skin changes
Unlike scars, erythema tends to disappear as collagen production slows down. Since the process takes from 6 months to several years to be effective, many people prefer to reduce the time by undergoing treatments with specific products.
- Effective treatments should contain lightening or tone-correcting agents. These lotions are very popular in Asian countries, where the desire for fair skin is widespread.
- Look for products that contain kojic acid, vitamin C, arbutin, nicotinamide, mulberry extract, azelaic acid, and licorice extract. As these active ingredients have been scientifically tested as lightening products, they are generally safe to use and should not cause adverse reactions when applied correctly.
- You may have heard that in the United States and other non-European countries some dermatologists prescribe creams with hydroquinone. However, this substance has been banned in Europe since 2009 due to its severe side effects in both the short and long term.
- Serums with vitamin C are able to regenerate collagen by smoothing the complexion to limit post-inflammatory erythema. It should be emphasized that many over-the-counter products of this type do not contain a sufficient concentration of the active ingredient to be effective. If you want to use serum with vitamin C, your best bet is to have a dermatologist prescribe a concentrated product.
- Always apply sunscreen. This product protects the skin from damage from UVA and UVB rays, thus reducing the spontaneous healing time of erythema.
Step 3. Give it a try with chemical exfoliation
Over-the-counter products that contain alpha-hydroxy acids (AHAs) are able to exfoliate the skin and promote cell turnover, treating both acne and post-inflammatory erythema.
- AHAs are effective exfoliants, which means they stimulate the skin to get rid of the surface layers more quickly, thus revealing those underneath, fresh and without blemishes. Always use sunscreen because alpha hydroxy acids cause photosensitivity and you can burn easily.
- Consider a chemical peel (which uses both glycolic acid and other AHAs or beta-hydroxy acids) at your dermatologist's office. This procedure is far more effective than the one you can do at home with over-the-counter products. The chemical penetrates deeper into the skin, so it will take several days or even weeks for the redness and irritation to disappear; keep in mind that this treatment will be more expensive.
Step 4. Use retinoids
These are acid derivatives of vitamin A and are very effective in treating various skin problems such as wrinkles, fine lines, acne and blemishes.
- Retinoid creams help to discolor the signs of hyperpigmentation by accelerating cell turnover; they are also effective against atrophic scars because they stimulate the production of collagen.
- These are only available with a prescription, so you will need to make an appointment with your dermatologist to undergo the treatment. It should be emphasized that retinoids make the skin very sensitive to sunlight and should only be applied in the evening.
- Over-the-counter skin care products typically use retinol, a weaker version of retinoids. The manufacturers claim that these creams and lotions are as effective as retinoids, but their effects cannot even compare to those obtained with prescription creams.
Step 5. Consider laser treatment
If post-inflammatory erythema or hyperpigmentation does not go away within several months, then you can consider laser therapy to reduce the appearance of the spots and make them less visible.
- The most modern techniques are able to reshape the surface of the skin while eliminating any imperfection or dark spot of hyperpigmentation. These lasers also stimulate the production of collagen which will fill the "holes" left by scars. Other lasers, such as pulsed dye lasers, perform a specific action against redness and blemishes caused by acne.
- The only downside to laser treatments is the cost and it typically takes up to three sessions to completely eliminate hyperpigmentation. At the end of each session the skin will be irritated and sensitive; however, you will be able to appreciate the results in a short time, which will be permanent and satisfying.
Step 6. Experiment with home remedies
Although medical procedures and treatments have a very high success rate, some people may prefer less invasive products that are available in every home and are safe to use.
- Honey mask. Honey contains sugars, amino acids and lactic acid. This means that it is able to attract moisture and trap it in the layers of the skin while at the same time performing a lightly exfoliating action to treat acne. Prepare the skin by pouring very hot water into a bowl, bring your face close to the surface and cover your head with a towel to trap the steam. This "pretreatment" dilates the pores of the skin so that they can absorb the honey well. After a few minutes, spread some raw honey on your face and let it sit for 15 minutes before washing it off.
- Aloe vera. It is another natural moisturizing product that smoothes and rejuvenates hyperpigmented skin. Although there are many products on the market that contain the sap of this plant, know that the gel extracted from the aloe leaf is ready to be used immediately. Just detach a leaf from the plant and spread the gelatinous content on the skin. If you wish, you can add one drop (and no more than one) of tea tree oil at a medicinal concentration to the sap. Pure tea tree oil causes chemical burns, so it must always be diluted. It is a natural product with antibacterial properties that is able to lighten the skin and treat acne. Alternatively, you can use diluted neem oil.
Step 7. Know which home remedies you need to avoid
Many online articles recommend using products that are dangerous or harmful to the skin. Before relying on a topical remedy, do your research to make sure you can use it safely.
- Remember that just because an ingredient is "natural" doesn't mean it's "safe". Mercury and poison ivy are natural substances and plants, yet you would never put them on your skin, so always be careful with "natural" ingredients, regardless of whether they are home remedies or commercial ones. Always choose active ingredients whose efficacy and safety are scientifically proven.
- Food is also no exception - just because it's an edible food doesn't mean it's safe for the skin. The pH of certain foods is harmful to the epidermis. Treat your skin with all the caution due to a sensitive organ and not as if it were a "dinner plate".
- In particular, avoid all homemade concoctions based on lemon juice or baking soda. You shouldn't apply them to your face as they can cause chemical burns and worsen erythema. Additionally, lemon juice causes photosensitivity. Both have a pH that is too different from the natural pH of healthy skin (5, 5) and are not usually recommended for skin care.
Method 3 of 3: Take Care of Your Skin
Step 1. Use a cleanser with a balanced pH
Be gentle on your skin and use a soap with a pH of 5.5. This is the natural acidity level of human skin and the optimal pH. Under these conditions, the skin forms a protective acid coating that prevents acne development.
- Check that the cleanser you have chosen is specific for the face, for sensitive skin or skin prone to acne breakouts.
- Do a skin test. Before using a new product, test it on a small area of the skin to make sure there are no adverse reactions. If you notice any signs of irritation, discontinue use. Be cautious about relying on new products. For some individuals, a pH balanced cleanser can be irritating due to the scents contained. If so, switch to another soap or use plain coconut oil to cleanse the skin.
- Do not wash your face with very hot water (because it dries the skin) and do not use a rough cloth or sponge to physically exfoliate the skin, as it will only cause irritation. Instead, use only lukewarm water and a pH balanced cleanser.
Step 2. Exfoliate the skin
For this operation it is very important to use a chemical product that contains alpha-hydroxy acids or beta-hydroxy acids and thus treat acne and related erythema. Thanks to exfoliation, you eliminate dead cells, free pores and treat acne lesions. This procedure also smoothes the skin by reducing the evidence of both scars and erythematous marks.
For AHAs and BHAs to be effective, they must have a pH between 3 and 4. Use a beta-hydroxy acid twice a day while the alpha-hydroxy acid should only be used in the evening, as it triggers photosensitivity. If you want to use it during the day, remember to also apply an SPF cream
Step 3. Gently exfoliate your skin
If you proceed with a physical exfoliation you can use a Konjac sponge or a small towel wet with water. Rub the cloth across your skin in small circular motions.
- You can do this once a week or as often as you see fit. However, if you tend to have dry skin and feel tight after treatment, then you should exfoliate it more rarely.
- Do not perform a mechanical action using plastic microgranules or walnut shells, as the former are polluting and the latter damage and prematurely age the skin.
- If you find that your skin becomes very red or irritated, reduce how often you peel it or try another product.
Step 4. Apply sunscreen and don't tan
Ultraviolet radiation is the number one cause of premature aging and can lead to skin cancer. If you expose your skin to dangerous UVA and UVB rays, you damage it and promote the development of post-inflammatory hyperpigmentation, as sunlight stimulates the cells that produce melanin. This way you also prolong the effects of the erythema.
- Sunlight not only extends the healing time of post-inflammatory erythema and triggers hyperpigmentation, but also promotes premature skin aging, the formation of sun spots, wrinkles and fine lines. SPF creams are effective anti-aging products that must be used by everyone, regardless of age, because they also prevent skin cancer. Remember that "prevention is better than cure". There is no "safe tan", while sun damage is a real risk.
- Use 30 factor protection every day.
- When you have to be outdoors for a long time, seek shelter in the shade most of the time, wear a wide-brimmed hat and light but long-sleeved clothing. Wear sunglasses, especially if you have blue or green eyes. Also consider using a parasol; in Asian countries, for example, it is considered a very popular fashion accessory.
Step 5. Drink lots of water and eat a healthy diet
While these healthy habits alone don't make scars go away, they do help the body function at its best and encourage skin rejuvenation.
- Water removes toxins from the body and hydrates the skin making it fresh, firm and healthy. You should drink 6-8 glasses of water a day.
- If you eat a lot of fruits and vegetables, you are absorbing a large amount of vitamins and nutrients that are essential for healthy skin. Work hard to get enough vitamins A, C, and E (found in vegetables like broccoli, carrots, spinach, tomatoes, avocados, and sweet potatoes), as they are the most beneficial nutrients for the skin.
Step 6. Don't tease the spots and don't touch your face
It is not easy to follow this advice, but you must resist the temptation to squeeze, scratch and tease the skin, so find a way to keep your hands off your face. Such behavior would only make the situation worse in the long run.
- Instead, make it a point to only touch your face twice a day when you wash in the morning, in the evening, and when you apply the products. For the rest of the day, it leaves the skin undisturbed.
- Change your pillowcase regularly, as bacteria and oil that accumulate on its fabric can contribute to acne development.
- If you're still struggling with acne breakouts, read these helpful wikiHow articles: How to Avoid Acne and How to Prevent Acne.
Advice
- Hydration helps scars heal, so don't neglect this aspect. Avoid lotions that aren't specifically listed as "non-comedogenic," as they cause blackheads to form.
- To avoid the pitted look that makes scars even more noticeable, try to even out the complexion with makeup. Use an oil-free, non-comedogenic cosmetic. Mineral-based ones are often your best bet.
- If you expose yourself too much to the sun without using a sunscreen, you contribute to the phenomenon of photoaging, which makes the scars darker and more permanent. Always use a sunscreen that protects you from UVA and UVB rays.
- If you are pregnant or breastfeeding, inform your dermatologist. Not all treatments and medications are safe during these stages of a woman's life.
