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The 5 Kinds of Acne Scars & How To Treat Each Type

The only thing worse than breaking out? Those deep, dark marks your pimples leave on your skin long after they’re gone. Whether the fallout your skin experiences post-pimple is a deep indent in your skin or a dark spot that’s more obvious than your original breakout, acne scarring and pigmentation is the worst. Trust us, we get it! We’re here to breakdown each type, so you’re prepared to treat whatever kind you encounter on your face.

What are the most common acne scars and how do I treat them?

Hyperpigmentation

Technically, pigmentation isn’t actually a type of scar, just darker discoloration of the skin, sometimes a result of the healing process after inflammation — caused by a pimple. Hyperpigmentation tends to occur in darker complected people (people who produce more melanin and tan pretty easily).

How do you treat hyperpigmentation?

The good news is that most of these dark marks will fade and disappear over time. You can do a few things to speed up the healing process however, so you're not continually trying to cover marks with makeup and concealer. Reach for ingredients like Salicylic Acid and Retinol. A cleanser like SLMD's Salicylic Acid Cleanser will improve discoloration by gently exfoliating the skin's surface. In addition, SLMD's Retinol Serum is another dark spot fighting champ, that deserves a spot in your bathroom cabinet because of its ability to increase cell turnover and regeneration. Also, be sure that you are using and reapplying a broad-spectrum SPF, as sun exposure is going to darken those marks even more. Get that SPF in SLMD's Daily Moisturizer, or a powdered sunscreen like UV Bounce, which can easily be applied throughout the day! If you have a few specific stubborn dark spots, you can also apply a targeted spot treatment with Salicylic Acid, like SLMD's Salicylic Acid Spot Treatment, to help exfoliate and correct that area.

Keloids

When your skin becomes discolored, bumpy and raised, it’s likely scarring into what is commonly called a keloid. These mounds form as a result of the body trying to heal itself post-inflammation, but your body accidentally produces too many cells.

How do you treat keloids?

The first way to attack a keloid is typically with a shot of cortisone, but this isn’t a guaranteed way to shrink them. Retinol topicals and laser treatments can also be used on keloids once they’ve been flattened a bit. Keloids can be surgically removed, but they can often grow back (frustrating, we know) so treating them topically is typically a better bet.

Icepick Scars

The best way to describe icepick scars are as itty bitty depressions in your skin — they almost look like someone took a tiny needle and punctured your skin. Icepick scars form when your skin loses collagen, causing the overlaying skin to collapse and leave a “hole”. They’re typically narrow yet deep, and are usually the result of cystic acne — those really deep, incredibly painful pimples you get on your jawline, chin and cheeks due to hormones.

How do you treat icepick acne scars?

A popular way to treat these is with chemical peels, which will cause a “burn” that actually causes the skin to heal itself and close the openings. Chemical peels must be done carefully, however, as they can make some scarring worse. Icepick scars can be tricky to treat, but you can target them with the same laser and resurfacing methods as rolling and boxcar scars. A Punch incision procedure is also a popular treatment in which your dermatologist cuts out the scar and resurfaces the skin.

Rolling Scars

If your skin has rolling or wave like scars, it’s likely you’ve got rolling acne scars. They can look almost like tiny saucers, and usually give the skin a wavy texture. They tend to be shallower, so if you were to stretch the skin, it might be hard to tell that they’re there. Their “shoulders” (the term a dermatologist uses to refer to the edges of something) are typically soft and smooth. Rolling scars are almost always a result of long-term inflammatory acne. Unfortunately, this type of scar can become more obvious and/or severe as you get older, when your skin loses its natural tightness and elasticity.

How do you treat rolling acne scars?

Laser treatments are a common way to target rolling scars, as they resurface the top layers of your skin. Unfortunately it’s not a “one and done” option — laser treatments do take multiple sessions and can require some downtime, but they are a great way to target scar tissue and encourage collagen production. Facial fillers — like Juvederm, Restylane, and Bellafill are another viable option for patients. They are FDA approved to correct moderate to severe facial scars from acne.

Boxcar Scars

When you have inflammatory acne (red, inflamed, irritated papules and pustules), boxcar scars are an unfortunate common aftermath. They tend to be shallow, but they have sharper edges, unlike the rounder, softer edges of rolling scars. Boxcar scars look almost like someone pushed their fingernail directly into your skin. This depression in your skin holds scar tissue that becomes pulled downward into the rest of the skin.

How do you treat boxcar acne scars?

This type of scar can be treated with subsicion, which involves a dermatologist or PA using a sharp needle underneath the surface of your skin to break up that tough scar tissue. Punch excisions are another option, which means a dermatologist will remove the indented area of the scar and then use a suture to pull the edges of the scar together, closing the gap. Collagen-boosting laser treatments are also used in conjunction with these treatments to encourage the skin to produce collagen and naturally “re-plump” itself. Skincare professionals can also use fillers, such as Bellafill, or fat transfers to fill in boxcar scars.

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