What are the most effective acne spot treatments according to dermatologists. How do ingredients like benzoyl peroxide and salicylic acid target blemishes. Which over-the-counter products provide fast results for various types of acne.

The Science Behind Effective Acne Spot Treatments

Acne spot treatments are designed to target individual blemishes quickly and effectively. But what makes these products work? The key lies in their active ingredients and formulation. Dermatologists recommend looking for spot treatments containing proven acne-fighting compounds like benzoyl peroxide, salicylic acid, and retinoids.

Benzoyl peroxide is particularly effective due to its multifaceted approach to treating acne. It works by:

• Killing acne-causing bacteria
• Preventing and clearing clogged pores
• Reducing inflammation
• Exfoliating dead skin cells

Salicylic acid, on the other hand, is a beta-hydroxy acid that penetrates pores to remove excess oil and dead skin cells. This makes it especially useful for treating blackheads and whiteheads.

Retinoids, such as adapalene found in Differin Gel, work by increasing cell turnover and reducing inflammation. This not only treats existing acne but also helps prevent future breakouts.

Top Dermatologist-Recommended Acne Spot Treatments

Based on expert recommendations, here are some of the most effective acne spot treatments available over the counter:

1. AcneFree Terminator 10 Acne Spot Treatment

This powerful spot treatment contains 10% micro-benzoyl peroxide, making it suitable for all types of acne. Dr. Hadley King, a renowned dermatologist, recommends this product for its ability to kill bacteria, clear clogged pores, and reduce inflammation. The formula also includes soothing ingredients like chamomile, ginger, and sea whip to counteract potential irritation.

2. Neutrogena On-The-Spot Acne Treatment

Dr. Shari Sperling, a New Jersey-based dermatologist, praises this affordable and effective option. Its lightweight, oil-free formula contains benzoyl peroxide and absorbs quickly without drying out the skin. Being non-comedogenic, it won’t clog pores or cause additional breakouts.

3. Mario Badescu Drying Lotion

This cult-favorite product is recommended by esthetician Candace Marino. Its unique formulation includes salicylic acid, calamine, and sulfur. The calamine soothes and cools the skin, while sulfur purifies pores and salicylic acid exfoliates and removes oil buildup.

4. Murad Rapid Relief Acne Spot Treatment

Dr. Sperling highlights this fast-acting treatment containing salicylic acid. Users report seeing improvements in blemish size and appearance within hours of application. According to brand studies, 97% of users noticed improved blemish appearance after just one day of use.

5. La Roche-Posay Effaclar Duo Dual Action Acne Treatment

While pricier than some options, Dr. Sperling believes this treatment is worth the investment. It combines benzoyl peroxide with a unique lipo-hydroxy acid for enhanced exfoliation and oil control. Users may see improvements in their skin within a week of consistent use.

6. Differin Gel

Dermatologists universally praise Differin Gel as a must-have for acne sufferers. Dr. Melissa Levin calls it the “gold standard” for treating various types of acne. The active ingredient, adapalene, is a prescription-strength retinoid that not only treats and prevents breakouts but also offers anti-aging benefits.

How to Choose the Right Acne Spot Treatment for Your Skin

Selecting the most suitable acne spot treatment depends on your skin type and the nature of your breakouts. Consider these factors when making your choice:

• Skin sensitivity: If you have sensitive skin, opt for products with lower concentrations of active ingredients or those containing soothing compounds.
• Type of acne: Different ingredients target various types of acne more effectively. For example, salicylic acid works well for blackheads and whiteheads, while benzoyl peroxide is excellent for inflammatory acne.
• Severity of breakouts: For mild to moderate acne, over-the-counter treatments are often sufficient. Severe or persistent acne may require prescription-strength products or professional treatment.
• Additional skin concerns: Some spot treatments offer added benefits, such as reducing hyperpigmentation or addressing signs of aging.

Proper Application Techniques for Maximum Efficacy

To get the most out of your acne spot treatment, follow these expert-recommended application tips:

1. Cleanse your face thoroughly before applying the treatment.
2. Use a small amount of product and apply it directly to the blemish.
3. For most treatments, apply once or twice daily unless otherwise directed.
4. Be patient and consistent – results may take several days to become noticeable.
5. If irritation occurs, reduce the frequency of application or consult a dermatologist.

For specific products like the Mario Badescu Drying Lotion, follow unique application instructions. As Marino explains, “Do not shake the product. Dip a Q-tip all the way to the bottom, remove without stirring, and dab it on the blemish overnight.”

Combining Spot Treatments with a Comprehensive Skincare Routine

While spot treatments can be highly effective for targeting individual blemishes, they work best as part of a complete skincare regimen. To maximize your results and maintain clear skin, consider incorporating these steps into your routine:

• Gentle cleansing: Use a non-irritating cleanser suitable for your skin type twice daily.
• Exfoliation: Incorporate chemical exfoliants like salicylic acid or glycolic acid 1-2 times per week to prevent clogged pores.
• Moisturizing: Even oily, acne-prone skin needs hydration. Choose a lightweight, non-comedogenic moisturizer.
• Sun protection: Apply a broad-spectrum sunscreen daily to prevent hyperpigmentation and protect your skin from UV damage.
• Consistent use of acne-fighting ingredients: Consider using products containing benzoyl peroxide or salicylic acid as part of your daily routine to prevent breakouts.

When to Seek Professional Help for Acne

While over-the-counter spot treatments can be highly effective for many people, there are instances where professional intervention may be necessary. Consider consulting a dermatologist if:

• Your acne is severe, persistent, or leaving scars
• Over-the-counter treatments haven’t shown improvement after 4-6 weeks of consistent use
• You’re experiencing significant emotional distress due to your acne
• You have hormonal acne that may require systemic treatment
• You’re unsure about which products are best for your skin type

A dermatologist can provide personalized treatment plans, prescribe stronger medications if needed, and offer advanced treatments like chemical peels or laser therapy for more stubborn cases of acne.

The Role of Diet and Lifestyle in Acne Management

While topical treatments play a crucial role in managing acne, it’s important to consider the impact of diet and lifestyle factors on skin health. Research suggests that certain dietary and lifestyle changes may help support clear skin:

• Maintain a balanced diet rich in fruits, vegetables, and whole grains
• Limit consumption of high-glycemic foods and dairy products, which may exacerbate acne in some individuals
• Stay hydrated by drinking plenty of water throughout the day
• Manage stress through relaxation techniques, exercise, or meditation
• Get adequate sleep to support skin repair and regeneration
• Avoid touching your face frequently and clean items that come into contact with your skin (e.g., phone screens, pillowcases) regularly

By combining effective spot treatments with a holistic approach to skincare and overall health, you can significantly improve your chances of achieving and maintaining clear, healthy skin.

Addressing Common Myths About Acne and Spot Treatments

There are many misconceptions surrounding acne and its treatment. Let’s debunk some common myths to ensure you have accurate information:

Myth: Acne is caused by poor hygiene

Fact: While cleanliness is important, acne is primarily caused by factors like hormones, genetics, and excess oil production. Over-washing can actually irritate the skin and worsen acne.

Myth: Spot treatments work overnight

Fact: While some spot treatments can show rapid improvement, most require several days of consistent use to see significant results. Patience and persistence are key.

Myth: Natural remedies are always better than over-the-counter treatments

Fact: While some natural ingredients can be beneficial, scientifically formulated OTC treatments often contain proven active ingredients in effective concentrations. It’s important to choose products based on evidence rather than assumptions about “natural” versus “synthetic” ingredients.

Myth: Acne only affects teenagers

Fact: Adult acne is increasingly common, affecting many individuals well into their 20s, 30s, and beyond. Hormonal fluctuations, stress, and other factors can contribute to adult acne.

Myth: Toothpaste is an effective spot treatment

Fact: While toothpaste contains some ingredients that may dry out pimples, it can also irritate the skin and potentially cause more problems. It’s better to use products specifically formulated for acne treatment.

By understanding these facts and choosing evidence-based treatments, you can make more informed decisions about your acne care routine and achieve better results in your quest for clear skin.

8 best acne spot treatments of 2020

While there are tons of acne spot treatments on the market, finding one that actually works can be quite a challenge. To help you with your research, Shop TODAY asked a handful of dermatologists and an esthetician about the best acne spot treatments to help clear up your skin in a hurry.

From pimple patches to drying lotions, you’ll achieve a glowing complexion in no time.

The best acne spot treatments, according to experts

1. AcneFree Terminator 10 Acne Spot Treatment

Dermatologist Dr. Hadley King recommends looking for acne-fighting and anti-inflammatory ingredients, like this formula from AcneFree. This spot treatment contains 10 percent micro-benzoyl peroxide and calming ingredients like chamomile, ginger and sea whip. Best of all? It works on all types of acne.

“Benzoyl peroxide is helpful for treating acne because it not only kills bacteria that contribute to acne but also helps to prevent and clear out clogged pores,” she said. “It also has anti-inflammatory properties and comedolytic properties, meaning that it works for all different kinds of acne: blackheads, whiteheads and larger red pimples. I recommend applying a small amount in a thin layer in order to avoid unnecessary irritation, and I would recommend using it one to three times per day.”

2. Neutrogena On-The-Spot Acne Treatment

“This drugstore option is affordable and effective,” said Dr. Shari Sperling, a New Jersey-based dermatologist.

In addition to benzoyl peroxide’s pimple-banishing powers, this product is lightweight, absorbs quickly and won’t dry out your face. “It’s also oil-free and non-comedogenic, so it won’t clog pores and cause more breakouts,” Sperling said.

She also recommends using it up to two times daily with your morning and nighttime skin care regimen.

3. Mario Badescu Drying Lotion

This cult-favorite breakout buster is another great way to get rid of all of your unforgiving blemishes. Esthetician Candace Marino swears by this drying lotion formulated with salicylic acid, calamine and sulfur.

“The calamine lotion is going to help soothe and cool the skin,” she noted. “Sulfur helps to purify the pores and the salicylic acid will help exfoliate the pores and help remove oil buildup.”

While it may be tempting, Marino says you should not shake this product before applying. “It’s clear on the top and pink on the bottom. So what you want to do is take a Q-tip, dip it all the way through to the bottom and remove without stirring it,” she explained. “Then, dab it on and then sleep with it overnight.”

4. Murad Rapid Relief Acne Spot Treatment

Made with salicylic acid — a powerful acne-fighting ingredient that exfoliates and unclogs pores — this spot treatment also reduces blemish size in just hours, says Sperling.

She also mentioned that many users claim they see fast results with this blemish fighter. According to a study from the brand, 97 percent of users agreed that the appearance of their blemish improved after just one day.

“This stuff works wonders. I noticed a huge difference shortly after I applied this to my pimples. I have pretty decent skin, just get a pimple every now and then, but this does the trick!” wrote one Sephora reviewer.

5. La Roche-Posay Effaclar Duo Dual Action Acne Treatment

While this La Roche Posay acne treatment is definitely on the pricier side, Sperling thinks it’s worth spending the extra cash.

Like many of the other options on this list, this product’s hero ingredient is benzoyl peroxide. It’s also made with a unique lipo-hydroxy acid.

“This exfoliates the skin to remove dead skin cells and excess oil,” Sperling said. “This (product) is best for people with mild to moderate acne. It can be applied in one to three thin layers to the affected areas per day. You can see a difference in your skin within a week or so.”

6. Differin Gel

Dermatologists agree: Differin is a must-have for anyone with acne (it also doubles as a great anti-aging product).

“Hands down my favorite over-the-counter treatment is Differin Gel, which is a prescription-strength retinoid that is the gold standard for the treatment of different types of acne, from whiteheads to blackheads to mild to moderate acne or even occasional breakouts,” said Dr. Melissa Levin, a board-certified dermatologist and founder of Entière Dermatology.

Levin isn’t the only one who loves this product.

“Differin is my go-to product recommendation for my patients suffering from acne,” Sperling said. “It’s affordable and easy to get now that it doesn’t require a prescription.”

The active ingredient in Differin is a retinoid called adapalene. “This powerhouse ingredient treats and prevents breakouts, promotes cell turnover, stimulates collagen, reduces discoloration and restores your skin’s natural texture and tone,” Sperling said.

Differin also has anti-inflammatory properties and is “photo-stable,” meaning you can use it during the day when the sun is out, added Levin.

As for application, a little goes a long way. “You only need a pea-sized amount to cover your whole face, so much less for spot treatment. I recommend using only once daily and integrating it into your nighttime skin care routine,” she said. “Those with mild to moderate acne-prone skin will see the best results, but it can be used on all skin types. “

Just keep in mind that mild irritation, dryness, and redness are normal when first starting retinol — so allow your skin time to adjust.

Pimple patches

1. Peace Out Acne Healing Dots

Pimple patches also make convenient spot treatments. Not only do they have awesome blemish-fighting ingredients, but they’ll prevent you from picking or popping your pimples, which affects inflammation and healing time.

“If someone has an inflammatory acne spot — something that’s above the surface and angry — I love these because you just slap them on and then you forget about it,” Marino said. “These really help to penetrate the pores and to get to the root of the problem.”

King is also a fan of the Peace Out Acne Healing Dots. “I like these because they include salicylic acid, which helps to remove oil and keratin debris from pores. They also include aloe vera, which is soothing and has anti-inflammatory properties,” King said.

Marino pointed out that you shouldn’t leave one on for longer than eight hours at a time, but they’re gentle enough to use continuously until the blemish clears up.

2. ZitSticka Killa Pimple Patches

While Levin typically prefers full-face treatments to spot treatments, she does like these pimple patches from ZitSticka.

“If you are in a bind and unable to see a dermatologist, I recommend applying a specialized hydrocolloid acne patch from ZitSticka,” she said. “It’s a 24 freeze-dried micro darts bandage that self dissolves over two hours in order to deliver acne-fighting ingredients with oligopeptide-76, a new novel peptide shown to be as effective as a traditional anti-inflammatory ingredient.”

These patches also contain acne-fighting benzoyl peroxide, salicylic acid and anti-inflammatory vitamin B3.

King also likes this as a spot treatment option because it’s formulated with moisturizing hyaluronic acid.

This article was originally published on March 25, 2020.

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Acne Scarring—Pathogenesis, Evaluation, and Treatment Options

Abstract

Acne vulgaris is a ubiquitous problem affecting 80 percent of people ages 11 to 30 years, with many patients experiencing some degree of scarring. This review focuses on atrophic scars, the most common type of acne scar. We briefly address the cellular sequelae that lead to scar formation and the initial evaluation of patients with acne scars. We then discuss an algorithmic approach to the treatment of acne scarring based on the classification of scars into erythematous and atrophic types. Lastly, we discuss the future treatment of acne scars and ongoing clinical trials.

Keywords: Acne scarring, acne vulgaris, acne, laser, light devices, resurfacing agents

ACNE VULGARIS IS A UBIQUITOUS PROBLEM, affecting up to 80 percent of people ages 11–30 and five percent of adults 30 years and older in the United States.¹ While epidemiologic data on acne scarring vary, many patients experience some degree of scarring. Here, we address the most common type of acne scar— the atrophic scar— and discuss options for amelioration in a comprehensive manner. Heterogeneity in study design, assessment scales, and level of evidence regarding efficacy for various treatment options make comparative conclusions difficult. In clinical practice, a tailored combination approach using multiple modalities is optimal.

PATHOGENESIS

Acne vulgaris is an inflammatory process localized to the pilosebaceous units of the face, chest, upper arms, and back.² The presumed pathophysiology involves alteration of keratinization within the pilosebaceous unit resulting in comedone formation, increased sebum production, proliferation of Propionibacterium acnes (P. acnes), and production of perifollicular inflammation.³

The early preclinical inflammation in acne persists throughout the acne lesion’s life cycle, from micro-comedones to closed comedones to inflammatory lesions and eventually to postinflammatory erythema (PIE), post-inflammatory hyperpigmentation (PIH), and scarring.⁴ PIE is typically persistent in individuals with fair skin and PIH is more typical in individuals with dark skin. Both sequelae represent grossly visible and histologically notable inflammation⁵ that may be partially related to slow degradation of non-viable P. acnes within the follicle.⁶ PIE results from wound healing-related microvascular dilatation that is perceived as general redness, not visible telangiectasia, which is exacerbated by repair-related epidermal thinning.⁷

Acne affects the face in a majority of cases, with many patients experiencing some degree of scarring, the severity of which correlates to acne grade.⁸ Acne scars result from an altered wound healing response to cutaneous inflammation, with inflammatory cell infiltrates found in 77 percent of atrophic scars.¹¹ Different P. acnes phylotypes differentially activate epidermal innate immunity, contributing to variations in acne severity.¹² In patients not prone to scarring, early lesions have a large, nonspecific immune response that subsides in resolving lesions.¹³ In contrast, in patients prone to scarring, early lesions are characterized by a smaller number of skin-homing CD4+ T-cells compared to non-scarring patients, a response that becomes more active in resolving lesions. ^13,14

Atrophic scars. Aberrant production and degradation of collagen during the healing process leads to various types of acne scars. In 80 to 90 percent of cases, there is a net destruction of collagen in the dermis that results in atrophic scars. Less commonly, there is a net gain of collagen that results in hypertrophic or keloid scars.

Atrophic scars are classified according to the depth and size of destruction; however, different scar types are typically seen on the same person, making differentiation difficult ().¹ In addition to the variations in collagen, the appearance of acne scars may be accentuated by PIE in individuals with light skin, making PIE treatment an important initial component of therapy.

The three types of atrophic acne scars: A) icepick, B) boxcar, and C) rolling

Icepick scars comprise 60 to 70 percent of atrophic scars. These narrow, less-than-2mm, V-shaped epithelial tracts have a sharp margin that extends vertically to the deep dermis or subcutaneous tissue. Their depth of involvement makes icepick scars resistant to conventional skin resurfacing options. Boxcar scars comprise 20 to 30 percent of atrophic scars. These scars are wider, 1.5-to 4.0mm, round-to-oval depressions with sharply demarcated vertical edges. Shallow boxcar scars (0.1–0.5mm) are amenable to skin resurfacing treatments, whereas deep boxcar scars (≥0.5mm) are resistant. Rolling scars comprise 15 to 25 percent of atrophic scars. These scars are the widest and may reach up to 5mm in diameter. Fibrous anchoring of the dermis to the subcutis results in superficial shadowing and an undulating appearance of the scars. Treatment must focus on correction of the subdermal component.

EVALUATION

The approach to treatment of acne scarring involves both a comprehensive physical exam of the patient and a discussion regarding patient goals, concerns, and tolerance of various treatment options. Considerations include the presence of erythema and the type, depth, and location of scarring as well as the patient’s baseline skin phototype (SPT).

Expectation management is important in approaching the discussion of treatment options. Complete resolution of acne scarring is the exception rather than the rule. Patients should be well-informed about potential risks, including post-procedure erythema, infection, poor wound healing, hyperpigmentation, and paradoxically, scarring. Finally, interventions often entail a significant cost, and financial considerations should be addressed.¹⁵

TREATMENT OF ACNE SCARRING

The management of acne scars should follow an algorithmic approach that targets each component of scarring (). Treatment should begin with targeting erythema, if present. Once scar-associated erythema has been addressed, treatment should focus on addressing atrophic scarring, with the approach determined by the types of scar present and whether generalized or individual scars predominate. Combination treatment in a patient-specific way can offer the best chance of significant improvement. Early treatment of active acne remains the best way to prevent or limit acne-related scarring. ¹⁶ It is also imperative to ensure active acne has been treated before approaching scar treatment so as not to create a cycle where active lesions continue to scar in areas already addressed.

Acne scarring treatment algorithm

Scar-associated erythema. For patients with significant scar-associated erythema (SAE), treatment to address the redness can be an initial and dramatic step toward improving the overall appearance of acne scarring. Pulse dye laser (PDL) and other laser and light devices have been successfully utilized in treating SAE.

Pulsed dye laser (PDL). PDL is the gold-standard for treating SAE.¹⁷ PDL utilizes selective thermolysis to destroy vascular components of the dermis leading to clinical improvement of erythema. The major chomophore of PDL is oxyhemoglobin within cutaneous vessels, which absorbs light in the yellow and green range, with peaks at 418, 542, and 577nm.¹⁸ The long-pulsed PDL (595–600nm) slowly heats target vessels with less risk of post-procedure purpura. ¹⁹

In a split-face, observer-blinded study of 22 patients with erythematous and/or hypertrophic facial acne scars, one or two treatment sessions with a 585nm flashlamp-pumped PDL (0.45ms pulse, average fluence 6.5J/cm², 7mm spot size) decreased clinical erythema/scarring by 68 percent compared to untreated skin six weeks post-treatment.¹⁷ Complete clearing of PIE often requires multiple treatments. Purpura is a relatively PDL-specific side effect.²⁰

In addition to treating SAE, PDL also induces collagen remodeling. Heat energy created by the laser diffuses from targeted vessels into the surrounding dermis and results in increased transforming growth factor beta (TGF-β), which ultimately stimulates fibroblasts.^21,22 In a small study of 10 patients (SPT I-IV) with atrophic acne scarring, PDL improved the depressed appearance of scars, with one patient experiencing a two-day episode of transient purpura. ²⁰

PDL performance was shown to be comparable to the 1,064nm Nd:YAG with regard to atrophic scar improvement. A split-face, single-blinded comparative study of 18 patients with darker SPTs (IV and V) demonstrated that the mean improvement in scarring between 585nm PDL and the long-pulsed Nd:YAG (fluence of 50–70J/cm², 50-to 100ms pulse duration, 7mm spot size) were nearly equivalent (18.3 vs. 18.7% improvement, respectively). Subgroup analysis revealed that icepick scars responded better to PDL and deep boxcar scars responded better to Nd:YAG laser.²¹ A small study of 12 Korean patients found no significant difference in efficacy between 595nm PDL and 1,550nm erbium-doped fractional laser (EDL) in treating PIE but more patients in the fractional laser group were satisfied (91.7 vs.75%).²³ In patients with dark skin, PDL should be used cautiously, as purpura or blistering can result in PIH or hypopigmentation.

Other vascular laser and light devices. Other laser and light devices have been successfully utilized in treating SAE. These devices include the potassium titanyl phosphate (KTP, also known as frequency-doubled Nd:YAG), EDL, and intense pulsed-light (IPL).^24–26

Like PDL, the wavelength of KTP (532nm) has a target specificity for the first peak of the oxyhemoglobin absorption curve. A single-blinded, split-scar study comparing the efficacy of KTP to 595nm PDL in reduction of erythema in surgical scars found no significant difference in blinded photographic scar assessments, investigator and subject treatment/satisfaction assessments, and intraoperative pain scores.²⁶ The KTP laser did show significant improvement in the vascularity component on the Vancouver Scar Scale, which was originally developed to assess burn scars and also measure height/thickness, pliability, and pigmentation of scars. The thermal energy delivered by KTP extends only to the papillary dermis, making it useful for PIE without significant effects on collagen remodeling. ²⁷ The KTP laser is especially successful for SAE with pulse durations of 20 to 30ms, fluences of 6 to 9J/cm², and spot sizes of 4–5mm.²⁸

The 1,550nm wavelength emitted by EDL penetrates to approximately 1,000μm into the skin to target tissue water, allowing for improvement of erythema through microvascular destruction of vessels deeper in the dermis.²⁴ Although fractional 1,550nm EDL is considered a front-line agent for atrophic scars, a case study of two patients revealed improvement in scar erythema after one treatment.²⁴ Microsecond-pulsed Nd:YAG lasers (Laser Genesis™, Cutera Inc., Brisbane, California) have shown a greater reduction of SAE by delivering energy to the papillary dermis through small a spot size (5mm), short pulse durations (0.3ms), low fluence (13–16J/cm²), and quick (5–10Hz) laser bursts.^28,29

IPL emits incoherent light across a range of wavelengths (500–1,200nm), with the application of filters to achieve the preferred effect. ³⁰ With the IPL, one has the ability to manipulate settings, including pulse duration, fluence, and the application of filters, allowing treatment of various conditions, sometimes simultaneously (e.g., hyperpigmentation and erythema). However, adjacent, competing chromophore absorption peaks and poor specificity may prevent optimal reduction in scar erythema if settings are not chosen properly. In one study of 35 patients (SPTs I–III) with diffuse facial erythema, a broad-filtered IPL (555–950nm) achieved clinical improvement of at least 25 to 50 percent in 72.7 percent of patients after 1 to 2 treatments, compared to a 35-percent improvement in those treated with the 530 to 750nm filter.³¹ While both PDL and IPL effectively treat SAE, IPL does not typically produce purpura, and larger spot sizes allow for greater surface area to be treated deeper and more quickly. However, given the range of wavelengths that may be used, drawing conclusions regarding efficacy in treating scar erythema with IPL is difficult. Care must also be taken to avoid post-inflammatory hypopigmentation and PIH in dark skin types.²⁸

Generalized atrophic scars. Atrophic scars are seen in nearly 80 to 90 percent of patients, and they are typically numerous.⁸ Treatment of generalized atrophic acne scars involves a field approach, including lasers, chemical peels, dermabrasion, microneedling and radiofrequency.

Laser resurfacing. The options for laser treatment of acne scarring have expanded in recent years and have gained in popularity given their impressive results. Lasers for acne scarring fall under two main categories: ablative (traditional and fractional) and non-ablative (traditional and fractional) (). Laser resurfacing for acne scarring uses monochromatic light to deliver thermal energy, which ultimately stimulates dermal fibroblasts to replace lost collagen and elastin.³² As newer technologies develop, expanding options allow physicians to tailor the balance between efficacy, tolerability, and side effects for each patient. Traditional ablative lasers offer impressive clinical results but are associated with significant peri-procedural discomfort, prolonged recovery, and a significant risk of side effects. Alternatively, non-ablative lasers are more tolerable with shorter recovery times; however, multiple sessions are required and results are often less clinically impressive.

TABLE 1.

Traditional ablative lasers. Considered the gold standard in acne scarring treatment, ablative lasers offer significant improvement in scar appearance with collagen contraction, remodeling, and skin tightening. Improvement is significant after one treatment session, compared to multiple sessions required with non-ablative lasers. The marked clinical improvement comes at a cost, namely significant procedural discomfort or pain, increased risk of dyspigmentation, scarring, and infections with prolonged healing when compared to non-ablative lasers. Due to the extensive injury to the skin, pre-operative prophylaxis (e.g., antiviral therapy) is typically administered, as the rate of herpes virus infection post-treatment has been reported to be as high as seven percent for traditional ablative lasers.³³ Pre-procedure antibiotic therapy is also commonly administered. As collagen remodeling continues after 12 months, a waiting period of up to 18 months prior to evaluating the need for retreatment is warranted. ³⁴ Traditional ablative lasers used for acne scarring include 10,600nm carbon dioxide (CO₂) lasers and 2,940nm pulsed Er:YAG lasers. The target chromophore of these lasers is water in the skin. Despite the higher wavelength of these lasers, the emitted light is readily absorbed by water, so these lasers have less dermal penetration than their fractionated counterparts.³⁵

Traditional 10,600 nm CO₂ laser. The ablative CO₂ laser emits light in the far infrared spectrum. An 18-month prospective, uncontrolled study of 60 patients with moderate-to-severe atrophic facial acne scars demonstrated significant immediate and prolonged improvement in skin tone, texture, and appearance after one treatment session of the high-energy CO₂ laser.³² Clinical improvement scores were 69 percent at one month and 75 percent at 18 months. Persistent collagen formation was noted on histology 18 months post-procedure. Post-procedure erythema lasted 14 weeks and one-third of patients experienced temporary hyperpigmentation. The use of a pulsed, single-pass CO₂ non-overlapping laser (300mJ, 60 watts, CPG density of 5) has comparable efficacy with decreased recovery time (3.5 weeks) but increased transient hyperpigmentation (46 vs. 36%).³⁶

Traditional 2,940nm Er:YAG laser. The traditional 2,940nm Er:YAG laser was developed as a less aggressive alternative to the traditional CO₂ laser.³⁷ The emitted wavelength is also in the infrared spectrum but the thermal energy is more circumscribed and precise. The light from the Er:YAG laser is more efficiently absorbed by water within the skin by an order of magnitude of 12 to 18.³⁸ With a pulse duration of 250sec, a short-pulsed Er:YAG laser ablates 10 to 20μm of tissue per pass with a residual zone of thermal damage of up to 15μm, compared to 20 to 60μm of tissue ablation and up to 150μm of residual thermal damage with each pass of the CO₂ laser.³⁹ This allows for increased absorption of energy higher in the dermis and decreased non-specific damage to surrounding structures. ^37,40 The decreased dermal damage translates into shorter recovery times and decreased intraoperative pain. However, the ER:YAG laser does not have hemostatic properties akin to the CO₂ laser and thus treatment with the laser confers and increased bleeding risk.^37,40

The Er:YAG laser has comparable efficacy to the CO₂ laser for treatment of acne scarring.^37,40–45 In a study of 35 patients with pitted facial scars and dark skin types (SPT III–V), multiple passes with the long-pulsed Er:YAG laser resulted in excellent (36%) and good (57%) results.⁴⁰ All patients had erythema after treatment, and this lasted longer than three months in 54 percent of the subjects. PIH occurred in 29 percent of the subjects and lasted longer than three months in six percent. A non-randomized prospective study of 158 darkly pigmented patients (SPTs III–V) comparing the efficacy of short-pulsed, variable-pulsed, and dual-mode Er:YAG lasers found that all three modes resulted in significant improvement in acne scar appearance. The dual-mode showed the most consistent results across the varying types of atrophic scars. Deep boxcar scars showed only a “poor to fair” response with the short-pulsed Er:YAG laser treatment.⁴³ Er:YAG and CO₂ lasers show comparable rates of re-epithelialization and transient hyperpigmentation but post-procedure erythema is decreased with Er:YAG.⁴⁴

Ablative fractional lasers. Ablative fractional lasers were developed to combine the milder side effects profile of fractional technology (as discussed below) with the efficacy of ablative lasers. Although a single treatment can produce noticeable results, multiple treatments create greater clinical improvement.⁶¹ Adverse effects of fractional ablative lasers include erythema that lasts for 3 to 14 days and resolves by 12 weeks, PIH that lasts for approximately one month, and procedural discomfort that typically necessitates full-face anesthesia akin to traditional ablative lasers. ⁶¹

Fractional 10,600 nm CO₂ laser. Multiple studies support the efficacy of fractional CO₂ lasers on acne scars, albeit with less marked clinical improvement than traditional ablative lasers. In a single-blind study of 13 patients, treatment with fractional CO₂ showed only modest improvement in scar texture and scar atrophy.⁶² The authors purported that low pulse energies of 48 to 56mJ accounted for the modest results. A study of 13 patients (SPTs I–IV) with moderate-to-severe acne scars treated with fractional CO₂ laser with higher pulse and larger microscopic treatment zones showed significant improvements of 26 to 50 percent on a quartile-scale and improved scar depths of 66.6 percent.⁶⁹ All patients experienced erythema, which resolved within one month in most patients. A high-fluence, low-density setting has been shown to be more efficacious than a low-fluence, high density setting.⁷⁰

Fractional CO₂ laser has shown better clinical efficacy compared to non-ablative lasers, but increased rates of PIH and a more protracted side effect profile were reported. ^71,72 Fife et al¹²¹ reported four cases complicated either by scarring located on the neck or ectropion, two of which involved preceding bacterial infections in the area. The deeper penetration of the laser might lead to contraction of the underlying muscle, so lower energy and density should be used on the neck, chest and periocular region.

Fractional 2,940nm Er:YAG and 2,790 Eryttrium scandium gallium garnet (Er:YSGG) lasers. Similar to the fractional CO₂ laser, the fractional 2,940nm Er:YAG and the 2,790nm YSGG have been shown to produce comparable rates of improvement in atrophic acne scars after multiple treatments.^73,74 Mild erythema has been reported, but no serious adverse events, such as scarring or long-lasting dyschromia, were seen.

Traditional non-ablative lasers. With newer therapies, the adverse effects and a long recovery period of traditional ablative lasers have made them less popular. ^46,47 Non-ablative lasers, such as the short- and long-pulsed and Q-switched Nd:YAG lasers, induce collagen remodeling by targeting water as their primary chromophore, albeit less specifically than ablative lasers. They also demonstrate variable amounts of absorption by hemoglobin and melanin.²⁸ These lasers deliver photothermal energy to the dermis without ablating the overlying epidermis, thereby minimizing epidermal damage and decreasing postprocedure downtime. However, results are accordingly modest, and multiple treatment sessions are required to achieve typically less impressive results.⁴⁸

1,064nm Nd:YAG laser. The 1,064nm Nd:YAG induces collagen remodeling in the papillary and reticular dermis, confirmed by post-treatment histologic examination that revealed thickening of papillary dermal collagen⁴⁹ and increased expression of heat-shock protein 70 and Type I procollagen by dermal dendritic cells.⁵⁰ Due to its decreased scatter and increased depth of penetration, the Nd:YAG can be used to treat dark skin types with minimal risk of pigment alteration. ⁵¹ Undesired consequences of epidermal injury can be avoided, since thermal damage is limited to the dermis; cooling systems may be employed to reduced heat injury.⁵²

Variations on the 1,064nm Nd:YAG laser include short-pulsed (0.2–0.5ms, 13–18J/cm²), long-pulsed (50–100ms, 50–70J/cm²), and Q-switched (4–6ns, 5–15J/cm²).⁴⁸ Improvement in appearance of atrophic scars typically ranges from 20 to 30 percent.³⁷ The short-pulsed 1,064nm Nd:YAG targets oxyhemoglobin and produces gradual dermal heating through cumulative absorption within the dermal microvasculature. Since the heat has time to diffuse into the surrounding dermis, cooling systems are not required to protect the skin. An uncontrolled study of 10 patients with atrophic scars showed a 29.4-percent mean cumulative improvement after eight sessions with the short pulsed 1,064nm Nd:YAG laser.⁵¹ Post-procedure side effects were minimal, with erythema lasting less than two hours and with no reports of pain, swelling, oozing, or scarring.

The long-pulsed 1,064nm Nd:YAG laser has also shown efficacy in atrophic acne scars. A study comparing long-pulsed Nd:YAG laser to combined 585nm/1,064nm laser in 19 patients (SPTs IV–V) who underwent four treatment sessions at two-week intervals with atrophic facial acne scars found the combination to have a slightly greater clinical improvement (27% vs. 32%, respectively), which was most significant in deep scars.²⁹

The 1,064nm Q-switched Nd:YAG delivers nanosecond rapid pulses that target pigmented structures, such as melanin, hemosiderin, and tattoo ink. Data regarding the efficacy of the Q-switched laser for acne scarring are contradictory. A non-blinded study of 11 patients (SPTs I–III) with atrophic acne scars showed an improvement in skin smoothness of 39.2 percent and skin roughness of 23.3 percent.⁵³ In contrast, a study of 10 Iraqi patients (SPT III) showed no significant improvement in scar appearance.⁴⁸

1,320nm Nd:YAG and 1,450nm diode lasers. The 1,320nm Nd:YAG laser has historically been used for facial rejuvenation and rhytides, while the 1,450nm diode laser has been used for active acne.³² While a few studies have shown the lasers to have similar efficacy to other non-ablative lasers,^45,52–56 other studies have shown less impressive clinical results compared to the 1,064nm laser.^57,58 There is also a considerable risk of PIH with the 1,450nm diode laser, with occurrence rates from 18 to 39 percent.^45,58,59,60

Non-ablative fractionated lasers. Newer fractional lasers improve acne scarring by inducing photothermal damage that stimulates collagen remodeling with variable absorption by melanin and hemoglobin in addition to water.²⁷ Ablative lasers uniformly treat the skin in horizontal planes, leaving no reservoir of intact skin for re-epithelialization. In contrast, fractional lasers emit microscopic columns of light or microthermal zones (MTZs), leaving the intervening skin unaffected and minimizing damage to the epidermis. The skin adjacent to sites of laser injury remains intact, allowing for rapid post-procedural re-epithelialization due to migration of intact cells into the damaged microcolumns. The stratum corneum contains little water and remains intact after treatment, decreasing average recovery time to three days.⁶¹ Similar to traditional non-ablative lasers, this comes at the expense of efficacy with decreased collagen remodeling,⁶² more treatment sessions, and decreased clinical improvement.⁴⁸

Fractional 1,540nm Er:glass laser. The Er:glass laser has been shown to improve atrophic acne scars in multiple trials. An examination of 10 patients (SPTs I–IV) revealed an improvement in smoothness with transient erythema and no reported scarring or dyspigmentation.⁶² A larger study of 87 Italian patients (SPTs I–V) revealed greater than 50-percent improvement in atrophic scars compared to baseline in 92 percent of patients after six months. ⁶³ Confocal microscopy revealed increased collagen production and bundle arrangement that was closer to normal skin. Another study of 16 Asian patients (SPTs II–IV) revealed a greater than 50-percent improvement in atrophic scars in 62.5 percent of patients, with only transient erythema and edema reported.⁶⁴ Twelve weeks post-procedure skin samples showed an increase in collagen and elastin content within the papillary dermis. The efficacy of the fractionated Er:glass laser on different scar types was examined in 35 Asian patients.⁶⁵ Boxcar scars showed a 52.9-percent improvement in appearance, followed by 43.1-percent for rolling, and 25.9-percent for icepick.

Fractional 1,550nm Erbium-doped laser (EDL). The 1,550m EDL was the first available fractional laser. Compared to its ablative counterparts, multiple studies have shown decreased bleeding and post-procedure erythema, edema, infection and scarring; however, multiple therapy sessions are required are required and less impressive results are seen. A study of 53 patients (SPTs I–V) with atrophic acne scarring showed a scar improvement within the 51 to 75-percent quartile in 87 percent of patients.⁶⁶ Improvement in scars did not significantly differ depending on SPT. Side effects included transient erythema, edema, and skin dryness but no dyspigmentation, ulceration, or scarring was reported. In a study of 29 patients (SPTs I–VI) with atrophic facial and truncal acne scars treated with the EDL, 79 percent of patients showed at least 50-percent improvement. Erythema resolved within 2 to 5 days.⁶⁷ This laser is safe in dark skin types, with less dyschromia than ablative lasers. Lower densities have been associated with less risk for hyperpigmentation.⁶⁸

Emerging laser technologies.

Picosecond 755nm Alexandrite laser. Compared to the traditional nanosecond lasers, picosecond lasers deliver shorter pulse durations with lower fluences of energy, and therefore may lead to fewer adverse effects. ¹¹⁶ The picosecond 755nm Alexandrite laser Picosure^® (Cynosure, West Hartford, Massachusetts) received FDA-approval to treat tattoos and pigmented lesions in 2014. It has also been evaluated for the treatment of acne scars and, with the aid of a diffractive lens array, which delivers pulses 500μm apart, permitting treatment of a greater surface area and pattern density per pulse. The Picosure^® has been shown to improve the appearance and texture of atrophic rolling scars similar to fractional ablative lasers.¹¹⁶ Histologic examination after treatment showed evidence of laser-induced optical breakdown consistent with a localized plasma formation in the epidermis. This breakdown is initiated by absorption of the picosecond light by melanin.¹¹⁷ These changes led to dermal wound healing with formation of new collagen, elastic tissue, and mucin.¹¹⁷ Notably, this technology has a favorable safety profile that is reproducible across SPTs I to V. The mean pain score was mild, and downtime was minimal, with transient erythema and edema. No exfoliation, vesiculation, crusting, scarring, hypopigmentation, or PIH was noted. PicoWay^® (Syneron-Candela, Irvine, California) is a 532nm and/or 1064nm Alexandrite picosecond laser that is currently being investigated for the treatment of acne scars (clinicaltrials.gov {“type”:”clinical-trial”,”attrs”:{“text”:”NCT02592993″,”term_id”:”NCT02592993″}}NCT02592993).

Other resurfacing agents.

Dermabrasion. Dermabrasion utilizes a manual hand or machine-driven source (e.g., high-speed brush, fraise, silicon carbide sandpaper, diamond cylinder) to remove the epidermis with or without part of the dermis. This is in contrast to the crystal-based dermabrasion offered at many medispas, which does not represent a true dermabrasion. The procedure allows the clinician to precisely define scar edges. It is best used for well-defined scars with distinct borders or broad-based scars with indistinct borders,⁷⁵ but not for icepick or deep boxcar scars. ⁷⁶ Dermabrasion seeks to reorganize the papillary dermal collagen without injury to the reticular dermis. Improvement correlates with histological evidence of new collagen formation in the dermis.⁷⁷ Adverse effects include significant pain, scarring, pigment alterations, and milia formation.¹⁵ After treatment, patients will experience increased sun sensitivity for several months, and unprotected skin can often develop hyperpigmentation.⁷⁵

Chemical peels. Chemical peels are used to treat small, depressed scars but not icepick or deep boxcar scars.⁷⁹ They induce injury to the skin that stimulates collagen remodeling and are categorized as superficial, medium, and deep based on the depth of the injury.⁷⁸ Superficial peels, such as lactic acid, salicylic acid, glycolic acid, Jessner solution, and 10 to 25% trichloroacetic acid, only affect the epidermis. Medium depth peels, such as combined Jessner solution with 35 to 50% trichloroacetic acid affect the epidermis and papillary dermis. In most patients, medium-depth peels result in moderate clinical improvement (51–75% clearance), with transient PIH resolving within three months.⁸⁰ Deep peels, such as phenol, injure skin to the mid-reticular dermis. A thicker zone of collagen was induced by a deep phenol peel than by a pulsed CO₂ laser treatment three months postprocedure in one study.⁷⁸

Adequate control of the peeling depth may be difficult to achieve. Complications, including prolonged erythema, infection, PIH, and scarring, are more common in dark SPTs, deeper peels, and sun exposure.^76,81 Phenol has been associated with cardiac toxicity related to systemic absorption.⁸² While phenol peels produce a thicker zone of collagen than a pulsed CO₂ laser, it is rarely used due to its risk of cardiotoxicity.

The chemical reconstruction of skin scars (CROSS) technique. The CROSS technique is indicated for icepick and narrow boxcar scars. It involves a high-strength trichloroacetic acid (TCA) peel (65–100%) applied to the base of the scar to ablate the epithelial wall and to promote dermal remodeling. The degree of clinical improvement is proportional to the number of courses of CROSS treatment, with good improvement after 3 to 6 courses reported in more than 90 percent of cases.¹⁰⁴ Another study of 53 patients (SPTs IV and V) treated with 70% TCA CROSS found that treatment of boxcar scars and higher pretreatment scar severity were associated with better treatment outcomes.¹⁰⁵ PIH of the treated areas was noted in 34.0 percent and more likely to occur in SPT V. Fractional 1,550nm erbium-doped laser has been shown to outperform CROSS for the treatment of rolling scars, but no difference has been observed for icepick scars.⁸⁴

Microneedling. Microneedling (collagen induction therapy) utilizes tiny needles to puncture the skin multiple times, creating micro-clefts that penetrate into the dermis. The trauma in the dermis initiates wound healing and growth factor release, leading to collagen production and deposition in the upper dermis.⁸³ Skin needling renders facial skin smoother and improves rolling acne scars.⁸³ Similar to subcision, the tethered rolling scars can be overcome by greater collagen and elastin deposition induced by needling.⁸⁴ The full result may take 8 to 12 months as the deposition of new collagen takes place slowly.⁸³ One important advantage is that the epidermis remains intact, eliminating most of the risks of chemical peeling or laser resurfacing. In a study of 36 patients (SPTs IV–V) who underwent five microneedling sessions under topical anesthesia, there was a decrease in mean acne scar assessment score from 11.73 at baseline to 6.5, and a 50- to 75-percent improvement in the majority of patients on a quartile scale.¹¹⁸ Furthermore, microneedling provides a clear channel for the efficient absorption of topical agents, including platelet-rich plasma (PRP), which can improve cosmetic results. ⁸⁵ In a split-face study that investigated the use of microneedling plus PRP on one side of the face versus microneedling plus distilled water on the contralateral side, the PRP-treated face showed greater improvement in acne scarring after three monthly sessions (62.20% and 45.84% improvement, respectively).¹¹⁹ Results of microneedling treatment were comparable to the non-ablative fractional laser in one study. Forty-six patients with atrophic facial acne scars were randomized to three monthly treatments with microneedling (2mm microneedles, 20 passes in four directions) or the 1,340nm non-ablative fractional laser (5ms, 120J/cm²). Blinded assessments at six months post-treatment showed a significant, but not significantly different, improvement in acne scars in the microneedling and in the laser groups (4.05 and 3.41, respectively) on the Quantitative Global Grading System for Postacne Scarring.¹²⁰

Radiofrequency. Non-ablative radiofrequency (RF) treatments can be used as a monotherapy or adjuvant therapy with fractional lasers. Radiofrequency delivers a current through the dermis that stimulates dermal remodeling, producing new collagen and softening scar defects.⁸⁶ With traditional unipolar or monopolar RF, a single electrode allows for penetration deep into the dermis, but this is associated with increased pain and discomfort.⁸⁷ New developments have allowed for more precision in the delivery of RF energy to deeper tissues, with decreased injury to the overlying epidermis. Bipolar RF allows for delivery of a more focused current to the dermis. Fractional RF uses an array of electrodes to create zones of thermal wounds that stimulate dermal remodeling. Micro-needles can be used to deliver the electrical current to a particular depth within the dermis. Microneedle bipolar RF and fractional bipolar RF treatments offer the best results for acne scarring, particularly icepick and boxcar scars.⁸⁸ An improvement of 25 to 75 percent can be expected after 3 to 4 treatment sessions.⁸⁶ The results are optimal three months after the final treatment due to the time required for fibroblast activation and upregulation of collagen production. ⁸⁶ The adverse reactions associated with RF include transient pain, erythema, and scabbing that resolve within 3 to 5 days.⁸⁶

Individual atrophic scars. For isolated acne scars or for scars that remain after treatment of generalized atrophic scars, the following techniques may offer cosmetic improvement.

Fillers. Injectable fillers can be used to augment soft tissue, particularly in soft atrophic rolling or boxcar scars. Modes of injection include serial punctures, linear threading, fanning and cross-hatching, deep bolus, and superficial micro-droplet injections. The common adverse effects include infection, pain, erythema, lumps, swelling, and abscess formation. Fillers can be classified as temporary, semi-permanent, and permanent.

Temporary fillers typically last for a few months, making repeated treatments necessary, which increases cost. The injection of hyaluronic acid fillers (HAF) stimulates collagen production by fibroblasts, augmenting soft tissue and improving the quality of the overlying skin. ^89–91 Biphasic HAFs comprise cross-linked HA particles suspended in a lubricating non-cross-linked HA gel, which allows passage through a fine needle.

Semi-permanent fillers can last up to two years and are biostimulatory, stimulating fibrous tissue formation. Poly-I-lactic acid (PLL) is commercially available as Sculptra^® (Dermik Laboratories, Berwyn, Pennsylvania) and New Fill^® (Valeant US, Sinclair Pharma, Paris, France), which have both shown significant improvement in acne scars, particularly rolling scars.^92,93 Calcium hydroxylapatite (CaHA) is a synthetic filler, available as Radiesse^® (Merz North America, Raleigh, North Carolina), that has shown improvement in boxcar scars as a monotherapy⁹⁴ and when used one week after subcision.⁹⁵

Permanent fillers comprise larger particles that cannot be phagocytosed. They can last several years to lifelong and can be displaced over time due to changes in the adjacent connective tissue. ⁸⁹ Adverse effects can be permanent and might require their complete removal. Silicone is relatively cheap and is stable for 10 to 20 years.⁹⁶ Despite widespread use, there have been no controlled studies on scar improvement. Polymethylmethacrylate (PMMA) is a synthetic permanent filler suspended in bovine collagen and lidocaine. Commercial products, including Artecoll^® (Canderm Pharma, Saint Lorent, QC, Canada), Artefill^® (Canderm Pharma, Saint Lorent, QC, Canada), and Bellafill^® (Suneva Medical, San Diego, California, USA), improve acne scars when compared with controls.^97,98 Bellafill^®, the first FDA-approved medical device for the correction of acne scars, is indicated for moderate-to-severe atrophic, distensible acne scars on the cheeks in adults. The safety and efficacy of Bellafill^® in acne scars is being further evaluated as a monotherapy (clinicaltrials.gov, {“type”:”clinical-trial”,”attrs”:{“text”:”NCT02642627″,”term_id”:”NCT02642627″}}NCT02642627) and following microneedling (clinicaltrials. gov, {“type”:”clinical-trial”,”attrs”:{“text”:”NCT02643628″,”term_id”:”NCT02643628″}}NCT02643628)

Punch excision and punch elevation. Punch excision is indicated for icepick and boxcar scars.³² A punch instrument approximately the size of the scar should be selected, followed by excision to the subcutaneous layer. The defect should be closed by sutures along relaxed skin tension lines.³² Placing a single non-absorbable suture for punch holes 2.5mm or larger might facilitate wound healing and minimize spreading.¹ Some authors espouse punch excision followed by secondary intention healing, in which a scar is created but is less noticeable because of change at the depth of the base.⁷⁵ For scars larger than 3.5mm, elliptical excision may be more favorable than punch excision.⁹⁹ Punch excision also works well in conjunction with laser resurfacing.

Punch elevation is best suited for treatment of broad boxcar scars without underlying fibrosis. ¹⁰⁰ The scar is excised by punch instrument equal in size to the depressed scar down to the subcutaneous tissue. The tissue is then elevated and sutured in place at a level slightly higher than the surrounding skin to account for contraction during wound healing¹.

Subcision. Subcision is best suited for rolling acne scars, with less efficacy for icepick and boxcar scars.¹⁰¹ The procedure involves inserting a needle under the acne scar to sever the fibrous components that anchor the scar below the dermis.¹⁰² The release of the fibrous tether elevates the scar and, when successful, produces new collagen formation through normal physiological healing, without recreating a depression.^101,103 Needle choices include an 18- or 20-gauge tri-beveled hypodermic needle or an 18-gauge Nokor™ needle (Becton Dickinson, Franklin Lakes, New Jersey), whose triangular tip allows for the smooth and thorough separation of the fibrous tethers. Multiple treatments may be required to achieve an optimal outcome. Adverse events include depression recurrence, swelling, bruising, bleeding, and infection.¹⁰¹

15 Best Acne Scar Treatment Products

It took a century and a half to get your pimples to go away, but now you’ve received their parting gift: red, sometimes indented scars. Unfortunately, these spots like to overstay their welcome too.

First, let’s figure out exactly what kind of spots you’re looking at: “There’s the pitted scarring that can occur when an inflamed blemish resolves with an ice-pick-like divot in the skin, and discoloration that occurs from inflammation, or the darkened spots as blemishes resolve,” says Susan Massick, M.D., a board-certified dermatologist at The Ohio State University Wexner Medical Center. This is actually called post-inflammatory hyperpigmentation (PIH) and is mistaken for “scars.” While pitted scarring tends to be more challenging to treat, “PIH is reversible and will fade with time, a process that can routinely take three to six months or longer,” says Dr. Massick. Hey, better than permanent damage!

So what causes acne scars, exactly?

Post-breakout tissue damage. Those annoying pink spots, for example, are “known as post-inflammatory erythema, which is when your acne goes away and you still have a pink area for a few weeks to a few months, much like with a cut or scratch,” says Jennifer T. Haley, M.D., a dermatologist practicing in Scottsdale, AZ, and Park City, UT.

Then there’s post-inflammatory pigmentation. “It occurs in those with medium-to-dark skin, where the inflammation invites pigment cells to the area and when the acne resolves, a brown spot is left for weeks, months, even years,” says Dr. Haley.

The toughest form of acne scarring is a result of severe inflammation destroying the collagen in the deeper layers of skin. As the body attempts to repair the damage in the skin, “over-production of collagen may result in raised acne scars, also known as hypertrophic scars,” explains Philadelphia-based dermatologist Rina Allawh, M. D. “Under-production may lead to depressed or pitted scars (a.k.a. atrophic), and are referred to as ice-pick scars, rolled scars, or box-car, depending on appearance.”

Choosing the best acne scar treatment for your skin

Prevention is key: Not to be all Captain Obvious, but getting your acne under control is the best first step to not only healing your acne scars, but preventing future scarring. Your skincare regimen should include a gentle or medicated cleanser, moisturizer, sunscreen, and makeup remover at night, all of which should be hypoallergenic (which won’t cause inflammation) and noncomedogenic (won’t clog pores).

Look for key ingredients: “There are numerous products being sold for acne scarring today,” says Manhattan-based board-certified dermatologist Emmanuel Loucas, M.D. “Many of the products are good, but many product’s ingredients haven’t been proven to be effective.” To ensure you have a legit product, look for one that contains retinoids (vitamin A), alpha and beta hydroxy acids, azaleic acid, niacinamide, vitamins C and E, hydroquinone, kojic acid, or resorcinol.

Know your scars: “Best results are often obtained by using many of these ingredients in combination,” says Dr. Loucas, who recommends applying your acne scar treatment after washing your face and before moisturizing.

• If your acne scarring is dark, the best ingredients to look for in your OTC products are retinol, hydroxy acids, azaleic acid, vitamin C, and hydroquinone, says Dr. Loucas.
• If acne scars have caused some deformity in the skin, “retinols and hydroxy acids are often the most effective ingredients to try and remodel the skin,” he says.
• If your acne scars are inflamed and red, you should proceed with caution. Consider dealing with the inflammation first (with ingredients such as niacinamide, ceramides, and licorice extract) before tackling your acne scars.
• If the acne scarring is significant, you may need to combine your topical regimen with dermatological procedures. “This is because these types of scars are often bound down by excessive scar tissue and need to be surgically released or removed to see improvement,” says Dr. Loucas.

Ready to get bright, even skin? Here, the best dermatologist-recommended products to help fade your acne scars, plus your full guide on how to boost their efficacy.

BEST OVERALL

Differin Adapalene Gel 0.1% Acne Treatment

“Prescription-strength retinoids increase cell turnover, decrease sebum production, and diminish breakouts that can lead to PIH,” says Dr. Massick. Differen Gel is a prescription-strength retinoid (the first available over the counter!) that can prevent new blemishes from forming and strengthen damaged skin by restoring texture and tone.

BEST VALUE

The Ordinary Azelaic Acid Suspension 10%

Azaleic acid can block pigment production in the skin. This prevents acne scars from getting darker and helps to fade dark and pink spots over time, says Beverly Hills-based board-certified dermatologist Tsippora Shainhouse, M.D., who recommends this lightweight cream-gel from The Ordinary.

“Azaleic acid is particularly well-tolerated in patients with sensitive skin and rosacea,” adds Dr. Massick.

RAVE REVIEWS

Dr. Dennis Gross Alpha Beta Peel

These pre-soaked pads contain glycolic, salicylic, malic, lactic, and citric acids to help even out tone, reduce texture, minimize lines, and boost your glow (trust us—you’ll notice a difference). The first pad exfoliates, while the second neutralizes the acids to bring back balance, thanks to soothing green tea and chamomile.

BESTSELLER

Drunk Elephant C-Firma Vitamin C Day Serum

This super-potent serum contain vitamin C (to help rebuild collagen), vitamin E (to seal cracks in the skin), pumpkin ferment extract, and pomegranate enzyme that all work together to exfoliate and brighten the complexion. “Its ingredients are safe and effective, and gentle for patients with sensitive, dry, and acne-prone skin,” says Dr. Allawh.

BEST FOR SENSITIVE SKIN

The Ordinary Magnesium Ascorbyl Phosphate 10%

This budget-friendly hydrator contains magnesium ascorbyl phosphate (obvi), a vitamin C derivative that offers up similar skin-brightening perks as straight-up vitamin C. However, it is less potent, making it a perfect acne scar treatment for those with sensitive skin, says Dr. Allawh.

BEST FOR KELOID SCARS

bioCorneum Scar Treatment Plus SPF 30 Silicone Scar Gel

Rarely, acne will cause a keloid scar (a raised scar that can grow larger than the original area), but it can happen. If you know your skin reacts in this way, try using a liquid silicone gel like bioCorneum, says Joyce Imahiyerobo-Ip, M.D. , of Vibrant Dermatology in Wellesley, Massachusetts. “The silicone puts pressure on the scar as it’s healing, making it hard for excessive collagen to form,” she says.

CeraVe Resurfacing Retinol Serum

Ideal for all skin types, CeraVe’s Resurfacing Retinol Serum is formulated with ceramides to restore the protective skin barrier and heal damage, niacinamide to reduce inflammation and redness, and retinol to speed skin cell turnover for brighter, healthier looking skin. Major bonus: It’s fragrance-free and noncomedogenic.

RoC Retinol Correxion Deep Wrinkle Facial Serum

This noncomedogenic serum by RoC has a unique formula with retinol, magnesium, zinc, and copper to help bring newer skin to the surface. “It helps lighten dark spots, remodel acne scar tissue, and smooth the skin,” says Dr. Loucas.

Peter Thomas Roth Max Complexion Correction Pads

These ultra-potent pads contain 10% glycolic acid to exfoliate the skin, encouraging newer, healthier cells to the surface. They also pack salicylic acid to keep your pores clear, smooth, and virtually nonexistent. Meanwhile, aloe vera maintains moisture and soothes the skin to keep redness at bay.

Murad Environmental Shield Rapid Age Spot and Pigment Lightening Serum

Not only does this serum combine vitamin C with hydroquinone (a skin-lightening ingredient) to help fade dark spots, it prevents future pigment formation as it brightens your complexion, earning a recommendation from Dr. Loucas.

L’Oreal Revitalift 10% Pure Vitamin C Concentrate

Dr. Shainhouse recommends L’Oreal’s Revitalift vitamin C serum, which is tested for stability and efficacy, and visibly boosts skin’s radiance in just one week. The cream formula quickly absorbs to even out hyperpigmentation. It’s also been tested on all skin types, including sensitive complexions, and doesn’t clog pores.

Neutrogena Rapid Wrinkle Repair Face Serum

Dr. Shainhouse loves this fast-absorbing retinol serum by Neutrogena because it’s made with retinol SA, which has a rep for being one of the more effective forms of vitamin A. The serum itself also contains hyaluronic acid, a moisture-attracting ingredient that helps plump the skin and reduce some of the irritation often caused by retinol. 

HydroPeptide 5X Power Peel Daily Resurfacing Pads

This peel has a blend of glycolic acid (to even out tone and texture), lactic acid (to soften the skin) and salicylic acid (to fight acne). It also contains mushroom enzymes, which will gently exfoliate the skin and lighten spots without irritating, says Dr. Imahiyerobo-Ip. Each peel is individually packaged, so you can easily throw them into your travel bag.

SkinCeuticals C + AHA

SkinCeuticals
SkinCeuticals

$136.00

“This treatment pairs vitamin C with alpha hydroxy acids, which help lighten spots and smooth the skin,” says Dr. Loucas. The 15% concentration of vitamin C does its thing by preventing UV damage and boosting collagen production, while the 10% dose of hydroxy acids gently exfoliates, revealing a brighter complexion.

Biopelle KNR Serum

Biopelle’s KNR Serum contains retinol to help support collagen health and lift off dead layers of skin that contain pigmentation, says Dr. Haley. It also contains niacinamide to nix inflammation and kojic acid to lighten and even out skin tone.

How to maximize results from your acne scar products

Always wear sunscreen: “When you have inflammation in the skin, the body automatically responds by putting down pigment,” says Dr. Shainhouse. “Because skin with more pigment will tan more readily and hold onto its color for longer, your skin won’t even out with sun exposure—rather, the scars will appear even darker and stay darker for longer.”

Wearing a broad-spectrum sunscreen with SPF 30+ and minimizing unnecessary sun exposure will keep your acne scars as light as possible, so they can blend into surrounding skin as they continue to heal. Try EltaMD UV Clear Broad-Spectrum SPF 46 sunscreen, which won’t clog pores.

Go easy on your skin: “When people have marks on their face, they tend to be harsh on their skin—trying to scrub them away—but this often makes everything more angry and inflamed,” says Dr. Haley. Ditto for picking at and popping pimples, as it can result in continued melanin production and super-stubborn spots that take even longer to fade.

Have hydrocortisone handy: Sometimes mild irritation can strike from using acne scar products. When this happens, “use OTC hydrocortisone 1% cream for a few days or longer, until your skin calms down,” says Dr. Loucas. This should allow you to continue treating your scars sans having to start and stop your treatment regimens.

Try Aveeno 1% Hydrocortisone Anti-Itch Relief Cream, which is formulated with aloe vera, vitamin E, and finely ground oats to lock moisture into your skin.

What if topical acne scar treatments don’t work?

For deeply indented scars where topical procedures alone won’t cut it, your dermatologist can add additional tools to your skincare repertoire. Fillers like Juvederm, for example, can temporarily fill the space of deep scars.

For a more permanent therapy, there’s a laser treatment called MiXto. “It’s the best out there,” says board-certified dermatologist Kenneth Mark, M.D., a clinical assistant professor at NYU Langone. “The laser shrinks the edges of the scar and stimulates collagen to lessen its depth.”

Additional reporting and writing by Jessica Migala

Krissy Brady
Krissy is a regular contributor to Prevention, and she also writes for Cosmopolitan, Weight Watchers, Women’s Health, FitnessMagazine.com, Self.com, and Shape.com. 

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12 Best Acne Spot Treatments for Men 2021

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As much as we’d like to pretend otherwise, sporadic breakouts happen to the best of us (and yes, even the most well-hydrated, well-rested, and thoroughly scrubbed of us). Acne is a unifier, affecting between 40 and 50 million people in the United States alone. You might have even noticed you’re getting more breakouts lately (I certainly have) thanks to very high stress levels and the new-ish phenomenon maskne: breakouts caused by wearing face masks.

You can do everything right—wash your masks regularly, exfoliate with Pharell-like dedication—and still find yourself with a fat pimple perched prominently on your nose without warning. We’ve all been there before. Although long term solutions might involve switching up your skincare regimen or looking into other forms of preventative care with a dermatologist, there are a few things you can do when you see those inevitable zits pop up. Step number one: Invest in a go-to emergency spot treatment.

Everyone needs a spot treatment in their medicine cabinet, but especially if you’re prone to breakouts or have oily skin. A spot treatment lets you target an active zit with a laser-like specificity (though, to be clear, there’s no, ah, actual lasers involved) and deliver concentrated ingredients like salicylic acid or benzoyl peroxide to help reduce the life of a pimple. Here are 12 of the best available now to help you get started on your way to healthier, acne-free skin.

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Advantage Acne Spot Treatment

Real skincare gurus likely already know salicylic acid can be a game-changer when it comes to treating any unwanted pimples. Clean & Clear’s no-frills option puts the ingredient front and center in a winning formula that’ll help your skin stay, well, clean and clear all day long.

Rapid Clear Spot Treatment Gel

If your pimples tend to be of the swollen, bright-red variety, Neutrogena’s treatment works to reduce irritation and tackle even the most intimidating of breakouts in a matter of hours. 

Drying Lotion

Take it from someone who’s used it more times than they care to count: Mario Badescu’s lotion works, and works wonders.  

Peace Out

If you’re looking to zap a zit or two while hanging out at home (where else are you going, really?) invest in an acne-healing dot. Simply apply it to the problem area and let it sit for a few hours.

Acne Spot & Area Treatment

Peter Thomas Roth’s specialty formula is great for both treating—and, crucially, preventing—any surprise flare-ups.

Super Spot Remover Acne Treatment Gel

A touch of this salicylic acid-infused gel on an unwelcome pimple will shrink it down substantially in no time at all, helping reduce inflammation and soothe affected areas of your skin in the process. 

Emergency Blemish Relief

Proactiv’s specialty relief formula derives its considerable powers from benzoyl peroxide—the silver-bullet ingredient of acne treatments, if you will—and is is designed to zap unexpected blemishes as soon as they pop up.  

Acne Treatment Nighttime

To help treat pimples while you sleep, simply apply a touch of Malin+Goetz’s nighttime concoction to a cotton swab and dab directly on the blemish to minimize irritation. 

Fade Spot Treatment

Spot treatments work best when you apply them and let them sit unbothered for a few hours (or overnight), but most of them don’t help actually hide the zit while you’re waiting for it to go away. Frontman combines a powerful salicylic acid-based zit zapper with concealer so you can fight breakouts without needing to go “camera off.”

Killa Kit 8 pack

Pimple patches are great in most cases—the set-it-and-forget-it of acne treatments. Most of them work best, however, once the pimple has come to a head and aren’t great for those deep-seeded cysts you can feel but not necessarily see yet. These patches solve that with microdarts that sink into your skin and dissolve to deliver salicylic acid below the surface.

Effaclar Duo Dual Action Acne Treatment Cream

La Roche-Posay enlists the help of benzoyl peroxide and micro-exfoliating LHA (trust me) in a pocket-sized formula that packs a hell of a punch. 

Breakout Control Targeted Acne Spot Treatment

This one uses sulfur to help reduce redness and absorb excess oil. Most important: it works—extraordinarily well.

Garrett Munce
Garrett Munce writes about men’s style and grooming.

Avidan Grossman
Avidan Grossman is the Style eCommerce Editor at Esquire, covering men’s fashion, shoes, grooming, and accessories.

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Will Acne Scars Fade Over Time?

The only thing worse than an acne breakout is the scarring it can leave behind.

We’re all guilty of picking at our acne — sometimes rather aggressively — and the visual outcomes are almost always a reminder of why we should resist the urge next time.

But, even when you do find the strength to leave your acne alone, sometimes you still scar.

Annie Christenson, medical aesthetician at Houston Methodist who practices with our ENT specialists, is here to explain why.

When and why does acne scar?

While acne often makes its presence very known above the skin, the reason it leaves scarring behind actually has to do with what’s happening underneath the skin.

“During a breakout, inflammation is happening underneath your skin. This inflammation causes trauma to skin tissue — leading to scarring,” says Christenson. “Whether there’s scarring and how exactly it presents depends on your skin type and the extent of damage.”

The two main types of acne scarring are:

• Discoloration scarring – hyperpigmentation that causes the affected skin to remain darker after the blemish has healed
• Indentation scarring – more common with severe acne, occurs when the top layer of skin doesn’t fully heal and regenerate — leaving an indentation in the skin

“In most cases, acne scarring mirrors how your skin generally scars. Some people’s skin discolors easier than others, for instance. I have a Hispanic background and my skin hyperpigments fairly easily, so I myself am prone to discoloration scarring after a breakout,” adds Christenson.

So…scarring can happen whether you pick at your acne or not, but here’s why you should still avoid the urge to pop.

“Inflammation-related acne scarring aside, aggressively pinching or squeezing a pimple or whitehead just makes the underlying inflammation worse. This, in turn, makes scarring even more likely. Plus, if your hands aren’t clean, picking at your acne can lead to a small, localized infection or your acne spreading to other areas of skin,” explains Christenson.

Are acne scars permanent?

Now time for some good news. Christenson says there are definitely things you can do to reduce acne scarring once you have it.

“The best course of treatment depends on the type of scarring you have, with indentation scarring often requiring more advanced treatment,” says Christenson.

For discoloration acne scarring, start by trying the at-home retail topicals aimed at counteracting hyperpigmentation, such as brightening serums or retinol-containing products.

“The one watch-out about using retinol is that it can make your skin more sun-sensitive. It’s always important to use sunscreen to protect your skin, but be even more diligent about applying sunscreen while using a retinol product,” warns Christenson.

For hyperpigmentation that doesn’t respond to retail products, and for the deeper indentation scarring, Christenson recommends the more advanced treatment options a medical aesthetician can provide, including:

• Chemical peels
• Microneedling
• Prescription brightening products

“Chemical peels are great for both discoloration and indentation scarring, and these peels can also help with what’s called ice pick scarring — very deep indentations that form due to severe acne lesions,” explains Christenson. “Microneedling, which uses tiny needles to stimulate your skin’s healing process, works incredibly well to reduce indentation scarring and make your skin look smoother.”

Lastly, for discoloration scarring, a skin-brightening product containing 4% hydroquinone typically offers the best results. However, it must be purchased in a medical office.

5 tips for preventing acne scars

While there are treatments for acne scarring, you might also consider the following tips for preventing scarring in the first place.

1. Avoid the urge to pop a pimple

As mentioned, serious squeezing, pinching and scraping of pimples causes more harm than help, making it more likely for you to scar. In addition, popping a pimple may result in a small, local infection or result in you inadvertently spreading acne elsewhere on your skin — again, more chance for scarring.

2. Know the different types of acne

You see the whiteheads, blackheads and pimples, but have you ever wondered about those acne bumps that never actually seem to surface. They’re hard, red bumps that can really hurt, but, unlike other types of acne, they remain under the surface of your skin.

“Cystic acne is a type of acne characterized by inflammation underneath the skin with no pore to the surface. Since there’s nowhere for the fluid to actually come out, you really want to avoid trying to apply pressure to cystic acne. Attempting to pinch or pop this type of acne will just lead to the inflammation spreading underneath the skin, creating a larger area of damage and, ultimately, a larger area of discoloration scarring,” explains Christenson.

For cystic acne, Christenson recommends applying ice to help relieve the inflammation — and leaving it at that.

3. If you really want to handle a whitehead or blackhead, don’t overdo it

Whiteheads and blackheads are unsightly, so — naturally — you want them gone.

If you want to take action on a whitehead, Christenson recommends following these steps:

1. Wash your hands
2. Gently apply light pressure to remove the whitehead
3. Wipe the area with alcohol
4. Apple an acne serum
5. Wash your hands again

“If removing the whitehead takes anything more than gentle pressure, stop what you’re doing and try again the next day,” recommends Christenson.

And while blackhead removers can help clear your pores, Christenson adds that you should only use these devices if (and only if) you know how to do so correctly.

“It’s very easy to get carried away while using a blackhead extractor, especially if you have a heavy hand. These devices can be dangerous if not used correctly,” warns Christenson.

4. Start acne treatment ahead of time

If you break out once a month or in a predictable cycle, start treating your skin early.

The type of acne treatment that works best varies from person to person, but consider applying your acne serum, retinol product or antibacterial topical before the breakout even begins.

“In addition to these topicals, wearing sunscreen can help prevent any hyperpigmentation that may occur as a result of acne,” adds Christenson. “Just be sure to choose a sunscreen that’s appropriate for your skin. A sunscreen that clogs your pores can make your acne worse, causing more chance for scarring.”

5. See a skin care specialist

If you feel like you’re using all the right at-home preventive measures but still can’t control your acne or acne scarring, consider seeing a medical aesthetician.

“In our medical spa, we offer many advanced, effective treatments for acne and acne scarring, including chemical peels, microneedling, hydrafacials and prescription skin products,” adds Christenson. “We can also help you understand your skin and recommend the retail topical products we trust.”

In particular, Christenson recommends visiting a medical aesthetician for help with treatments and choosing the correct products for your skin if you’re prone to acne and/or acne scarring.

“Having monthly maintenance skin care retreatments, including facials, can be very helpful. It can also help with anti-aging in the long run!” adds Christenson.

20 Best Pimple Creams of 2021

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It’s a reality of life is that if you have skin, you’ve probably had a pimple. We can all agree that zits are the worst, but figuring out how to get rid of them can be worse. There are thousands of remedies out there from cleansers, to lights, to even stickers. But when you’re staring at an angry pimple in the mirror, you don’t have time to experiment; you just want to get rid of it, fast.

Your most versatile tool in acne-fighting is pimple cream and there are two main categories: preventative measures and spot treatments. If breakouts are something you struggle with on a regular basis, incorporating a preventative cream into your routine can cut pimples off at the pass before they show up in the first place. And then if they do, use a spot treatment to help get rid of them quickly and effectively.

Traditionally, acne spot treatments work by drying up oil and sucking the life out of the pimple, but that way might not always be the best pimple treatment for sensitive skin or if you have consistent acne problems. Finding the best pimple creams for you may take some trial and error, but these 20 expert-recommended creams are the best place to start.

Best Overall

Differin Adapalene Gel 0.1% Acne Treatment

Nearly every dermatologist we spoke to recommended Differin Gel, which used to be prescription-only but is now available over the counter. This easy-to-use retinol gel reigns supreme because “it targets a few factors that contribute to acne including inflammation and facilitating cell turnover,” says dermatologist Dendy Engelman, MD. It can even help fade dark spots from old pimples and help keep blackheads at bay. If you have mild, but consistent, acne it can be a game changer (but keep in mind it’s not a spot treatment and should be used regularly).

The Ordinary Retinol 0.5% in Squalane

Retinol has always been one of the go-to ingredients professionals recommend in the fight against acne. Dermatologist Steve Xu, MD recommends this affordable retinol because “it puts active ingredients first at an affordable price.” Start with a low concentration and see how your skin reacts, particularly if you have sensitive skin.

Kamedis Acne Spot Treatment with Salicylic Acid (2%)

Salicylic acid is another proven ingredient to help clear pimples quickly and effectively. The beta hydroxy acid goes deep into pores to help clear built-up oil and debris. Dermatologist Joshua Zeichner, MD recommends this potent spot treatment because it not only “helps dry out pimples and exfoliate dead cells to keep pores clear, but it is also enriched with Chinese herbs that help soothe skin irritation. ”

Clean & Clear Advantage Acne Spot Treatment

You’d be hard-pressed to find a better salicylic acid treatment at a better price. This spot treatment goes on clear and dries up angry pimples quickly and effectively. It’s a classic for a reason.

Neutrogena On-the-Spot Acne Treatment

Benzoyl peroxide is a classic pimple-fighting ingredient because it “helps lower levels of acne causing bacteria and calms inflammation in the skin,” says Zeichner. Benzoyl peroxide can be irritating on skin, but “studies have shown that 2.5% is just as effective as five or ten percent, but the lower concentration is associated with less skin irritation,” he says.

La Roche-Posay Effaclar Duo Dual Action Acne Spot Treatment

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“This is the fancy version of a typical benzoyl peroxide treatment,” says dermatologist Morgan Rabach, MD. “Not only does it contain benzoyl peroxide (the best for spotting on red pimples), but it also contains lipo-hydroxy acid which helps exfoliate dead skin and dry up excess oil.”

Kiehl’s Since 1851 Breakout Control Targeted Acne Spot Treatment

Dermatologist Adam Geyer, MD is also a fan of sulfur. He likes this spot treatment because “it contains 10% Sulfur to unblock pores and reduce inflammation, and Vitamin B3 to help fade post-break-out discoloration.”

Mario Badescu Drying Lotion

saksfifthavenue.com

$17.00

This classic spot treatment also contains sulfur as well as zinc oxide which absorbs oil quickly. It also contains salicylic acid to help break up buildup deep down inside pores.

Eau Thermale Avene Cleanance Expert Lotion Treatment

Engelman recommends this multi-functional all-over cream, because it “contains monlaurin to reduce oil and diolenyl to reduce the appearance of redness. ” It’s particularly good if you have oily skin.

Murad Rapid Relief Acne Spot Treatment

This spot treatment is perfect for quick, overnight zit sapping. It combines potent salicylic acid with botanical extracts that help reduce redness and irritation. Put it on at night and see zits fade by the time you wake up.

Peace Out Salicylic Acid Treatment Serum

If creams aren’t your thing, this clear serum is a great option. It’s designed for daily use (apply it after you wash your face and follow with moisturizer) and contains salicylic acid to help get rid of the pimples you already have and prevent new ones from popping up.

Hyper Clear Brightening Clearing Vitamin C Serum

In addition to containing the all-important salicylic acid (as well as botanical extracts) to help clear and prevent breakouts, this potent serum also contains vitamin C and fruit enzymes to help smooth skin’s appearance and help prevent dark spots, which could stay behind even once the pimple itself has healed.

Dermalogica Retinol Acne Clearing Oil

Here’s a secret: it’s possible to have dry skin and acne, especially if you’re using retinol, salicylic acid, or benzoyl peroxide to treat it. Those ingredients, while effective, can also trigger irritation and dryness. This ingenious oil combines powerhouses retinol and salicylic acid for a 360-degree acne treatment and prevention combo. And the oil base can help keep skin moisturized and irritation to a minimum.

Neutrogena Rapid Clear Acne Eliminating Spot Gel

Sometimes the old standards are the most effective. Case in point, this simple and effective spot treatment that not only won’t break the bank, but will help dry those pimples in a flash. Trusty salicylic acid is the hero here (it has the maximum amount allowed in over-the-counter treatments), but there’s also witch hazel, which helps reduce redness and irritation.

Kate Somerville EradiKate Acne Treatment

This quick and effective spot treatment features a trifecta of acne-busting ingredients. There’s zinc to help absorb oil, exfoliating salicylic acid, and sulfur, which does both. These ingredients are great together, but when their powers are combined, they’re even more effective against even the biggest, juiciest zits.

Proactiv Emergency Blemish Relief

Salicylic acid might be the go-to for acne creams and spot treatments, but don’t sleep on benzoyl peroxide. This spot treatment gel contains the powerful antibacterial ingredient, which helps kill acne-causing bacteria down in your pores. It’s a powerful tool, but can cause irritation, so if you have sensitive skin or a darker skin tone, use it sparingly at first.

Paula’s Choice CLEAR Regular Strength Skin Clearing Treatment

amazon. com

Many daily acne treatments use salicylic acid to keep your skin exfoliated and your pores clear (to kill existing pimples and prevent new ones). This one, however, uses benzoyl peroxide to keep the bacteria that lead to acne away from your precious pores. And unlike spot treatments, this one has a low quantity of benzoyl peroxide to minimize irritation and make it perfect for daily use.

Origins Super Spot Remover Acne Treatment Gel

You use this gel for the salicylic acid, but that tingle you feel when you dab it on a blemish is the essential oils like oregano that also help to clean out your pores and reduce buildup inside. Coupled with skin-soothing fruit extracts, this spot treatment is a potent combination of science and nature.

My Clarins CLEAR-OUT Targets Imperfections

Sure, this gel has salicylic acid, which by now you know is one of the most effective acne-fighting ingredients out there. But it’s not as strong as some of the others on this list, which is a good thing. The fruit extracts and naturally-derived ingredients help soothe the skin while the acid goes to work on your pimples. Pro tip: use this to help heal angry, popped pimples, too.

Dr. Dennis Gross Skincare DRx Blemish Solutions Acne Eliminating Gel

This powerful acne-squashing gel can be used two ways: as a spot treatment or all-over for full-face protection against pimples. The requisite salicylic acid is here, but so are exfoliating alpha hydroxy acids and skin-strengthening niacinamide in addition to aloe vera and green tea to keep your skin soothed and happy while the acids go to work.

Garrett Munce
Garrett Munce writes about men’s style and grooming.

This content is created and maintained by a third party, and imported onto this page to help users provide their email addresses. You may be able to find more information about this and similar content at piano.io

10 Home Remedies To Remove Acne Scars- MyGlamm

Pimple scars are a sign of acne. As bacteria invades the pores, infections will begin to show and pimples get formed. Though pimples can be treated easily, it is difficult to get rid of pimple scars. Pimple scars are the result of inflammation caused by pimples. Often pimples leave a deep mark on the skin which becomes difficult to get rid of, hence, in this article we will tell you how to get rid of acne scars? These are just simple home remedies that are your key to know how to remove pimple marks easily using ingredients available at home.

How to Remove Pimples Marks with Home Remedies?

Our grandma knows every secret when it comes to home remedies for every problem. Earlier when there was no internet and there was no digital media for communication we used to rely on ancient Ayurvedic methods to care for our skin and body health. Now we have access to vast information and the right answer to how to remove pimple marks is still under confusion. How do we know which will be best for our skin that effectively removes pimple scars. So here are the home remedies for pimple scars that will help you make your skin flawless 

Lemon Juice

Lemon juice not only has powerful skin lightening properties but also heals and makes the skin look fresh and youthful. Lemon juice helps in removing tan and hence, it’s a great anti-tanning agent in the world of skin treatment. Follow this procedure to get rid of pimple marks fast:

What You Will Need?

• Lemon

• Bowl

• Water

• Cotton Swab

• Moisturizer

How to Prepare?

1. Squeeze a lemon into a bowl

2. Dilute the lemon juice with a little water if your skin is sensitive

3. Take a cotton swab, dip it in the juice and dab it over your pimple scars

4. Let it sit on your face till the mask dries up

5. Rinse your face with cool water

6. Moisturize your face using a gentle moisturizer

Tip: Lemon is acidic in nature, so if you have sensitive skin then adjust the amount of lemon accordingly or skip this method.

Baking Soda

Baking soda has exfoliating properties, it can be used as a homemade remedy to erase pimple scars. If you use this method daily, it will help you remove pimple spots and marks fast. Baking soda gently removes the scar tissue layer by layer giving you a complete new scar free skin. It acts as one of the best home remedies to remove pimple marks. Follow the procedure below to erase pimple scars naturally:

What You Will Need?

• Baking Soda

• Mixing Bowl

• Water

How to Prepare?

1. Make a paste of sodium bicarbonate by adding baking soda into a mixing bowl

2. Add some water and stir the mixture well to make a smooth paste

3. Apply the paste over the pimple scars

4. Leave the paste on overnight and rinse your face in the morning

You’ll be left with clear and glowing skin in the morning

Tip: While taking an amount of Baking soda be extra careful as excess soda may not be good for skin.

Honey

Honey, with its antibacterial properties, makes for a good homemade remedy for curing pimple marks. Use raw honey to get rid of acne scars, marks and spots.  Honey not only works in removing acne scars but also helps in skin smoothening. Follow this procedure to remove pimple scars with raw honey:

What You Will Need?

How to Prepare?

1. Apply some raw honey directly on the pimple scar

2. Leave it on overnight

3. Rinse your face in the morning

Potato Juice

Potato juice makes for one of the best homemade remedies to treat patches and scars on the face. You can even treat blemishes with this juice. Potato juice has skin lightening properties that helps in removing pimple scars hence it can be considered as best home remedies to remove pimple marks.  

What You Will Need?

How to Prepare?

1. Slice a fresh potato into thin slices

2. Place them directly onto the affected areas on your face

3. Let the potato slices sit on your face for a few minutes

4. Rinse your face with lukewarm water 

Tips: For more effective results, you can make a potato-honey face mask by grating potatoes. You will be left with a clear skin within few weeks

Aloe Vera

We all know how aloe vera is effective when it comes to how to  remove acne scars naturally? With Aloe Vera, you can prevent pimple marks from forming by treating the zits early. Aloe vera is a natural dark spots corrector. Follow the procedure to cure pimples using aloe vera:

What You Will Need?

How to Prepare?

1. Pick a fresh aloe vera leaf, precisely a succulent one.

2. Squeeze the leaf to get aloe vera gel out of it.

3. Gently massage the pimple marks with this gel using your fingertips.

4. Follow this method twice a day for a few weeks to get rid of pimple marks.

Tips: Face mask made out of aloe vera leaf can help you get a clear and glowing skin.

Turmeric Powder

Turmeric Powder has multiple benefits when it comes to skin treatment. It’s antibacterial property makes it useful in terms of home remedies to remove pimple marks. Turmeric powder is very effective for lightening dark spots and clearing pimples. Here’s how you can get rid of acne marks using this aloe turmeric recipe.

What You Will Need?

• Turmeric Powder

• Milk

• Mixing Bowl

• Lemon Juice

How to Prepare?

1. Make a thick paste out of turmeric powder, milk and lemon juice.

2. Apply it on your skin where there are pimple scars.

3. Let it dry completely.

4. Wash your face with lukewarm water.

Coconut Oil

Coconut oil is just healthy for your skin as it is healthy for your inner body health. It’s active properties help in acne scar removal. Coconut oil acts as a healing agent hence it is beneficial at the early stage of pimple marks removal making your skin tone even. Follow these steps to prepare your acne removal remedy.

What You Will Need?

How to Prepare?

1. Warm a few tablespoons of coconut oil, so that it can be liquified.

2. Now take a small amount of oil and massage the oil into the scar for about 10 minutes.

3. Leave the skin for a minimum of one hour so that it can absorb the oil.

4. Repeat two to four times every day.

Tip: You can skip coconut oil remedy if you have oily skin.

Shea Butter

Shea butter works best in correcting skin discoloration and making skin tone even. It has properties that make it a great skin lightening product, therefore, you will find shea butter as key ingredient in skin care products for skin lightening.  It has healing properties to heal and remove pimple marks effectively.

What You Will Need?

How to Prepare?

1. Add 1 tablespoon of raw shea butter into a  bowl.

2. Stir the shea butter vigorously until it becomes creamy.

3. Add the essential oils and continue stirring.

4. Once all ingredients gets mixed properly, scoop the mixture into a clean jar 

5. Apply it to your acne scars every night.

Vitamin E

Research says that Vitamin E has the capability to heal scar and moisturize skin. Its anti-inflammatory properties help in new cell growth and repair. Vitamin E moisturizes skin and helps in skin glowing. It has proven to be effective in removing pimple marks, you can try this method to help yourself with removing pimple marks.

What You Will Need?

• Vitamin E capsule

• Mixing bowl

• Coconut oil

How to Prepare?

1. Take a vitamin E capsule and cut open and pour the oil into the mixing bowl.

2. Add a few drops of coconut oil to the bowl and mix well.

3. Now apply the oil on your acne scar.

4. For about 10 minutes, massage the oil on and around the scar.

5. After about 20 minutes, wash off the oil with warm water.

6. Repeat this process a minimum of 3 times per day.

Tips: You can also apply the mixture all over the face and not just on acne and take advantage of glowing skin.

Apple Cider Vinegar

It said that Apple Cider Vinegar helps lighten acne scars due to its high acidic content. It comes from the fermented juice of apples and can be found easily in your nearby stores.

The acids in ACV may help reduce the appearance of scars by removing the damaged cells, and outer layers of the skin and promoting regeneration.

What You Will Need?

• Apple Cider Vinegar

• Cotton balls

• Water

• Bowl

How to Prepare?

1. Mix four tablespoons of distilled water with 2 tablespoons of apple cider vinegar.

2. Dip a cotton ball into the water-cider solution and generously dab your scar.

3. Let it dry.

4. Do this every night before you go to bed, washing the area in the morning.

5. Notice the best results.

Well you might have got your answer to your how to remove pimple marks naturally at home. Instead of spending huge money on costly products, if you have all the available ingredients in your reach, you can surely get rid of pimple scars in less time.

FAQ

Q. Which is the best oil to help in getting rid of pimple marks?

Coconut oil is handy and easily available at home as most of the time it is used for hair treatment. Similarly, coconut oil is a cooling agent and is effective when it comes to getting rid of pimple marks. Its anti-inflammatory properties help in reducing skin inflammation.

Q: What Causes Pimple Marks?

When pimples appear it penetrates the skin deeply, thereby damaging the skin and the tissue beneath it. When the  acne clears, the skin tries to repair this damage. In the process of healing, it produces collagen—a substance that gives the skin support. So if there’s too little or too much collagen production, you will see a scar. 

Q: How to prevent pimple marks?

Using home remedies to remove pimple marks can help you to get rid of acne scars but at the same time it is important to follow prevention tips so that pimples don’t occur now and then. Here are the points to follow to prevent acne from occuring.

1. Treat pimples as soon as they develop.

2. Reduce inflammation.

3. Don’t pop and squeeze your pimples.

4. Don’t pick at scabs

5. Check with your doctor for deep breakouts or cysts.

Also Read

How to Get Rid Pimple Marks: Know how to remove acne scars in less time at the comfort of your home.

Home Made Packs to Cure Acne Scars: Try these face packs prepared from homely ingredients to get rid of acne scars.

Skincare Myths Busted: Do you know 50% of information on the internet about skin care is myth. Find out skincare myths to avoid them in future.

These simple home remedies to remove pimple marks will give you a huge relief if you will follow them seriously. Also, while selecting any remedy make sure that you are not allergic to any ingredients due to skin type. So, now that you know how to remove pimple marks, go follow the remedies and have that flawless skin.

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Moskovsky prospect, 143

Dermatologist, specialist in laser technologies in oncodermatology

Moskovsky prospect, 143

Grazhdansky prospect, 107, office 4

Kolomyazhsky prospect, 20

Dermatovenereologist, trichologist, cosmetologist, laser technology specialist

Moskovsky prospect, d.143

Grazhdansky prospect, 107, office 4

Kolomyazhsky prospect, 20

Dermatovenereologist, trichologist, cosmetologist. Highest qualification category.

Moskovsky prospect, 143

Dermatologist, cosmetologist, Laser technology specialist in oncodermatology

Kolomyazhsky prospect, 20

Dermatovenereologist, specialist in laser technologies in oncodermatology

Moskovsky prospect, d.143

Kolomyazhsky prospect, 20

dermatologist, cosmetologist, laser technology specialist

Grazhdansky prospect, 107, building 4

Dermatovenereologist, Doctor of Medicine, Professor

Moskovsky prospect, 143

Dermatovenereologist, specialist in laser technologies in oncodermatology

Grazhdansky prospect, 107, building 4

Oncologist-dermatologist, candidate of medical sciences

Moskovsky prospect, d.143

Grazhdansky prospect, 107, building 4

Kolomyazhsky prospect, 20

Acne treatment

Acne is a skin disease that significantly reduces the patient’s quality of life. Psychoemotional disorders occur in 40-50% of patients with acne. Most often acne occurs among adolescents aged 15 to 18 years and therefore the disease has another name – “teenage rash”. In more than one third of cases, this pathology requires serious, sometimes long-term treatment by a specialist.

ACNE Treatments

There are many different ways to clear clogged pores, from the use of acids (such as salicylic or glycolic acid) to regular cleansing by a beautician and laser therapy. You can also fight acne by changing your lifestyle, changing your diet, and using products with retinol or benzoyl peroxide.

A comprehensive approach is important in the fight against acne. This is not only the treatment of skin imperfections on the outside, but also the elimination of inflammation from the inside. Acne is often caused by hormonal changes or a lack of vitamins, so it is important to consult a dermatologist for safe treatment.

Only a doctor can select the correct, effective treatment, calculate the required dosage of drugs and prescribe individual home care.

New Skin Laser Treatment

Acne can be caused by bacteria. In this case, doctors recommend laser treatment. Penetrating deep into the skin, the laser has a pronounced bactericidal effect, reduces the activity of the sebaceous glands. Thanks to this, after the first procedure, clogging of pores stops, and the development of acne stops.The advantage of the laser is in its point effect, which does not cause intoxication or burns. At the same time, the laser fights not only with acne, but also removes stagnant spots and scars – post-acne.

Laser therapy is one of the most modern and safest acne treatments. We use a unique method of laser treatment for acne “New Skin” (Germany), which gives excellent therapeutic and cosmetic results.

• First, the laser beam penetrates into the deep layers of the skin, where the bacterial lesion is located.The gradual, controlled heating kills bacteria and relieves inflammation and swelling.

• Then the laser acts on the middle layers of the skin to improve its quality from the inside – to reduce porosity and unevenness. This mode promotes healing and renewal of the skin as a whole

The course of “New Skin” procedures allows you to completely get rid of acne in a short time and make your skin smooth and attractive. For a complete cosmetic effect, we recommend using a special laser procedure “New Skin Ultra”.This is a soft but very effective resurfacing of the skin surface – without pain and trauma to the skin. As a result of “New Skin Ultra”, scars and irregularities are smoothed out, the skin looks healthy and well-groomed.

Advantages:

• the most sterile way to eliminate acne
• result after the first procedure, very fast treatment, compared to other methods
• safe treatment
• point effect on the affected skin areas
• does not cause intoxication of the body
• suitable for acne treatment at any age.

Treatment of post-acne acne in Kazan

Quite a serious problem, when the face is covered with acne, and not only in adolescence, is successfully solved by doctors – cosmetologists of the beauty and health centers “Aesthetic City”. In the arsenal of our specialists there are several techniques that have proven to be extremely successful. One of them is the treatment of acne with Erbium laser.

The technique is unprecedented, as it can be used to combat existing problems, as well as to treat deep scars after severe acne.Erbium laser acts not only superficially, but also deep in the subcutaneous layers. Its effect on the skin destroys the protein coat of bacteria that cause acne. Result:

• sebum secretion decreases, pores are opened and then cleansed;
• closed comedones are formed, which prevent the further development of infection under the skin;
• inflammation disappears, the skin gets rid of traces of acne and, directly, of the acne themselves.

How Erbium Laser works on acne.

Doctor – cosmetologist of the beauty and health center “Aesthetic – City” will thoroughly prepare the skin for the procedure, cleanse and treat it with special means. Then he will carefully and carefully treat the required areas with a laser. In this process, it is important not to miss a single area in order to completely rid the skin of inflammation.

During the procedure, the laser energy destroys the epidermis layer with spectral glow.Because of this, the cell fluid begins to evaporate, as a result, collagen is additionally formed, the growth of new cells is stimulated and the creation of new fibers. In other words, removing the infection, getting rid of inflammation, will be replaced by new healthy cells.

Erbium laser removes a thin layer of skin. After gentle exfoliation, the action of the laser occurs on the upper subcutaneous layer, the treatment of which will allow you to get rid of acne permanently or for a long time. At this time, a specialist carefully monitors the process so as not to injure the skin, but at the same time treat all problem areas.

The laser treatment procedure lasts no more than half an hour. During it, the patient will be completely relaxed, he will not feel any unpleasant sensations. We know how to create a pleasant atmosphere. You just have to trust our professionals and just relax. At the end of the procedure, the cosmetologist will tell you how many sessions you need to go through in order to consolidate the result.

Indication for use of the erbium laser

Laser treatment is indicated not only for combating skin rashes, but also for other equally serious problems.In principle, in the hands of professionals in beauty and health centers, the erbium laser can solve many skin problems. The most common ones are as follows:

1. Reduction of scars, including after traumatic and burn scars.
2. Smoothing out wrinkles, both large and small.
3. Acne and its consequences, benign formations.

In Kazan, only Estetik-City employs specialists who use effective but gentle methods that allow the body to activate its defenses, be able to overcome the problem on its own and in the future live a full, healthy life.Come and see for yourself! We are waiting for you and we are ready to do everything to make you young, healthy, beautiful and happy!

REMOVAL OF ACNE TYUMEN PRICE, cost

An inflammatory process on the skin is an indicator that there are problems in the body that require immediate treatment. Red bumps on your face can ruin your appearance and seriously affect your mood.

In the clinic of aesthetic medicine Bioswiss to get rid of acne, patients will be offered a number of procedures aimed at getting rid of the problem, improving the condition of the skin.

For example, cosmetic facial cleansing is designed to quickly and effectively remove all impurities from the pores. Regular washing and other home procedures are not enough for high-quality cleansing, since the impurities are located deep in the epidermis. Therefore, a professional cosmetic cleaning procedure works a real miracle.

The method remains one of the most widespread and is in high demand. Of course, you can do a deep cleaning yourself, but it is still better to entrust this to a professional beautician in order to avoid the appearance of inflammation and irritation.The procedure for cleaning from external and internal contaminants is carried out manually, as well as by hardware.

It is recommended for the treatment of acne, acne; in order to prevent such diseases; in order to regularly care for the skin of the face, preserving youth and beauty. In the clinic of aesthetic medicine Bioswiss, to get rid of acne, patients will be offered a number of procedures, for example, a comprehensive facial cleansing, which may include hardware or manual skin cleansing, application of skin care cosmetics and massage.Comprehensive cleansing will relieve inflammation and cleanse the skin of impurities, provide the necessary hydration and nutrition.

After the procedure, the cosmetologist may prescribe additional measures to consolidate the effect – cryomassage, D’Arsonval or a complex of face masks. It is recommended to carry out complex face cleansing at least 2 times a year.

There are contraindications, specialist advice is required.

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