Healing Scars: Specially Requested Topic

 This blog was born out of two reasons: 1. for my daughter to have a documented way to take care of herself...when she decides mama has something worthwhile to say and 2. from the numerous friends and family who have asked to have my ideas and research documented for them. The specific topic of healing acne scars was something that has been requested a few times so I thought it was about time to document it!

What is scarring?

So, for the purpose of this post, I will be discussing acne scars. Many people refer to any mark left after acne is gone as acne scars but there are actually two different types of scars, PIH and atrophic scars.

PIH (Post-inflammatory Hyperpigmentation)

These are the red or brown discolorations that are left after your acne is healed. This can be a result of popping the pimple or just because you have melanin and your skin is prone to pigmentation. They are not 3-dimensional and you may have reasonable success in covering it with makeup.

These scars will get worse with sun exposure so SPF is a must. The following ingredients have research backing their efficacy and have proven to help reduce hyperpigmentation:

- Vitamin C

- tretinoin/retinols

- niacinimide

- hydroquinone

- kojic acid

- soy

- most chemical exfoliants like AHA and BHAs

- papaya

These procedures can also help with hyperpigmentation:

- microdermabrasion

- chemical peels

- lasers

- IPL

The sensitivity of your skin will determine how much and which ingredients you can tolerate. You can run the risk of over-exfoliating your skin and damaging your moisture barrier if you overdo it so GO SLOW. Below is a sample routine for a beginner:

AM: Aveeno Positively Radiant Face Wash (has soy in it); Vitamin C serum; sunscreen

I prefer Vitamin C in the morning because of its ability to fight off free radicals and because it allows me to use another active at night but feel free to add it in the evening if you like!

PM: Skinfood Rice Cleanser (rice water has kojic acid in it); tretinoin with niacinimide, Glow Recipe Watermelon Sleep mask (has AHA in it)

Be sure your skin can tolerate both tretinoin and niacinimide before adding a new active like AHA.  When used directly, my sensitive, oily skin was actually breaking out with niacinimide but in combination with tretinoin, I tolerated it better. 

What if you have texture skin left over from acne??

Sigh, this was me...after years of battling acne and finally getting it under control, I was shocked that I didn't have airbrushed skin. Aside from all that being a lie, I was finally able to see the havoc and damaged collagen that acne had left in its wake. Basically, the P. Acnes bacteria and white blood cells battling it out on your face, leave a hole where the collagen has been damaged. When your skin needs to go into emergency healing, it essentially just pours the equivalent of concrete in the damaged area. There is no time for frivolous things like hair or even nerves if the damage is significant. This is why some burn victims are not able to grow hair in damaged area.

There are many different classifications of hypertrophic:

I had predominantly ice pick scars with some rolling and boxcar scars. It helped to know what type of scar I had because I honestly just thought I had large pores instead of acne scarring. The good news is that there are ways to resolve this. The not-so-good news is it is much harder to treat than PHP because the damage goes deeper in the layer of the dermis. 

You may see some improvement in texture, especially if the damage is shallow, with tretinoin but your time and money would be better spent on procedures which will help you see results.

Peels and Lasers 

If you have a darker skin tone, be cautious with these because stronger peels and lasers can actually cause more damage. There is a new treatment called Clear + Brilliant laser which is a less intense version of the Fraxel laser and has been shown to be safe for all skin types.

Microneedling 

This is a slower process but is also safe for all skin types. Combined with PRP (platelet rich plasma) or radiofrequency, this can be a highly effective way of improving skin texture and stimulating collagen. I have been microneedling at home but there are very specific steps and techniques I use to try and minimize the risks. Please, DO NOT microneedle at home until you have done your research and know how to be safe.

If you are interested, you can read more about my microneedling journey here.