Get rid of acne scars and dark spots

Scars from acne can seem like double punishment — first you had to deal with the pimples, now you have marks as a reminder.

Acne lesions (pimples) happen when the hair follicles (or "pores") on the skin become plugged with oil and dead skin cells. A plugged follicle is the perfect place for bacteria to grow and create the red bumps and pus-filled red bumps known as pimples.

What Are the Different Types of Acne?

Acne comes in different forms:

• mild acne: this causes the whiteheads or blackheads that most of us get at some point
• moderate acne: this can cause red, inflamed pimples (called papules) and red pimples with white centers (called pustules)
• severe acne: this causes painful, pus-filled cysts or lumps (called nodules) under the skin

Most serious scarring is caused by the more severe forms of acne, with nodules more likely to leave permanent scars than other types of acne.

The best approach is to get treatment for acne soon after it appears to prevent further severe acne and more scarring. If you have nodules, see your doctor or dermatologist for treatment.

Treating Acne Scars

Most of the time, those reddish or brownish acne marks that are left behind after pimples clear up will fade with no need for treatment. Picking or squeezing acne can increase the risk for scarring, though.

Acne scars take two forms:

1. scars with a gradual dip or depression (sometimes called "rolling" scars)
2. scars that are deep and narrow

A person's acne needs to be under control before scars can be treated.

Mild vs. Severe Scarring

Treatments depend on how severe the scars are. In some cases, a doctor or dermatologist may suggest a chemical peel or microdermabrasion to help improve the appearance of scarred areas. These milder treatments can be done right in the office.

For serious scarring from previous bouts with acne, several types of treatment can help:

• Laser resurfacing. This procedure can be done in the doctor's or dermatologist's office. The laser removes the damaged top layer of skin and tightens the middle layer, leaving skin smoother. It can take anywhere from a few minutes to an hour. The doctor will try to lessen any pain by first numbing the skin with local anesthesia. It usually takes between 3 and 10 days for the skin to heal completely.
• Dermabrasion. This treatment uses a rotating wire brush or spinning diamond instrument to wear down the surface of the skin. As the skin heals, a new, smoother layer replaces the abraded skin. It may take a bit longer for skin to heal using dermabrasion — usually between 10 days and 3 weeks.
• Fractional laser therapy. This type of treatment works at a deeper level than laser resurfacing or dermabrasion, Because fractional laser therapy doesn't wound the top layer of tissue, healing time is shorter. Someone who has had this type of treatment may just look a bit sunburned for a couple of days.

For "rolling" scars, doctors sometimes inject material under the scar to raise it to the level of normal skin. Finally, in some cases, a doctor may recommend surgery to remove deeply indented scars.

One thing you shouldn't do to deal with acne scars is load up your face with masks or fancy lotions — these won't help and may irritate your skin further, making the scars red and even more noticeable.

If you have a red or brownish mark on your face that you got from a bad zit, it should eventually fade. However, it may take 12 months or longer. If you're upset about acne marks, talk to your doctor, who might have advice on what you can do.

With many experiencing more breakouts in isolation, the concern around blemishes, and the marks they leave behind, has only grown. If you're wondering how to get rid of acne scars, trust that—while they can be frustratingly stubborn to treat—with time, dedication, and the right arsenal of products and treatments in your stable, you can effectively reduce their appearance.

A vital part of treating acne scars is first understanding what they are: small depressions or indentations in the skin that result from moderate to severe acne. Secondly, it’s important to note that there are different types, which include ice pick, rolling, and boxcar scars depending on their size, shape, and contour. “Acne breakouts, depending on the severity, can affect not only the top layer of the skin but also the deeper levels as well,” explains New York City dermatologist Shereene Idriss. “As the inflammation subsides and the skin tries to heal, scar tissue can ensue. Severely inflammatory acne, external factors such as picking, and delayed onset of treatment can all lead to scarring.”

Acne scars must be distinguished from superficial acne marks, like brown or red spots. “While many of my patients use the terms scars and marks interchangeably, I do make a point of defining these two very different sequelae of acne,” explains Andrew Alexis, M.D., MPH, and professor of dermatology at the Icahn School of Medicine at Mount Sinai. “Most notably, acne scars are permanent if not treated and are characterized by having an indentation or depression in the skin. Acne marks, on the other hand, do resolve eventually and are characterized by flat or smooth dark spots (hyperpigmentation) or persistent red spots (erythema) at the sites of a recent acne lesion.” The easiest way to tell if you have an acne scar? “Close your eyes and run your fingers over your face or the acne affected area,” Idriss advises. “If you feel textural changes, then you most likely have acne scars.”

From prevention to the most effective at-home and cutting-edge in-office treatments, here the pros weigh in on how to get rid of acne scars and marks.

Begin With Prevention

“Start with controlling and treating the acne first—otherwise, you may just be chasing more scars,” says dermatologist Naissan O. Wesley, M.D., FACMS, adding that some acne treatments will help improve the appearance of acne scars in and of themselves. “Once the acne is under control and there is not much new acne formation, then it would be appropriate to undergo additional acne scar treatments if needed to treat any scars still present.” In terms of the best products to treat moderate to severe acne, such as red bumps, pus bumps, and +/- cystic lesions beneath the skin, Alexis recommends following an acne regimen prescribed by a dermatologist. For an over-the-counter treatment, Wesley recommends a soothing daily acne treatment, such as Arbonne Clear Future Corrective Acne Treatment Pads. “They contain salicylic acid and willow bark extract in a pad form to help reduce acne inflammation and gently exfoliate the skin surface to heal acne and acne marks faster,” she explains, “as well as prebiotics, polysaccharides, calendula, and sage to help heal and maintain the skin’s moisture barrier.”

Tula Keep It Clear Acne Foam Cleanser

$34 at Ulta

Kate Somerville Anti Bac Acne Clearing Lotion

$42 at Sephora

Clinique Acne Solutions Oil-Control Cleansing Mask

$25 at Sephora

La Roche-Posay Effaclar Dermatological Acne Treatment System

$30 at Dermstore

Then I Met You Soothing Tea Cleansing Gel

$36 at THEN I MET YOU

HoliFrog Shasta AHA Refining Acid Wash

$38 at HOLIFROG

Target Discoloration

“When thinking of how to treat acne scars, I always encourage my patients to address the discoloration within the scars first,” explains Shereene Idriss. “It is amazing that when you even out the color of the scar, oftentimes the textual changes do not bother my patients as much as they think they would.” Needless to say, acne has different effects on different skin tones, which is helpful to keep in mind when identifying and addressing acne marks and scars. “Lighter-color skin tones or skin that sunburns more easily will often produce red marks after acne, whereas darker-color skin tones or skin that tans more easily will often produce brown marks after acne,” explains Wesley.

One of the most robust topical treatments for fading discoloration is a vitamin C serum, which is packed with antioxidants and protects the skin from harmful free radicals caused by sun exposure while brightening it to reduce the appearance of dark spots. Additionally, when carefully and slowly incorporated into your skin-care regimen, retinol—a derivative of vitamin A, which is one of the body’s key nutrients for boosting cell turnover and stimulating collagen production—can help treat discoloration. Another at-home strategy is doing regular mild peels infused with acids such as lactic, glycolic, and trichloroacetic, which gently exfoliate to reveal smoother and more even skin.

Perricone MD Acne Relief Retinol Treatment & Moisturizer

$45 at Ulta

Renée Rouleau Post-Breakout Fading Gel

$42 at Renée Rouleau

Agent Nateur Holi(c)

$120 at Dermstore

Dr. Dennis Gross Skincare Clinical Grade IPL Dark Spot Correcting Serum

$92 at Dermstore

SkinCeuticals Discoloration Defense

$98 at SKINCEUTICALS

Benton Aloe BHA Toner

$19 at BENTON

Glow Recipe Pineapple Vitamin C Serum

$49 at GLOW RECIPE

Try In-Office Treatments

The unfortunate truth is that once an acne blemish has scarred, it’s permanent, but in tandem with topicals, professional in-office treatments with lasers will offer maximum results in improving its appearance. “Lasers can be very effective in helping improve acne, acne marks, and acne scars,” explains Wesley. She adds that photodynamic therapy (light therapy) can be used to decrease inflammation of active acne, while vascular lasers and broadband light treatments, such as pulsed dye laser or IPL (intense pulse light), can be used to improve post-inflammatory pigmentation. Most significantly, non-ablative and ablative resurfacing lasers are some of our best treatments for treating acne scars, particularly those that are indented. For rarer hypertrophic or keloid scars from acne, dermatologists will often use the vascular lasers or resurfacing lasers combined with topical cortisone or intralesional cortisone injections (meaning injecting directly into the scar) to improve the scar appearance.

In addition to lasers, Wesley says other in-office treatments, like medical-grade chemical peels and microneedling (especially combined with PRP, which stands for platelet-rich plasma), can help diminish acne marks and scars. What’s important to note across the board is that patience is key, no matter what kind of acne abrasion you’re seeking to treat. This holds particularly true in the case of scars, where timing and results are contingent on the nature of the scar itself and the types of treatments chosen to treat it. That being said, from at-home topical treatments to medical treatments at the dermatologist’s office, there has never been more promising technology. “Acne scarring can be disfiguring, and I feel fortunate that we can do so much now to help patients treat acne scarring, hopefully making them look and feel just as beautiful on the outside as they are and feel inside,” says Wesley.

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