Blemishes, Marks and Scarring: What Helps

BEAUTY · UNITED KINGDOM

Blemishes, Marks and Scarring: What Helps

Post-inflammatory marks versus scars, ingredients with evidence, and professional options

What people call acne scarring is usually two different things, and only one of them is actually scarring. They respond to completely different treatments.

Marks versus scars

Post-inflammatory hyperpigmentation is a flat brown or purple mark left after a spot heals, and it fades on its own over months. Post-inflammatory erythema is the same thing in red or pink, common on lighter skin.

True scarring is a change in the skin's texture — depressed pits or raised tissue. That does not fade, because collagen has been lost or overproduced.

Look at the skin in side lighting. If you can see a dent or a bump, it is textural; if the surface is smooth, it is pigment and it will fade.

What helps pigment

Sunscreen every day, without exception, since ultraviolet darkens marks and slows fading more than anything else. Then retinoids, azelaic acid, vitamin C and niacinamide, all over months.

Expect eight to twelve weeks before judging anything, since skin turnover takes roughly that long.

What helps texture

Topical products do very little for true scarring. Microneedling, fractional laser, subcision and chemical peels performed by a qualified practitioner have the evidence, and they require several sessions.

Stop the new ones

Treating active acne is the most effective scar prevention there is. Picking is what turns a spot into a lasting mark, and that is entirely within your control.

Silicone for surgical scars

Silicone gel and sheets have reasonable evidence for raised and keloid scars from surgery or injury, used consistently for months.

Sunscreen does most of the work

Ultraviolet darkens post-acne marks and slows their fading more than anything else. Daily broad-spectrum sunscreen is the single most effective product for marks, and it costs less than most serums.

Reapply during the day if you are outdoors.

Patience

Marks fade over months rather than weeks, and comparing your own skin daily makes any progress invisible to you. Photograph your skin in the same light once a month instead.

Ingredients worth having

A retinoid for texture and turnover, azelaic acid for redness and pigment, niacinamide for barrier function, and vitamin C as an antioxidant. Introduce one at a time with four weeks between.

Never stack several exfoliating actives together on the same night, which is the usual route to a damaged barrier.

When to see a doctor

Acne that is leaving marks or dents should be treated medically rather than cosmetically, since prescription options are considerably more effective and prevent further damage.

When to see a doctor

Acne that is scarring should be treated medically rather than cosmetically. Prescription options are considerably more effective and they prevent further damage from occurring.

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