How I Treat My Acne Scars
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I got my first zit when I was in fifth grade. I vividly remember waking up with an inflamed, pencil eraser-size pimple in the middle of my chin and begging my mom to let me stay home from school that day. I was so embarrassed, and had no idea that single breakout would mark the start of my decades-long struggle with uncontrollable hormonal acne—and the scars it left behind.
Now, at 33, I no longer have breakouts, thanks to a solid routine of prescription Tretinoin (a topical retinoid) and a daily dose of Spironolactone, but up until a few years ago, I did have lingering physical remnants of my pimple past: acne scars.
After trying so many silicone-based serums (the hope being that silicone would fill in the scars so my foundation would sit better on top) with little to no avail, I’ve found the only thing that’s helped smooth out my scars is an in-office laser treatment.
Lasers, which “emit a narrow beam of a single wavelength, or color, of light,” dermatologist Shereene Idriss, MD, previously told Allure, can be used to treat different types of skin conditions, such as melasma, rosacea, and acne scarring. A laser’s wavelength is absorbed by “select targets of the skin,” dermatologist Robert Anolik, MD, told Allure, and once that target "becomes so hot, it breaks down or vaporizes.” For skin-resurfacing lasers, which are used for acne scars, that target is water molecules within the collagen layer of the skin. "Heating it creates a grid of “microthermal zones,” which trigger repair and collagen production," Dr. Anolik said.
The skin-resurfacing lasers used for acne scars (and the visible effects of sun damage and hyperpigmentation) are nonablative lasers, like Fraxel Clear + Brilliant or Picosecond. They use lower energy than some other laser treatments, allowing for more frequent treatments (one every few months). Numbing cream is optional and downtime is minimal, like one to two days of sunburn-like redness.
In the past, I’ve had Clear + Brilliant (see above), which I found visibly smoothed my teenage scarring after just three rounds of appointments. While my scars aren’t technically all gone, what was once an inflamed, divoted layer is now smooth, calm skin, which makes me feel incredibly comfortable and confident without a stitch of makeup.
Reader Question
How can I address pitted scars? With so many treatments out there, I don't know whether to start with microneedling, lasers, or fillers.
— asks Anonymous Allure Reader
Pitted scars (a.k.a. deep indentations, created by breakouts and collagen loss) can be difficult to treat with over-the-counter topicals, which is why dermatologists typically recommend in-office procedures, like nonablative lasers.
As for the other treatment options you mentioned, like microneedling and fillers, I recommend first booking an appointment with your dermatologist to talk through treatment options best suited for your skin.
For instance, if you have active breakouts, your doc may want you to actually avoid device-heavy procedures, like microneedling or lasers, for now—or at least until your skin clears up. During that time, they may prescribe a topical treatment, like Tretinoin, to both treat and prevent future flare-ups.
Have a burning skin-care question? Send one in.
Editor's Pick
BEST SCAR-HEALING SERUM: SkinCeuticals Advanced Scar Control Skin Protectant Gel
While I don’t get breakouts that often anymore, I am prone to hyperpigmentation. So when I do get that out-of-the-blue breakout, after it heals, this silky, silicone-based serum is usually my first line of defense to prevent post-pimple dark spots.
Quick Tip
After an in-office treatment, don’t forget to reapply sunscreen! Post-procedure skin is typically inflamed and super sensitive, so stick to a mineral sunscreen with SPF 30 and above to protect without irritating. And you can always throw on a wide-brimmed hat and sunglasses for extra protection.
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Tomorrow, Tomorrow, and Tomorrow by Gabrielle Zevin
★★★★☆
A sweet yet sorrowful story of two childhood friends coping with all of life’s most turbulent twists and turns, like loss, grief, and love. I cried, I laughed, and then I called my best friend.
Originally Appeared on Allure
