Anyone who has really struggled with acne knows the frustration pimples bring. For some, it seems that no matter how much they wash their face, they just can’t make the bumps go away.
But, what’s worse than those glaring red pimples? The blemishes they leave behind. Thankfully, because of acne scar treatment, there’s no need to let acne scars cause any more frustration.
Types of Acne Scars
When you’re ready to treat your acne scars, your first step is identifying what type you have. You may have one specific scar that bothers you or a combination of multiple types of scarring.
So grab a mirror and see what best describes the scars you’re facing.
First, see what general type of scar you have. Is it:
- Depressed – Goes down into the skin
- Raised – Rises from the skin
- Discolored – Lighter, darker, or redder than your skin tone
Once you know the category of the scar, identify the specific type.
Also called “pitted” or indented acne scars, they go down into the skin. Some are rather shallow; others extend to the lower layers of the skin. These scars usually appear on the cheeks and forehead and most likely came from inflammatory acne. Here are the three specific kinds:
Rolling scars are broad depressions with sloping edges. They can be shallow or deep but most likely came from long-term inflammatory acne. As the skin ages, it loses elasticity and fullness, making rolling scars more pronounced.
Because the edges are rolling, these scars respond great to treatment.
These scars also left broad depressions in the skin, but the edges of the scar are sharply defined. Since the edges are steeper and more distinct from the surrounding skin, they’re more difficult to treat.
Ice Pick Scars
These deep, narrow scars often look like an open, enlarged pore, or an ice-pick wound. As the deepest depressed scar, it’s also the most difficult to treat.
Depressed scars respond best to more aggressive treatments. Fractional laser treatments, Intense Pulse Light phototherapy, and RejavaPen improve the skin’s texture after acne. However, the depth of the scar and steepness of the edges often determine how effective the treatment will be.
If you have a raised scar, you likely had a cyst there before. As the cystic acne healed, too much scar tissue formed in its place. Now it’s a bulge of thick, rubbery scar tissue (called a keloid or hypertrophic scar) that protrudes from the skin.
These scars aren’t as common as other types, but if you have them, they’re likely on your chest, back, or jawline — where you had cystic acne.
Raised scars respond well to treatment. Laser resurfacing is especially effective in smoothing raised acne scars.
If you’ve had acne, you likely have skin discoloration. Discoloration isn’t technically a scar but is the most common side effect of acne. Whether brown, red, or white, the pigment in these areas isn’t the same as the rest of your skin tone. Often, the discoloration fades with time. But sometimes, the change in color becomes permanent.
There are three categories of discoloration — and treatment options for each!
If you have a brown discoloration, you’re dealing with hyper-pigmentation. The acne damaged the skin cells, and the cells that produce melanin (melanocytes) either multiplied or overproduced melanin in an effort to recover. Consequently, you ended up with a freckle-like spot that won’t go away.
There are several options for treating dark spots. We use laser and light treatments, hydroquinolone, or topical retinoids to reduce melanin production (so the pigment decreases) and increase cell turnover (so you can slough off the discolored skin).
Related: Retinol, Retin-A, & Retinoids: What’s the Difference?
Hypo-pigmentation is characterized by the light spots that result from a lack of melanin. With this type of skin damage, melanocytes are depleted from the injured area or lose their ability to produce melanin. This occurs when healthy skin has been replaced with scar tissue. Because scar tissue has a light pink color, it’s more noticeable on people with darker skin tones.
Few treatments completely erase hypo-pigmentation, but chemical peels and laser resurfacing can be helpful in creating a more balanced skin tone.
Erythema is a permanent redness that comes from damaged skin cells. Small capillaries near the surface of the skin become permanently dilated, resulting in a red spot. It’s common in acne patients and most visible in lighter skin.
For treatment, we can prescribe a topical medication to decrease vasodilation temporarily, or work toward more long-term solutions with Intense Pulse Light phototherapy.
What Acne Scarring Is NOT
An acne scar is a change in texture in your skin. Usually, it’s depressed. It’s not a brown spot. Discoloration is temporary, but texture changes are permanent.
This bumpy texture, also known as cobblestoning, starts when a pimple creates an indentation. If you notice a low spot form from a pimple, get the dermatologist ASAP. The more aggressively you treat this type of acne, the less likely you are to deal with the long-term effects of acne scarring.
Dr Pimple Popper’s 6 step guide on how to pop a pimple
- Sterilize the area and be sure to have clean tools, hands, and environment.
- You’ll want to make sure you wash your face before with warm water, or better yet, take a steamy shower, to really open up the pores.
- Use your fingers or a comedone extractor as I most often use in my videos, to place pressure on the skin immediately surrounding the whitehead, to push the contents out. If using fingers, increase traction by wrapping clean tissue paper around the fingers applying pressure.
- A whitehead should come out pretty easily if it is ready, but if the pimple is not popping, there’s definitely a time to give up because forcing it and continually pushing and squeezing will only irritate your skin cause increased swelling, redness, and pain, and certainly increase your risk for local infection and scarring.
- See a dermatologist or skincare professional to help you get these extracted. In short, Know When To POP and Know When To Stop!
- To finish I would recommend applying a topical corticosteroid and /or a topical acne spot treatment that likely contains benzoyl peroxide or an antibiotic, cool compresses if desired, or just try to leave the area alone.
What Causes a Painful Pimple?
Pimples hurt because the body is trying to get rid of the stuff that doesn’t belong there. The redness, swelling, and inflammation cause the pain. The body knows that the dead skin, oil, and bacteria are supposed to be in the hair follicle (which is outside the skin). So, as your body tries to push it out, you end up with more sensitivity in the area. If you try to pop that pimple, you reverse the progress the body has made in getting the buildup out.