Do You Have Acne Scars?
Consider this your treatment guide.
Last week I did a Facebook and Instagram LIVE answering all questions related to acne (like I do every week – on Tuesdays at 7pm EST). For some reason, I was overwhelmed with questions about acne scars.
Clearly you have a ton of questions – and I am here to give you the information you NEED to know to successfully prevent and treat acne scars.
I explain everything in detail in my video below, but here are the key points for those of you that are not into watching the video (don’t worry – I get it).
What are acne scars?
When the dermal layer of the skin (which is the layer below the epidermis) is damaged, cells called fibroblasts are mobilized to produce a fibrous collagen to repair the acne wound.
What are the three stages of acne scarring?
1. Inflammation stage – inflammation mobilizes fibroblasts to start producing fibrous collagen (Days 1 – 4)
2. Proliferation stage – the fibroblasts are laying down fibrous collagen to heal the wound (Days 4 – 21)
3. Remodelling stage – the fibrous scar becomes deeper and more permanent (Day 21 – 2 years)
How do you prevent acne scarring?
Because inflammation in the body and the skin stimulates the fibroblasts to initiate scarring, reducing inflammation in your body is key. This includes working from the inside out (balancing insulin levels, optimizing detoxification, healing the gut, managing stress, etc.) and from the outside in (repairing your skin’s moisture barrier, not using products that make your skin more prone to inflammation and sensitivity).
When you are able to reduce inflammation, your acne blemishes will start to reduce in frequency and intensity – and you will no longer scar.
Also applying some key topicals, such as niacinamide, aloe vera, hyaluronic acid, vitamin C, tamanu oil and retinols will help prevent scarring.
Acne scar prevention can only be done between Days 1 – 21 – once a scar is older than that you need to resort to more invasive treatments.
How do you get rid of existing acne scars?
Once an acne scar reaches the remodelling stage, which is usually after Day 21, topical creams are no longer going to get rid of the scarring. This is because the fibroblasts have already laid down the fibrous collagen to repair the wound, and this fibrous tissue is thick and topical solutions are not able to penetrate it and break it down.
Instead, either laser or professional micro-needling treatments are needed to penetrate and break-down the fibrous collagen that makes up the scar.
I love professional micro-needling because the needles are able to penetrate the fibrous tissue and after the treatment a serum can be applied that is able to penetrate into the dermal layer to encourage new collagen formation.
A few micro-needling tips:
– Micro-needling devices must have a length of 1.0 – 2.0 mm to really penetrate scars. At-home micro-needling devices usually only have a length of 0.2 – 0.5 mm, which is not deep enough to affect the scar tissue.
– Do not do micro-needling of any kind if you have active acne. This is a great way to spread bacteria and have the worst break-out of your life.
– Be sure to reduce inflammation in your body and skin before doing a micro-needling treatment. Micro-needling damages the skin, and you do not want more fibroblasts making more scar tissue in response. Instead we want to trigger normal collagen production.
Dr. Stacey Shillington ND