Dark spot after pimple

Contents

How to fade dark spots in skin of color

Have you tried treating dark spots on your own without getting the results you want? Do you constantly see new dark spots appear as others fade?

If you answered yes, you’re not alone. Darks spots and patches rank as one of the most common reasons that people with skin of color see a dermatologist.

Before and after treatment

His dermatologist used laser therapy and prescription-strength hydroquinone cream to clear the spots of color in 8 weeks.

Effective treatment begins with understanding why you get this discoloration. If you can eliminate the cause, many spots will clear on their own and you can prevent new ones from appearing.

Why dark spots and patches appear

People who have medium to darkly colored skin get dark spots and patches because something triggers their skin to make extra melanin, the substance that gives skin its color. Many everyday things can trigger extra melanin in people who have skin of color.

Dark spots and patches often appear when:

  • A pimple or patch of psoriasis clears

  • A wound caused by an insect bite, cut, burn, or other injury heals

  • You take (or apply) certain medications

  • A skin or hair care product irritates your skin

  • Changes due to hormones occur, such as during pregnancy

If you treat a skin condition like acne or psoriasis so that you stop the flare-ups or breakouts, you’ll eliminate what’s causing the discoloration. Most dark spots will then fade on their own.

Likewise, if you find that a skin care product is causing the discoloration, switching to a gentle product that doesn’t irritate your skin can stop new dark spots from forming and allow existing spots to clear.

Could a medicine be causing your dark spots?

Don’t stop taking it. That could make you very sick. Ask the doctor who prescribed the medicine if discolored skin is a possible side effect. If it is, ask if you could switch to another medicine.

Fading can take time

Once you stop what’s causing the dark spots or patches, fading can take time. A spot that is a few shades darker than your skin will usually fade within 6 to 12 months.

If the color lies deep in your skin, however, fading can take years. Discoloration that lies deep in the skin is often slate blue to gray in color. It may also be brown, but the brown is much darker than your natural skin color.

Treatment can speed up fading of dark spots and patches.

Effective treatment begins with sunscreen

Whether you’re treating the dark spots on your own or seeing a dermatologist, sunscreen is essential. Used daily, even when it’s raining or snowing outdoors, sunscreen can prevent further darkening.

You’ll want to apply sunscreen to all skin that clothing won’t cover.

Sunscreen is essential to effective treatment

To get the protection you need, use a sunscreen that offers SPF 30 or higher, broad-spectrum protection, and zinc oxide or titanium dioxide.

If you have oily skin, look for the words “won’t clog pores” or “non-comedogenic.” This will help prevent breakouts, which could lead to more dark spots.

Skin-lightening products can speed up fading

Once you eliminate what’s causing the discoloration and protect your skin from sunlight, skin-lightening products tends to be more effective. You may have success with a product that you can buy without a prescription.

When choosing a skin-lightener, look for a product that contains one of the following ingredients:

  • 2% hydroquinone

  • Azelaic acid

  • Glycolic acid

  • Kojic acid

  • Retinoid (retinol, tretinoin, adapalene gel, or tazarotene)

  • Vitamin C

These ingredients can lighten existing spots. In some cases, the ingredient can also slow down production of melanin, which is what causes the dark spots and patches.

Some skin lighteners do more harm than good

When buying a skin-lightening product, you want to choose carefully. Some contain ingredients that can be very harmful to your skin and your health.

Researchers have found steroids or mercury, which weren’t listed on the product’s label, in skin lighteners from other countries.

The steroids in these products can cause pimples and rashes. If you unknowingly apply it to your skin for a long time, the steroids can cause thin and fragile skin or permanent discoloration.

To protect your health, you want to buy a skin-lightening product made in the United States or one recommended by your dermatologist.

Also see: Skin lightener containing mercury can cause serious health problems

Never use liquid bleach

Liquid bleach is a harmful treatment for removing dark spots and patches. You should never apply it to your skin.

How a dermatologist can help

If the treatment you’re using fails to deliver the results you want, you may want to see a dermatologist. Dark spots and patches can be a challenge to treat. To fade some, you need more than a skin lightener.

A dermatologist has the knowledge and expertise to safely combine treatments to help you get the best results.

Images Image 1: Used with permission of Journal of the American Academy of Dermatology: J Am Acad Dermatol. 2010;63:274-83.

Images 2-4: Getty Images

References Heath CR and Taylor SC. “Postinflammatory hyperpigmentation.” In: Kelly AP, Taylor SC. Dermatology for Skin of Color. McGraw Hill Medical, New York, 2009:337-340.

Manuskiatti W, Triwongwaranat D, et al. “Efficacy and safety of a carbon-dioxide ablative fractional resurfacing device for treatment of atrophic acne scars in Asians.” J Am Acad Dermatol. 2010;63(2):274-83.

Roberts WE. “Melasma.” In: Kelly AP, Taylor SC. Dermatology for Skin of Color. McGraw Hill Medical, New York, 2009:332-6.

Long after your acne has faded, you still may be left with a reminder of its stay in the form of scarring. Why does this happen and how long does it take for these scars to fade? Read on for all that you need to know about acne scars.

Table of Contents

What Are Acne Scars?

In general terms, acne scars are the permanent reminders left behind after breakouts. There are two distinct types of scarring: atrophic scars are left behind as a result of tissue loss, while hypertrophic scars are caused by too much tissue. When looking to treat your acne scars, it is important to understand the various kinds of scarring and how each type best responds to the many available treatment options.

How Long Does It Take for Acne Scars to Fade?

Because each individual skin type reacts differently to acne scarring and healing, it is challenging to pinpoint an exact time frame. A study by Scott J. Trimas, MD found that the carbon dioxide laser is an effective modality for the treatment of facial acne scarring. Physician and patient satisfaction is high.

Nevertheless, multiple treatments may be necessary to achieve improvement, especially in the temple and lateral cheek areas; these anatomic sites respond less favorably to laser resurfacing than the medial cheek, perioral region, and forehead.Follow-up ranged from 16 to 40 months (mean, 24 months; median, 28 months).

Types of Acne Scars

There are 5 types of acne scars, and each have their own causes and treatments.

1. Rolling Scars

  • Development – These loosely defined scars are the result of fibrous tissue coming up between the uppermost layers of skin and the tissue located below the surface. The rolling appearance forms when the fiber bands pull the upper layers of skin down. As this process happens, wavy depressions are left across the skin.
  • Treatment – Although they are not likely to fade away on their own, rolling scars are some of the easiest scars to treat because of their shallowness. The most recommended course of treatment is a subcision procedure. This outpatient procedure uses a scalpel to cut the fibers at the base of the tissue. This process works to give the skin a visibly smoother appearance without the distinguishable rolling waves.

2. Boxcar Scars

  • Development – Distinguished by an oval depression on the surface of the skin, boxcar scars are wider than many of the other typical acne scars. This type of scar gives the skin a pitted appearance. The scars develop when inflamed skin causes a reduction in the amount of collagen in the skin, leading to the loss of rebuilding tissue.
  • Treatment – Boxcar scars are highly unlikely to fade on their own, even after years of waiting. Fortunately, many sufferers have found success in making the scars less visible through the use of punch procedures. A punch elevation procedure levels up the skin in an effort to smooth out the surface and minimize the appearance of the boxcar scar. Another option is using dermal fillers to lift up the scar’s depressed surface and make it even with the rest of the skin. The draw of dermal fillers is that they are most cost-effective compared to other types of treatment. However, because the results are not permanent, they must be repeated approximately every two years. Laser surfacing is also gaining in popularity as a means to minimize the appearance of these depressed scars.

3. Ice Park Scars

  • Development – Ice pick scars get their name from their resemblance to a long and skinny ice pick. These kinds of scars are caused by inflamed cysts and blemishes or infection. The scar begins to take root after the surrounding skin tissue is destroyed.
  • Treatment – The deep properties of ice pick scars mean that they are never likely to fade completely away. The most effective way to treat ice pick scars is through punch excision or grafting. The imperfections are treated by using tools to cut out the scar and then use a graft of skin taken elsewhere from the body to fill in the scar. While this procedure will cause its own scarring, it will be less visible than the ice pick scar had been.

4. Hypertrophic and Keloid Scars

  • Development – Both hypertrophic and keloid scars are defined by their raised appearance and firmness. They are both brought on by the production of too much collagen. Although they are similar in appearance, keloids are more severe. Men are most affected by hypertrophic scars, usually caused by deep wounds to the surface of the skin.
  • Treatment – Not everybody will decide to treat hypertrophic and keloid scars. If you do decide to pursue treatments, options include laser treatments, cortisone creams, silicone gels, and cryotherapy. Keloid scars can become more pronounced as a result of some of these treatment options, making it important to proceed with caution.

5. Post-Inflammatory Hyperpigmentation

  • Development – This type of scar differs from the others by its distinguishable colored flat marks that sit on the surface of the skin. Caused by inflamed acne, post-inflammatory hyperpigmentation is what is left on the skin after a pimple has healed and disappeared. Because of the inflammation, too much melanin is released and the area begins to darken as a reaction.
  • Treatment – Fortunately for people who exhibit post-inflammatory hyperpigmentation, this type of scarring is the most likely to fade naturally over time. Most scarring of this type will fade in approximately four to 24 months. However, if you are not willing to wait for nature to take its course, you can assist the process with a variety of OTC treatments. For best results, look for products that contain alpha hydroxy acids (AHAs) or consult with a doctor about prescriptions that boast topical retinoids or azelaic acid.

Acne Marks vs Acne Scars

Although many people use the terms acne scars and acne marks interchangeably, they are actually quite different. Acne marks are more likely to fade away with time, unlike their acne scar counterparts. Marks present with a dark color while laying flat across the surface of the skin.

Conversely, scars are mostly colorless and are indented in their appearance. True acne marks fade away in about three to six months, while scars will need professional treatment. Although scars are often less noticeable than marks because of their colorless presentation, it is easier to hide or minimize the appearance of an acne mark using concealer.

Best Products for Fading Acne Scars and Dark Spots

1. Paula’s Choice SKIN PERFECTING 8% AHA Gel

Best for: fading hyperpigmentation and dark spots

This leave-on exfoliant works hard to slough away dead cells and regenerate the skin. The concentration of eight percent glycolic acid can even out the tone that is negatively affected by post-inflammatory hyperpigmentation and other issues related to discoloration. The plant extracts and antioxidants work together to firm up the skin and give off a brighter glow.

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2. Prosper Beauty Dermaroll

Best for: pitted acne scars

This five-piece microneedle kit is engineered for use on pitted acne scars. The unique design consists of 600 titanium microneedles that operate to smooth out the skin and diminish the appearance of acne scars. The kit comes complete with three roller heads and a storage case.

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3. Mad Hippie Vitamin C Serum

This innovative vitamin C serum is formulated with a concentration of 15 percent L-ascorbic acid designed to reduce the appearance of fine lines, wrinkles, and acne scarring. Although this is certainly no miracle cure, this premium product may help to improve the overall tone and firmness of the skin. Because it remains active for at least 72 hours once applied to the skin, you can feel confident knowing that the product is providing long-lasting protection.

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4. Murad Rapid Age Spot and Pigment Lightening Serum

Best for: hyperpigmentation and dark spots

Formulated to lessen the visibility of dark acne scars, this product features two percent hydroquinone and glycolic acid. This treatment works to fight hyperpigmentation while brightening the overall tone of the skin. Additionally, use a qualify, broad-spectrum sunscreen with this product.

*Note that although these products will help to speed up the natural fading process, professional treatments will deliver faster and more effective results.

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When to See a Dermatologist

Consult with a dermatologist if you have exhausted over the counter products. Or if your acne scars are affecting your self-confidence.

FAQ

How long does it take for acne scars to fade with lemon juice?

Many people mistakenly believe that lemons can fade acne scars. Or that they are effective at reducing the appearance of post-inflammatory hyperpigmentation. However, lemons are not effective for acne scars. This is due to the irritating elements lemon’s high pH level. Instead, use a well-formulated and professional AHA product.

Can you get rid of red acne scars overnight?

There are no overnight miracles when it comes to skincare. Effective skincare requires patience and diligence in using quality products designed for specific purposes.

How long does it take for acne scars to fade with aloe vera?

Although aloe vera cannot rid the skin of most types of acne scars, the natural ingredient may prove helpful in reducing the appearance of post-inflammatory hyperpigmentation. The compound aloin is a depigmentation agent, meaning that it can lighten the skin.

How can you fade acne scars fast?

A dermatologist will help you to determine a course of treatment designed to provide the fastest results. Possible options include laser treatments, chemical peels, or microneedles.

Do acne scars go away over time?

Depending on the type and severity of the scar, some acne scars will go away. Others can be permanent unless you choose to seek professional treatment with a dermatologist. There are also various OTC products that will minimize the visible appearance of the scars.

Some men pick at their pimples and cause acne scarring, while others leave them alone and still wind up with a scar. If you’re in the second group, it probably doesn’t seem fair, does it?

Regardless of how you got the acne scar, you no doubt want it gone. Unfortunately, scars don’t disappear quickly, if at all.

Will your acne scar fade on its own? Can you speed up the healing process? Here are three things you need to know about how long acne scarring can last:

  1. While some scars will fade on their own eventually, others are more stubborn.
  2. Some acne scars are simply dark marks that will fade on their own, while deeper tissue scars may require laser treatments.
  3. Getting your acne under control is key to preventing future acne scars.

Acne Scar or Post-Inflammatory Hyperpigmentation?

Before we can answer whether or not your acne scar will go away, it’s important to identify if the mark on your face is truly a scar. Dark brown or red blemishes that won’t disappear may look like a scar, but they may be something called post-inflammatory hyperpigmentation.

Post-inflammatory Hyperpigmentation

Post-inflammatory hyperpigmentation (PIH) is a common pigmentation disorder which is often preceded by other diseases or injuries that affect the skin, such as acne or eczema. It’s a temporary discoloration that occurs when an irregular amount of pigmentation is produced in response to skin inflammation, causing discoloration.

According to a 2010 review published in The Journal of Clinical and Aesthetic Dermatology, the intensity of PIH may depend on the amount of melanin in the skin, although scientists are still exploring this theory (see claim: “The intensity of PIH may also correlate with higher skin phototypes…”) PIH seems to affect darker skin more intensely compared to lighter skin.

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Treatment Options for PIH

PIH can take up to two years to fade on its without treatment. However, it’s generally more likely to fade than true acne scars because the tissue underneath isn’t damaged.

Still, it’s not a guarantee that your PIH will disappear. To increase the likelihood that your PIH fades, be sure to stay out of the sun whenever possible and wear a daily moisturizer with SPF. PIH can worsen with UV ray exposure.

You can also treat PIH through regular exfoliation (2 times per week, max). Using a gentle exfoliating scrub on your skin can inhibit the production of melanin by increasing cell turnover.

Types of Acne Scars and Treatments

Unlike post-inflammatory hyperpigmentation, acne scars are more than just discoloration of the skin. Acne scars are often raised or form a depression in the skin, making them less likely (although not impossible) to fade.

However, knowing which type of acne scar you have can help you choose the right treatment option:

Atrophic Scars

Atrophic scars are caused by a loss of skin tissue, resulting in a depression in the skin. Types of scars in this category include boxcar scars (shallow scars with sharp edges), rolling scars (very shallow scars with soft, smooth edges) and ice pick scars (narrow and very deep).

Boxcar Scars

The best treatment for atrophic scars depends on the type of scar you have. For example, fillers can help temporarily treat small yet deep ice pick scars by filling in the depression, while boxcar scars are usually treated with subcision.

Subcision can also be used for rolling scars. According to a 2010 study published in the Journal of Cutaneous and Aesthetic Surgery, subcision is safe and effective in the long-term treatment of rolling scars (see claim: “Subcision is a safe, simple technique that provides significant long-term improvement in the ‘rolling scars’ of selected patients.”)

Hypertrophic Scars

Hypertrophic scars occur when your body produces excess collagen, resulting in a raised scar. They can be pink when the scar is fresh and fade to match your skin color.

If the scar is recent, cortisone can help slow down production of collagen to reduce the appearance of a raised scar. If it doesn’t fade enough for your liking, erbium laser resurfacing can be used to reshape the scar and decrease its size. Take the skin care quiz

Keloids

Keloids are another type of raised scar that occurs when the body goes overboard trying to repair itself after inflammation caused by an acne cyst. Keloids are much larger than hypertrophic scars and are often darker than your natural skin color.

Although this type of acne scar isn’t as common, it can be difficult to treat. One treatment option you can try is a retinoid-containing skin care product.

According to a 2010 review published in The Journal of Clinical and Aesthetic Dermatology, researchers noted that vitamin A derivatives such as retinoic acid can inhibit collagen production of human fibroblasts, which play a role in the formation of keloids (see claim: “Retinoids also exhibit an inhibitory effect on TGF-β1-induced type I collagen gene expression in human fibroblasts.”)

Bottom Line

The good news is that what most people think are acne scars are really just discoloration. PIH can take anywhere from two months to two years to fade, so try to be patient.

The bad news is that acne scars (and some PIH) can be notoriously difficult to ever get rid of completely. The first thing you should do to prevent acne scaring is to get on an acne treatment system to reduce acne breakouts.

If your acne scars won’t fade and are taking a toll on your self-esteem, it may be time to see a dermatologist. Although the solution may not be cheap, it could well be worth it to get your confidence back.

Chandrashekar B, Nandini A. Acne scar subcision. J Cutan Aesthet Surg. 2010;3:125–6.

Viera MH, et al. Innovative therapies in the treatment of keloids and hypertrophic scars. J. Clin. Aesthet. Dermatol. 2010;3:20–6.

Posted by Tiege Hanley in Tiege Hanley Men’s Skin Care Blog Feb 11, 2019 Tags: Acne Cream, Moisturizers, Scrub

Acne in Skin of Color

Chere Lucas, MD
What Is Acne?

Acne is a common skin problem. It is commonly called breakouts or pimples and can happen at any age. Usually starting when people are in their early teens, acne can continue into a person’s 30s or 40s. In some individuals, acne can start later in life even if a person never had acne as a teenager. Acne can occur on the face, chest, shoulders and back. It can be very mild with only a few pimples or severe with cysts (larger bumps under the skin) and scarring. Acne can be frustrating, but it is treatable.

For skin of color patients who develop acne, the secondary skin color changes can be of primary importance. Specifically, dark spots from acne, referred to as post-inflammatory hyperpigmentation (PIH), is often a chief complaint.

Different types of Acne

Mild: A few comedones (blackheads or whiteheads) with little inflammation (redness, irritation, pain)

Moderate: More comedones or even pustules (pus filled bumps), inflammation and few papules (small red or brown bumps)

Severe: a combination of comedones, papules and even cysts. It often has significant inflammation, pain and even scarring. Because this type usually leads to scarring, early treatment is important.

What causes acne?

Acne is caused by a combination of factors: clogged pores, increased oil production, inflammation (redness and irritation) and bacteria called Propionibacterium acnes (P. acnes). The pores of the skin become clogged and oil builds up in the pore or hair follicle. A pore clogged with oil is called a comedone. Whiteheads are closed comedones deeper in the skin. Blackheads are open comedones near the surface of the skin. They appear dark because the oil (sebum) and skin cells filling the pore become dry. They are not dark because of dirt. A comedone can become inflamed when the bacteria (P. acnes) on the surface of skin gets into the pore. This causes red bumps under the skin. These can be painful and tend to last longer.

What Makes Acne Worse?

•Squeezing, scrubbing or picking at the skin
•Irritants from the environment (i.e. pollution)
•Greasy products such as skin or hair products with oil
•Make-up and makeup brushes that aren’t clean
•Hormones, acne often worsens during puberty and may be related to women’s menstrual cycles
•Things that put pressure on your skin: sports wear, helmets, cell phones
•Grease in workplace (i.e. kitchen with fryers)

Does All Acne Scar?
No. You can have marks left by acne that are not permanent. The pink, purple and brown spots left from acne may take many months to years to fade but are usually not permanent. Some types of acne such as cystic acne can lead to permanent scars so it is important to get it treated early.

Treatment Options:
The goal of treating acne is to clear the existing lesions and then prevent new breakouts. Acne treatments target the causes of acne. This can take some time so it is important to be patient. There are many different treatments depending on what type of acne you have, what you have used in the past, and the amount of post inflammatory hyperpigmentation or scarring present. Some things that may have worked for your friends or family may not be the right choice for your skin type. Your doctor will work with you to develop a treatment plan. Once your acne is improved or clear, stick with the plan. It may be necessary to continue treatment to keep your skin clear long term.

Commonly used types of medications include:

Antibiotics
Antibiotics are used to clear bacteria from the skin and reduce inflammation. These can be applied to the top of the skin or taken by mouth. Examples of topical antibiotics include benzoyl peroxide, clindamycin, and erythromycin. Oral antibiotics may include tetracycline, minocycline or doxycycline. If you have an allergy to these, your doctor may choose something else.

Retinoids
Retinoids are a type of vitamin A. They help to exfoliate the skin and unclog pores, which is great for treating and preventing new comedones. Examples include tretinoin, tazarotene or adapalene. Retinoids in a pill form (isotretinoin) can help with severe acne.

Hormonal Agents
Hormones such as androgens play a role in acne. Androgens promote oil production in pores that contributes to clogged pores. Oral contraceptive pills and spironolactone are common hormonal agents that reduce androgen activity and can be effective treatments in select females.

SKIN CARE AND PREVENTION TIPS:

Gentle skin care
If a product stings too much or makes your skin dry it can worsen acne. Using things like rubbing alcohol to dry the skin can make acne worse.

No picking!
Squeezing, popping or picking at the skin can make acne last longer. It can also drive the clogged pores and bacteria deeper into the skin, causing large cysts that scar. Picking may contribute to scarring and post-inflammatory hyperpigmentation.

Skin care products
Be careful choosing products for your skin and hair. Use oil-free, non-comedogenic products. It should say this on the label. Hair products with silicone or dimethicone are less likely to block pores than oils.

Sunprotection is important
Even if you have darker skin, the sun can make the darks spots last longer. Limit sun exposure and use daily non-comedogenic sunscreen to help to acne pigmentation clear faster.

Be Patient!
It can take at least 6-8 weeks for acne to respond to treatment. Skin needs time to heal and change. If treatment is stopped early, you may not see results and the acne will return. Sometimes skin will look worse before it gets better as clogged pores are getting cleared out of the skin. Often, more than one medication is required. So stick with the plan and contact your dermatologist’s office if you have any concerns.

Additional Resources
Mayo Clinic
National Library of Medicine NIH MedLine

How to Fade a Dark Mark

When you have acne, an infection, a rash, or some other skin problem, you’re probably anxious for it to clear up. Yet even after these complexion woes heal, they may leave a visible reminder that they were once there — a dark mark on your skin.

“Dark marks and scars are the result of inflammation and injury to the skin,” says Susan Massick, MD, a dermatologist with the Ohio State University Medical Center in Columbus. “This inflammation induces melanocytes, the pigment-producing cells of the skin, to produce more melanin, which results in darkening in the areas of inflammation. The dermatologic term for this is post-inflammatory hyperpigmentation, or PIH.”

Older people may also experience dark marks from hyperpigmentation, commonly called liver spots or age spots, but these are related to sun exposure.

Dark Mark: About PIH

Acne, the most common skin condition, is often to blame for hyperpigmentation. “When an acne pimple or blemish resolves, it can leave these dark marks,” says Dr. Massick. The hyperpigmented scars are not permanent, but they can be slow to fade. In fact, an acne mark may persist for as long as three to six months after the pimple has disappeared.

If you develop acne marks or other dark spots on your skin, be patient. “Much can improve just with time,” says Massick. She also stresses how important it is to avoid a lot of sun exposure because ultraviolet light induces continued melanin production, which can darken skin spots. “I advise patients to be very consistent with sun protection — and with sun avoidance if possible,” Massick adds.

Treating Hyperpigmentation

While over-the-counter (OTC) products with alpha and beta hydroxy acids may help fade hyperpigmentation spots, Massick says the ingredient that provides the most benefit is hydroquinone. It’s available in different strengths — a prescription strength of 4 percent and OTC products in the 1 to 2 percent range.

Keep in mind that even an OTC hydroquinone product must be used carefully, and you need to follow the instructions. Massick says that the U.S. Food and Drug Administration has considered removing most of the OTC hydroquinone products from store shelves because of safety concerns. Before you use an OTC “fade cream” or other treatment for hyperpigmentation, talk to a dermatologist, who can provide patient safety information and teach you how to properly use the product. A dermatologist may also suggest a prescription strength treatment that is more effective.

People may also seek professional skin treatments to fade dark marks on their skin. However, Massick says that although procedures like a chemical peel or microdermabrasion can help alleviate some skin problems, “some patients may experience PIH from the procedures themselves. I advise patients not to be overly aggressive with pursuing these in the beginning.”

Properly treating acne will help prevent acne marks from scarring the skin. “If acne isn’t controlled, patients will experience more breakouts, more blemishes, and more PIH,” says Massick. Protecting yourself from the sun and working with a dermatologist can further help you prevent and lessen other dark marks on your skin.

It’s usually special and a bit thrilling to be told that you’re one in 200,000.

But when I turned 17 and my cystic acne hit like a category 5 cyclone, I felt like I’d been cursed.

After initially informing me of the rarity of this painful, disfiguring, and undesirably rare skin disease, my dermatologist helpfully added that I was the worst case he’d seen in two decades.

I knew nothing about acne before then, beyond it being a temporary affliction that could be cleared up with a greasy ointment or maybe antibiotics.

Zits were no big deal, or so I thought.

Little did I know the symptomatic hell that was about to be unleashed on my body in the next six months and beyond.

I tell my story now, more than 30 years after the fact, not to garner pity or sympathy; I moved through that stage long ago. Maybe it’s to help me understand it better, or show others that there’s light at the end of the very dark tunnel that cystic acne plunges you into.

According to the Medical Journal of Australia, acne is a chronic inflammatory disease of the pilosebaceous unit resulting from androgen-induced increased sebum production; altered keratinisation; bacterial colonisation of hair follicles on the face, neck, chest and back by Propionibacterium acnes; and an inflammatory response in the skin.

MJA notes that: “Scarring that occurs from acne, particularly severe acne, can persist a lifetime and have long lasting psychosocial effects. Depression, social isolation and suicidal ideation are frequent comorbidities in acne.” Gulp.

Acne is one of the most common skin conditions in Australia. A smaller slice of the population develops cystic acne, the most severe form of acne vulgaris marked by large, inflamed lesions that form deep within the skin and can result in painful, large bumps visible from the surface.

I was unlucky enough to fall victim to the most severe form of the worst aberration of acne. Both the condition and its after-effects have shaped my character in ways I’m only now beginning to understand. Mostly positive. But more of that later.

Section through human skin with acne.

None of this impending destruction was visible on my skin when I was going through puberty. As with many teenagers, I had only mild acne develop when I was 16. In fact, my face and other parts of my body were unmarked by even tiny pimples.

That changed quickly. In the winter of 1984, I began to get subsurface lumps on my back without even going through the blackhead or whitehead phase. I can’t remember much about the first time around. All I recall that it came and went pretty quickly and went away mostly of its own accord.

Things were a bit different in around March 1985. Again, it erupted from a standing start. Out of nowhere began a steady march of lumps around the size of a 20-cent piece sprouting from my body.

First across my back, then my neck, then my face. It didn’t take long, maybe a couple of weeks or so, before I started turning into a real freak show. My back and halfway down my arms became a bloody, pustulent, seething mass of scabs and infection.

When most people hear the word “acne”, they think of a small, sporadic problem that causes minor irritation before things return to normal once puberty ends. But my case was markedly different.

I soon sought coping strategies. After a couple of days of my white school shirt turning red and black, I started wearing white undershirts so the dried blood and pus wouldn’t show through.

Every afternoon when school ended, I went straight to the boarding school’s shower block so I could remove my undershirt – and with it, half the skin off my back. The back of my neck was similarly afflicted, with my hair sticking to the wounds.

At night, I found it impossible to find uninterrupted sleep. The slightest movement would put pressure on my skin and wake me up with the searing pain. I was forced to use my recesses and lunchtimes to grab short naps, otherwise I would’ve fallen asleep in class.

For a few months, I kept a dream diary to chronicle my descent into nocturnal madness. But eventually the images and scenarios that I faithfully recorded became too disturbing. I burnt it symbolically in the hope that it would purge me of my nightmares. It didn’t.

Then, the devastation began to spread across my face like a landscape scorched with napalm. While I had a number of isolated outbreaks across my cheeks, the worst reserved itself for my right-hand jawline, where a number of cysts merged to form an almighty abscess which was probably visible from space.

One day, when I was lining up to go into English literature class, another boy accidentally bumped me with his shoulder, breaking the surface of my abscess and causing it to bleed. I removed my white jumper vest to stem the bleeding.

By the time I had reached the school hospital, the vest was entirely soaked with blood. The nurse tried to patch me up with stitches, but because the skin was like tissue paper, she couldn’t do much. For the rest of the day, I had to wear a big gauze patch and a bandage around my head and jaw like a gout patient.

In my sleep-deprived haze, I struggled to get from boarding school to the city once a week to endure a session with the old-school dermatologist to whom I had been referred. He couldn’t do much aside from squeeze a whole load of sebum out of the blackheads and whiteheads on my back among the worst of the infection.

He used to show me the end results as if it constituted some form of victory over the hideous disease. But I remained uncured. No wide-spectrum antibiotics, sulphur ointment, or topical creams made any difference. And worse still, my condition just seemed to be getting worse.

It was at this point that I contemplated killing myself. Yet that contemplation passed soon enough. I decided that if it hadn’t killed me yet, I wouldn’t finish the job myself.

The daily mocking and torments from my fellow students didn’t help, but it was nothing compared to the unending physical pain that felt like it was corroding my very being. I felt like I was slowly melting away.

At the same time, my school grades and extra-curricular activities were suffering accordingly. In hindsight, it seems ridiculous to contemplate that I was attempting my Higher School Certificate – now the VCE – in the midst of all this.

It was perhaps unsurprising that the private school I attended was generally unsympathetic, contrary to their claimed ethos of “pastoral care”. I recall clearly the deputy principal telling me and then my parents that the disease was a punishment from God for being a miscreant. He’s dead now. Perhaps in God’s care.

I had to give up playing rugby for obvious reasons and spent a lot of time in the makeup chair before taking the stage for the lead role in the school play. I stemmed the occasional flow of blood with a handkerchief while playing the narrator in Thornton Wilder’s Our Town.

My interaction with the opposite sex was distorted by my own perception that any half-smart girl wouldn’t want to come within five metres of me. Yet through a miracle, I attracted some attention. This included a school dance where I got along just fine with a gorgeous girl who I later found out was school captain. Later I also heard she was heartbroken when I refused to return her numerous calls, preferring the misery of my own company.

And then, in the winter of 1985, my salvation arrived – a drug called Roaccutane. It belonged to a group of medicines called retinoids. They work by reducing the amount of the oily substance – or sebum – made by glands in the skin, reducing bacteria and inflammation, and opening clogged pores.

On the whole, it was a pretty vicious treatment. The list of side effects read like a piano roll. In addition to drying up your mucous membranes, the Roaccutane also dried out your skin, mouth, eyes, lips, and nose. It caused itching, nosebleeds, cracked skin, joint and back pain, dizziness and drowsiness. Oh, and nervousness, and changes in fingernails and toenails. To add insult to injury, the Roaccutane actually made the acne get worse before it finally started to improve.

Before I started on the drug, I had to sign a document confirming that I wasn’t pregnant and didn’t plan to get knocked up. The drug was known to cause spontaneous and immediate abortion. The Department of Health also had to give special approval for me to take it in the quantities necessary to have an effect.

But Jesus, Mary and Joseph … the drug worked.

After several months of intense treatment, my acne cleared up completely. But my scarring was immense. Halfway down both arms and my entire upper back and shoulders looked like I’d gone ten rounds with a blowtorch. And my face was a real mess. When I began interviewing people in my early career as a cadet journalist, they couldn’t stop staring. No one ever asked why I was so scarred.

At this point, I took up my parents’ offer to fund plastic surgery. The operation was a success, but I went into full hermit mode for six weeks after, hiding indoors because my new skin was too delicate to expose to the sun. My face was as pink as a newborn and about as tender. The doctor didn’t even attempt to touch my back. All my flat scarring meant I didn’t have enough skin on my body to trouble with a graft. When it was all over, my physical appearance was closer to normal. Only in certain light did one side of my face appear to have lost an argument with a spiked mace.

Over time, I became proud that I had endured such pain, and to this day the knowledge that I had come back from such a dark place gives me untold resilience and strength.

I have sought explanations for why this happened to me but no answers have been forthcoming. Hyperactive lymph glands, rapid metabolic rate, and so-called “tubercular taint” (left in the DNA from an ancestor who had tuberculosis) have all been proffered as potential factors in the viciousness and rapid onset of my cystic acne.

If there were any other positives to emerge from this experience, it was my attitude towards superficial appearance and vanity. My trauma had shown me that real beauty lies far beneath the skin, and that people can be at their cruellest when taunting others who don’t measure up to their own standards of physical normality.

It was some time ago that I gave up on quaint notions of redemption and being punished for sins in past lives. Instead, something that a mate recently posted on social media seemed to resonate.

The Japanese art and philosophy of kintsugi – translated as “gold scars” – tells us that broken objects are not something to hide, but instead to display with pride. Repairing broken ceramics gives a new lease of life to pottery that in turn becomes even more refined and unique because of its “scars”.

Kintsugi suggests that we should try to repair objects, and by extension ourselves, because sometimes in doing so we obtain even more valuable things.

That was my choice. To move through the darkness into light, and in doing so become whole again and stronger at the broken places.

• In Australia, the crisis support service Lifeline is on 13 11 14. In the UK Samaritans can be contacted on 116 123. In the US, the National Suicide Prevention Lifeline is 1-800-273-8255. Other international suicide helplines can be found at www.befrienders.org

The best solutions for post acne marks

Dark marks from past acne red acne scarring, especially if left untreated, can be visible on your face for years after the active breakouts and blemishes are gone. Unfortunately post acne marks and scars are all too common for anyone who has suffered from acne. Do you have red marks on your face that won’t go away? Whether you have red acne scarring, dark marks, or textured scars there are acne marks treatments to minimize the appearance and even completely diminish your post acne marks and scars. Keep reading to see the best solutions.

Preventing post acne marks and scars

Prevention is the best remedy for post acne marks, just as it is for most skin concerns. If you currently suffer from acne breakouts and blemishes, there are steps you can take to prevent lasting marks and scars. The absolute number one rule in preventing scars is to never pick at your skin.

Picking at your skin or popping your pimples can turn a temporary skin blemish into a permanent scar or acne dark spot, especially if you’re prone to hyperpigmentation.

“When you pop a pimple, you actually rupture the stretched and weakened follicle in your skin. This can lead to more breakouts and future scarring.”

Try as hard as you can to resist touching, picking or popping any acne or blemishes that crop up. Instead, topically treat your blemishes with a spot treatment like Breakout Control. This lightweight lotion will quick clear pimples without the risk of scarring.

Other than spot treatments, the right daily agenda is necessary if you currently suffer from acne. The quicker you manage your acne, the less chance you have of scarring. Cleanse and tone your skin twice a day (no more, no less) with a salicylic acid formula, like Spotless Cleanser and Acne Toner. If your skin is dry, follow your toner with a moisturizer for acne-prone skin, like these.

Sometimes, even if you try your best to prevent it, you can still end up with acne marks. Are there different treatments to deal with acne marks vs. acne scars? Yes – see how to deal with the two different types of acne marks and scars:

Dark or red acne marks

For some, acne marks show up in the form of red or dark pigmented spots. This is caused by Post-Inflammatory Hyperpigmentation (known as PIH), which can occur when your skin experiences an inflammatory wound, such as acne.

“When you get a breakout, the skin’s immune system responds to the bacteria and infection that is present in the skin, and produces melanin. Melanin has another purpose – to protect the skin when damage occurs. Since a breakout occurs in one ‘spot’, this is where the pigment goes. The trouble is that this pigment can last for weeks, months or even longer.” –Teresa Stenzel, Bioelements Director of Education

There are three different ways to get rid of PIH:

1) Always wear abroad spectrum sunscreen

Any UV exposure will make your acne spots darker and more difficult to treat. If you don’t protect your skin every single day from the sun’s harmful rays, all other treatments will be rendered completely useless.

2) Target the dark marks

LightPlex GigaWatt Dark Spot Corrector can help you pinpoint and obliterate stubborn dark spots, regardless of their cause. This is the best product for acne scars and dark spots of any kind. If you have age spots, discoloration or UV damage in addition to your acne marks, this will target those as well. Simply dab a small amount of the formula every morning and night until your dark spots disappear.

3) Boost overall brightness

Target all over discoloration along with pigmented acne spots with LightPlex MegaWatt Skin Brightener. This gentle antioxidant skin brightening cream will even out overall skin tone and leave skin luminous and hydrated. Apply a thin layer to your entire face every morning and night.

Textured acne scars

Deep pitted or textured scars are common for those who have suffered from severe acne or picked vigorously at their skin. Estheticians sometimes refer to these scars as “ice pick” scars and agree that exfoliation combined with the proper daily skin care routine is the best way to tackle them.

At home:

Exfoliating at home is a crucial element of any skin routine, especially when acne scars are present. Opt to exfoliate 2-3 times per week to avoid over exfoliation. Quick Refiner is our go-to choice because it works in as little as one day to visibly smooth skin with powerful alpha hydroxy acids.

In the treatment room:

Did you know that chemical peels can help tame existing acne and diminish leftover scars? Traditional chemical peels have a bad reputation, but modern formulas are pain-free and have zero downtime. Head to your local Bioelements spa to have a professional help diminish your acne scars and tackle other concerns.

Home remedies to avoid

There are many home remedies that claim to cure dark acne marks and scars – a quick Google search for ‘how to get rid of red acne scars overnight’ yields thousands of results. Here are just a few:

  • Toothpaste mask
  • Baking soda with oil
  • Aloe Vera
  • Tea tree oil and turmeric
  • Hot water and rubbing alcohol
  • Shea butter
  • Lemon and baking soda

Most of these results claim to eradicate scars overnight, but in reality, there is no fast fix. These acne home ‘remedies’ are just a waste of money and time. Plus, they have potential to cause invisible inflammation, which can lead to more scars for those prone to PIH. Stick with tried and true professional methods to ease dark acne marks and scars – your skin will thank you.

If you have any questions about red acne marks, post acne marks or scars, sign up for our email newsletter or comment below!

Okay, bad news first: Dark spots on your face can be brought on from either past breakouts (aka post-inflammatory hyperpigmentation), sun damage, or skin trauma—all of which can happen to just about anyone. Now the good news: These darkened patches are fairly easy to treat, meaning you’re not stuck with them forever, if you don’t want to be. Follow the tips below and you’ll start to fade the dark spots on your face in as little as four weeks, while preventing new spots from popping up, too.

How to get rid of dark spots on your face rule #1:

Do NOT pick that zit.

I know, it’s nearly impossible to resist. But if you’ve given into temptation in the past and picked the shit out of your face, you know the ugly aftermath: an inflamed red or brown mark (that can stick around for months) as a result of skin trauma.

Instead, keep your hands off and treat your pimples with a one percent hydrocortisone cream (you can get it at any any drugstore). It’s an anti-inflammatory, so it’ll soothe redness and swelling—and unlike traditional acne spot treatments, it won’t dry out or irritate your skin (which can end up creating more hyperpigmentation). Another option? Hydrocolloid pimple patches. These little stickers create a moist environment for wounds (aka your pimples) to heal, and also protect them from bacteria and your dirty fingers.

How to get rid of dark spots on your face rule number #2:

Use a chemical exfoliant.

Ditch your face scrub (sorry, but they’re generally too aggressive for skin that’s prone to dark spots and hyperpigmentation) and get yourself a chemical exfoliant, instead. Chemical exfoliators include alpha hydroxy acids (like glycolic and lactic acids), beta hydroxy acids (salicylic acid), and enzymes from fruit extracts. All three help dissolve the “glue” that holds together dead, discolored cells on the surface of your skin leaving you with clearer, brighter, all-around glowier skin. Plus, by sloughing away surface-level dead cells, your skin is better able to absorb any spot treatments or brightening serums you apply afterward, which helps make them more effective.

As a general rule, dark spots from acne can benefit from using a chemical exfoliators with salicylic acid (the ingredient is anti-inflammatory and helps clear excess oil from pores), while dark spots and marks from UV damage are better off exfoliating with an AHA like glycolic acid.

4 Ways to Chemically Exfoliate Your Face

This Exfoliating Serum La Roche-Posay Effaclar Serum dermstore.com $44.99

Glycolic and salicylic acids in this serum help fade spots—and fast—while keeping your skin and pores clear of excess oil and debris. Use it in the morning and/or at night before SPF and moisturizer.

This Gentle Exfoliating Toner Ren Clean Skincare Ready Steady Glow Daily AHA Tonic sephora.com $45.00

This ultra-gentle toner is infused with lactic acid and willow bark extract (a natural form of salicylic acid) to get rid of dulling dead skin cells, plus a dose of skin-brightening azelaic acid. Put a little on a cotton pad and sweep it on clean skin morning or night.

This Exfoliating At-Home Peel Dr. Dennis Gross Skincare Alpha Beta Universal Daily Peel sephora.com $88.00

I’ve used this at-home peel from Dr. Gross for years, it’s that good. The two-step system exfoliates, clarifies, and brightens with a potent cocktail of glycolic, malic, lactic, and salicylic acids. I use them two to three times a week in the morning to boost my glow before I head out for the day.

This Exfoliating Face Mask Ole Henriksen Transform Plus Phat Glow Facial sephora.com $50.00

The combo of exfoliating PHAs (a gentle form of alpha hydroxy acids), oil-absorbing bentonite clay, and nourishing nordic birch sap in this face mask make for an ideal weekly treatment if you’re looking to fade dark spots and marks and keep your pores clear too.

How to get ride of dark spots on your face rule #3:

Invest in a brightening serum.

Dark spots and marks takes weeks to fade, regardless of whether they’re from your handiwork (i.e., picking your skin) or from the sun or old breakouts. It’s the worst. But committing to a dark spot correcting serum—look for one with brightening ingredients like vitamin C, retinol, tranexamic acid, and/or kojic acid—can significantly speed up the process and help fade dark spots even faster. Check out these top picks below.

The Best Serums for Dark Spots

This Dark Spot Serum with Vitamin C Tatcha Violet-C Brightening Serum sephora.com $88.00 This Dark Spot Serum with Retinol PCA SKIN Intensive Brightening Treatment nordstrom.com $111.00 This Dark Spot Serum with Tranexamic Acid SkinMedica Lytera 2.0 Pigment Correcting Serum dermstore.com $130.90 This Dark Spot Serum with Kojic Acid SkinCeuticals Discoloration Defense skinceuticals.com $98.00

How to get ride of dark spots on your face rule #4:

Make sunscreen an everyday thing.

If there’s only one rule that you follow from this entire list, make it this one: Use a broad-spectrum sunscreen with SPF 30 or more every. single. day. Not only does regularly using sunscreen help prevent skin cancer, it also shields your skin from harmful UV rays—the culprit behind most dark spots. In response to the sun’s UV rays, cells send out protective pigment (or melanin) to keep your skin from getting burned. You know this process as “getting tan,” but it’s really your skin trying to protect itself.

So while you might like your glowing bronze color on top, know that deep within the layers of your skin, you now have damage that will later surface as tiny dark spots on your face. Also important to know: Post-inflammatory hyperpigmentation from breakouts is 100 percent made worse by the sun, so wearing SPF is a must for keeping the vicious cycle from occurring.

4 Top-Rated Sunscreens with SPF 30 or More

This Drugstore Facial Sunscreen Neutrogena Ultra Sheer Dry-Touch SPF 30 amazon.com $19.22 This Waterproof Facial Sunscreen Shiseido WetForce Broad Spectrum Face Sunscreen SPF 50+ sephora.com $36.00 This Chemical Facial Sunscreen Supergoop Unseen Sunscreen SPF 40 dermstore.com $34.00 This Physical Facial Sunscreen Drunk Elephant Umbra Sheer Physical Daily Defense SPF 30 sephora.com $34.00

One last thing v important thing! Dark spots don’t just disappear overnight, which means you need to make these four rules a regular thing in your routine. So, consistently practicing self-restraint (remember, no picking), using your chemical exfoliant and brightening serum regularly, and slathering on SPF every single day.

Lauren Balsamo Senior Beauty Editor Lauren Balsamo is the senior beauty editor at Cosmopolitan covering all things skin, hair, makeup, and nails for both the magazine and website.

Some acne marks and scars are completely within your control while others are pre-determined. Aside from genetics, there are several lifestyle habits that can make dark marks and scars worse. Spending time in the sun is a big one, and, to reiterate one last time, every dermatologist agrees that picking or squeezing pimples creates further inflammation and can ultimately lead to more damage.

Here’s the full run-down on how to get rid of acne marks and scars.

How to treat acne dark marks:

“The discoloration from dark marks will usually fade over time,” says dermatologist Sejal Shah, MD, who notes that they tend to take between 3-6 months to go away on their own. “But, there are a number of treatment options to help speed up the process.”

From sunscreens and vitamin C to retinoids and exfoliating, find out how to treat dark marks, officially known as hyperpigmentation, here.

How to treat acne scars:

Acne scar treatments are best handled with special attention and care from your dermatologist since they require more intense procedures than over-the-counter options. The downside: Treatments tend to be expensive. If you aren’t quite ready to put a dent in your savings, know that you aren’t alone in your struggle with acne scars. Just by reframing your way of thinking, you may even learn to feel much more comfortable with them.

Steroid injections: If you feel a stress pimple rearing its ugly head, a steroid shot can be administered the same day you call your derm because the process is very fast. Not only does it immediately reduce the inflammation of an existing zit, but cortisone can also help thick scars (keloids) appear softer and flatter. “These are specifically for raised scars, however,” says Dr. Shah. “It’ll help flatten out the scar, but it won’t do anything to any discrepancies in the texture.”

Dermal fillers: “Certain scars can be filled with a substance that elevates the depressed areas, like hyaluronic acid. This can make the surface of the skin more even and get rid of shadows,” says Dr. Bowe. Until recently, fillers weren’t a lasting solution. But now, if you’re over 21 years old, Bellafill is the first FDA-approved dermal filler designed for permanently correcting moderate to severely dented acne scars. Unlike other fillers, it contains two different ingredients to help improve acne scarring. “It’s 20% polymethylmethacrylate (PMMA), which helps your body make more protein to allow itself to heal,” says Dr. Shah. “PMMA are tiny balls that sort of act as a scaffolding. Most fillers degrade over time, but since PMMA cannot be absorbed into the body, this offers a permanent result,” she says. The other 80% is collagen. The procedure takes about 20-30 minutes, and while you may need a touchup a couple months later, some people just need the single treatment, says Dr. Shah.

There are also temporary options that apply like makeup and are easily removable — Dermaflage makes a great one.

Lasers: Dermatologists often remodel collagen using lasers, “which do not completely eliminate acne scars but can improve them by 30% or more,” according to Dr. Woolery-Lloyd. “These can be helpful in reducing the redness associated with acne marks and scars. I use a pulse-dye laser called the V-Beam for red scars. When treating older scars that are no longer red, I like to use the Fraxel laser. When lasers are used to treat acne scars, the results can differ dramatically based on two things: how many treatments you have done, and how much social downtime you’re willing to accept as part of the recovery process,” says Dr. Bowe. “Erbium laser resurfacing is also another option and it’s more aggressive than Fraxel,” says Dr. Shah. “It’s a minimal burning of surrounding tissues and has fewer side effects like less swelling and redness, but it’s won’t work for those with darker skin tones.”

Dark Spots and Marks

The good news is your acne is gone. The bad news? It left behind some evidence. Sometimes it’s in the form of acne scars, but often these are pigmented dark spots or marks that appear after pimples have healed. The technical name for these unpleasant acne reminders is post-inflammatory hyperpigmentation (PIH) and they typically appear tan or dark brown in color. Without treatment, darks spots and marks may take months to years to fade away.

How to Get Rid of Dark Spots

The best defense is a good offense, so using a Proactiv treatment system to prevent acne breakouts from forming and reaching the skin’s surface can keep dark spots from appearing in the first place.

There is more than one treatment option if you’re looking to get rid of post-acne dark spots, including over the counter topical products, prescription medications, and medical procedures.

We recommend the Proactiv Advanced Dark Spot Correcting Serum which contains the over-the-counter medication hydroquinone (2%), a depigmenting agent. Proactiv also makes Mark Correcting Pads, which are formulated with glycolic and salicylic acids to promote an even skin tone and texture. Both products can help reduce the appearance of post-acne dark spots and marks.

Increased sun exposure can also exacerbate your post-acne dark spots or worse, create new dark spots that have nothing to do with acne. Use a noncomedogenic (non pore-clogging) sunscreen such as Proactiv+ Oil Free Moisture Broad Spectrum SPF 15 to help protect your skin against the sun’s damaging rays and keep your dark spots from getting worse.

Skinacea

How to Fade Post-Acne Red Marks, Dark Spots, Pigmentation, Etc.

Learn how to fade dark marks from your skin |

Fading dark acne marks on my cheek

Post acne marks, or macules, are commonly referred to as “acne scars.” Real acne scars, however, are the indentations or protrusions left behind by acne. Acne marks, on the other hand, are the flat red or brown dots left behind by pimples. They are also a type of post-inflammatory hyperpigmentation.
NOTE: Treatment for acne macules is different from treatment for acne scars. We will be covering post-acne marks and post-inflammatory hyperpigmentation (PIH) here. To learn more about acne scars and their treatment options, check out this very informative site.
Acne isn’t the only thing that can cause discolored skin marks. Other dark spots and types of skin hyperpigmentation can come from aging, sun damage, and even using birth control pills.

Most of the time, acne marks and dark marks that you get from skin wounds will go away on their own. However, for some people, it can take anywhere from six months to many years for them to lighten completely. Other forms of hyperpigmentation (ones from aging, allergies, etc.) don’t fade on their own and may even get darker as time goes on.

To treat these red marks and pigmentation issues, consider the following options:

  1. Sunscreen

    Wearing sunscreen is essential, whether you are trying to fade marks or have no marks to fade whatsoever. It should be a part of your skin care routine because it protects your skin against the sun’s harmful UV rays and prevents cancerous lesions.
    If you want to speed up the fading of your hyperpigmentation, it is extra important to use sunscreen consistently. Sunscreen not only prevents sun damage, it helps prevent existing acne macules and other dark spots from getting even darker.

  2. Exfoliation

    Exfoliating helps fade your acne marks faster by shedding old skin and bringing new skin to the surface. There are lots of options for exfoliation, such as scrubs and washcloths. I personally prefer chemical exfoliation because I feel it penetrates deeper, works faster, and is less physically irritating than manual exfoliation.
    To get rid of red acne marks or hyperpigmentation, you can also consider using prescription retinoids, like Differin, Retin-A, or Tazorac. Prescription azelaic acid, like Finacea, is also known for lightening skin. On the other hand, if you don’t want to use prescription products, you can try over-the-counter products with AHAs as the active ingredient. (I’ve had good results with using an AHA serum to fade old acne marks.)
    Though exfoliation is one way to fade dark marks faster, be aware that these types of topical exfoliating products and treatments can cause irritation such as redness, peeling, and dryness. They can also make your skin more sensitive to sunlight, which makes wearing a good sunscreen that much more important.

  3. Skin Lighteners

    Aside from exfoliating to help skin renew itself faster, you can attack dark spots with skin lighteners such as kojic acid, licorice extract, arbutin, mulberry extract, and vitamin C.
    Hydroquinone is also a skin lightener. However, because there are cancerous risks associated with this ingredient, it has been banned in Europe and Asia. Over-the-counter hydroquinone products are still available in the US market, but anything over 2% requires a doctor’s prescription.
    Many Asian skin care products target the lightening and whitening of skin as well. However, before purchasing any of these products, make sure to check the ingredients to see if there are actually effective skin lighteners in the product.

Some people recommend applying vitamin E (either a vitamin E product, 100% vitamin E oil, or vitamin E poked from a gel capsule) on dark marks but in my experience, vitamin E oil can be very irritating when used on its own. In the past, I thought vitamin E would help with scars, marks, and overall healing, so I slathered it all over my face, only to wake up the next morning to lots of tiny red bumps. It took 2 days of cortisone cream to calm my skin down. So, just keep in mind that while vitamin E oil is healing, it can also cause irritation for some people!

When should you treat dark marks?

The fresher the post-acne mark, the brighter color red it will be. Acne macules usually go from bright red to a dark brownish color before fading completely. The earlier you use treatments (i.e. exfoliation, retinoids, AHAs, etc.) to fade marks, the better results you will have. However, you shouldn’t use treatment products too early either.

The best time to start using active treatments on dark marks is when the marks are no longer an open injury. If the post-acne mark still looks moist or has a scab, wait for it to dry up and for the scab to fall off on its own before you start any dark mark fading treatments. Exfoliating or using an aggressive treatment while your skin is still repairing itself will only prolong the healing process.

Think about it this way: if you had a cut on your arm and you wanted the cut to go away faster, you wouldn’t apply an acid (like an AHA) to the cut. Applying an acid would probably re-injure your skin and keep it red longer. The same line of thinking applies to any injuries (post-acne spots or not) on your face. While your skin is still red and raw, use healing products to speed up its recovery. Once some of the bright red fades from the acne mark, you can then start using an exfoliating treatment.

How long does it take for dark marks to fade?

Exfoliating or using topical products helps shorten the amount of time it takes for red marks to fade, but any product you use will still take time to work. Even if you are exfoliating every day or using the right products, dark marks won’t fade immediately. Everyone’s skin is different, but with consistent and long term use, you should see results in around two to three months. Depending on how fresh your acne marks are and how fast your skin naturally heals, you may even see results sooner.

While your marks are fading, you may notice some dry skin flakes around the mark or even a dead layer of skin forming over the mark. If this happens, do not pick it off. Let your skin shed on its own when it’s good and ready – it’s all part of the process of your skin healing itself and you don’t want to disrupt it or you’ll just make it take longer for your skin to recover. The good news is, most post-acne marks will fade with time. You just have to be patient!

However, if you are really impatient, you can opt for facial procedures such as chemical peels, lasers, and/or microdermabrasion for faster results. Facial procedures do not perform miracles either because they also take at least two to three treatment sessions spaced several months apart for you to start seeing your desired results.

Good things come with time

If you want a quick fix for any dark spots, a good concealer will do the trick. Otherwise, the best way to fade acne marks is to: 1) prevent the marks from getting darker by wearing a good sunscreen, 2) help your skin’s renewal process by using exfoliators or skin lighteners, and 3) be patient!

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How to Use Chemical Peels

Last updated: May 7, 2013

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ACNE SCAR OR DARK MARK? KNOW THE DIFFERENCE

When acne rears its ugly head (white, black, or otherwise), the ordeal isn’t necessarily over when the pain stops. Sometimes, the bigger the pimple, the longer the scars last on your face. But that spot on your face, is that a scar or a dark mark caused by hyperpigmentation?

Post-inflammatory Hyperpigmentation Marks (Dark Marks)

It’s a common point of confusion for everyone with acne. Sometimes, what we think are deep acne scars are really superficial dark marks which heal over time.

Those light or dark brown marks on your skin? They’re Post-Inflammatory Hyperpigmentation (PIH) marks left by mild to moderate acne breakouts. PIH can result in epidermal melanin which will appear as your body heals and eventually fade with time. They’re not scars at all. So you’re in luck if these are the dark marks you see on your skin. You can take steps to speed up the healing and get back to clear, even-toned skin.

Mild to moderate acne can leave dark marks which can last a long time.

However, dark marks can last for quite a while if caused by inflammatory acne (cystic lesions and nodules). This is because your skin treats inflammatory acne like an infection, sending immune signals to the affected area. Thus, PIH can result in dermal melanin when deposited inside the deeper layers of skin and it can take more than just one monthly epidermal cell-renewal process for these dark marks to disappear outside, on your skin’s surface.

Acne Scars

Acne scars usually run deeper as a result of damage that breaks down the support structure in the skin’s deeper layers— that is, the layer beneath the surface of your skin.

Moderate to severe acne that damages the skin’s inner layers can result in a deep scar that is visible on the surface of your skin.

As it turns out, we should’ve listened to Mom about not popping zits – it can injure your skin and turn a mild breakout into a permanent scar. Moderate to severe acne can break down collagen and elastin in the deeper layers of skin. This leaves an indented scar that needs special treatment from a dermatologist.

Picking pimples can cause deep acne scars.

Some of the types of permanent acne scars are:

Ice Pick Scars

Deeper than they are wide, with jagged edges, they can sometimes resemble large, scooped-out pores.

Boxcar Scars

Broad, rectangular depressions on your skin with steep, defined edges.

Rolling Scars

Broad depressions with rounded, sloping edges that reflect the name.

Well, now you know the difference between scars and marks. So what’s next? Let the experts from The Pond’s Institute show you how Pond’s Acne Clear can help reduce pimples/acne, and in effect the appearance of dark marks, so you’ll regain a clear, flawless complexion in just 3 days. Or, read more about the causes of acne.

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.

Acne Marks vs. Acne Scars

Most pimples leave behind evidence. Our hope is that their marks are superficial. If your skin remains smooth in dark or red areas, you simply have an acne mark. Those marks are not scars — they are just temporarily discolored. It usually takes 3-6 months for the marks to disappear.

However, if you have a scar, you’re dealing with permanent skin damage that needs treatment in order to disappear. An acne scar changes the texture of the skin. If acne has left indentations, or raised spots, the damage has occurred at a deeper level in the skin. This “cobblestoning” effect indicates scarring that needs more than a surface-level treatment.

Related: Tired of Hiding Acne Scars? Get the Skin You Deserve with Fractional Laser Scar Treatment

The best intervention for smooth skin is prevention. If you’re experiencing acne, you need to take steps to keep these scars from occurring. Treat new acne immediately, working with your dermatologist to find the best treatment option for you. And don’t pop pimples! You’ll just create more long-term damage.

If you notice that your skin remains bumpy after a pimple has cleared, visit your dermatologist for an early treatment plan. The ultimate goal is to stop the scars from forming.

What Causes Acne Scars?

Scars form when the skin is damaged. With acne inflammation, different types of blood cells and collagen rush to the point where injury may repair the skin. But they can’t always return the skin back to normal, especially when severe acne doesn’t give the skin time to heal before it breaks out again.

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.

Depressed Scars

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.

Boxcar scars

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.

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.

Raised Scars

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.

Discoloration

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.

The Best Acne Scar Treatment

Scars form because collagen fills in damaged skin areas in a column pattern that mimics the wound. The collagen binds the skin, but it also pulls the skin down and contracts it making it a different texture from surrounding skin.

In scar treatments, we break up the collagen. Then, as it re-grows, it comes back more randomly and the web of collagen produces smoother skin. If you’re living with scars, we have two primary treatments for breaking up the collagen and rejuvenating your skin.

Rejuvapen for Acne Scars

The most cost-efficient treatment is the Rejuvapen for acne scars. The Rejuvapen uses needles to pierce the collagen and change the pattern of the scar. The collagen then reforms in a different arrangement as the skin heals.

Laser Treatment for Acne Scars

Our second primary treatment, the Icon Laser, offers patients the best results for smoother skin. Laser therapy breaks up the scar with laser light. It punches holes in the collagen without ever piercing the skin. Because it doesn’t break the skin, recovery tends to be quicker after this treatment. Also, lasers penetrate deep into the skin causing long-lasting results.

The costs of laser treatments for acne scars vary drastically. Depending on the area and the type of laser you need, the costs of laser treatment for acne scars range from a few hundred to a few thousand dollars.

Why Is Dermatological Treatment Recommended for Acne Scars?

When you have true scars that have changed the texture of your skin, you’ll need a medical procedure to see improvement. We use a laser specifically approved by the FDA for treating laser scars. Some people try chemical peels, which aren’t very effective. Others try dermabrasion, a technique like a sanding wheel on your skin, but there’s a high risk of permanent scarring. A laser gets much better results without the same risk.

Schedule an Acne Scar Treatment Today

If you’re ready to start the process of removing your scars, rest assured, you’re in good hands. For an acne scar treatment in Dallas, just give us a call and we’ll help you choose the treatment that’s best for you.

We start with a consultation. An esthetician will examine your skin to determine your skin type and the severity of your scarring. Then they’ll decide how many treatments you’ll need. Typically, dark skin requires more treatments. Because dark skin is more prone to produce pigment, we reduce the amount of energy for each treatment. That way, you’ll avoid dark pigmented areas after your treatment.

You’ll also learn how to prepare for your treatment. We’ll give you products to apply before your procedure to prime your skin and avoid pigmentation. You’ll also receive information on pain medication and the downtime you’ll need as you recover. If you decide to take time off work, you can schedule your procedures before a weekend or take a few days off.

After your treatment, have your sunscreen ready. You’ll need to apply it heavily in the weeks following your procedure to avoid over-pigmentation.

If you’re a victim of acne scars, there’s no need to live with skin blemishes of the past. Laser treatments work at a deep level to leave you with beautiful smooth skin, and Rejuvapen delivers great results at a fraction of the cost. Contact us to discover the best choice for your skin!

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