How are pimple scars formed, and why am I not yielding results from my treatment?
Be it the occasional pimple or a full-blown breakout, often we are left with the aftermath of pimple scarring. Pimple scars form when the skin and tissue around it is damaged. During the repair process, too much or too little collagen produced can result in different types of scarring.
Atrophic scars such as boxcar scars, ice pick scars and rolling scars are scars that cause pits and depressions below the skin. These forms of scarring happen when the body produces too little collagen. If you have cystic acne or a tendency to pick at your pimples, you have higher chances of getting rolling or boxcar scarring due to the damage of the small veins and tissues around these spots.
Hypertrophic or keloid scars on the other hand, happens when the body produces too much collagen during its healing process, causing raised acne scars. This type of scarring is more common in African Americans, Hispanics and Asians with darker skin tones.
With these varying types of scarring, we suggest that you seek advicefrom an expert physician, to find the right acne scar treatment for you!But before that, read on to find out what are the top 6 treatmentsthat could help you treatyour pimple scars the right way, as recommended by Dr Isaac Wong, expert physician and medical director of The Artisan Clinic in Singapore.
Here are the top 6 treatments that might be missing from your regime!
1. Vitamin C
Do you practice putting on Vitamin C serum after cleansing and toning your face? Vitamin C, is an antioxidant that neutralises free radicals (unstable molecules that damage our body cells) in our body, so it’s important to apply this on your facial skin daily, as your skin is continuously exposed to free radicals. This could be caused by internal factors like your diet, stress, smoking and also externally from ultraviolet (UV) rays and pollution.
Applying Vitamin C on your face can also help reduce dark pimple marks due to its anti-pigmentation properties. On top of that, it helps to increase the production of collagen in your skin to minimise scarring, especially atrophic scars that cause loss of skin tissue and elasticity. Hypertrophic acne can cause skin discoloration and hyperpigmentation, so, Vitamin C can also inhibit melanin production that is responsible for unwanted pigmentation of your skin.
According to Dr Isaac Wong, Vitamin C serum is a well-known inhibitor of melanin production, and it is great for lightening those pesky post-acne dark marks. Apply it twice daily, right after cleansing and toning your face, and most importantly before your moisturiser! A small amount will do, as it is usually oil based, and you do not want to clog up your pores.
It is also crucial to slap sunscreen onto your face daily, even if you are working from home, as we are regularly exposed to UV rays even when indoors. UV rays from the sun trigger melanin production, and can cause acne scars to become more visible. Over time, lack of proper sunscreen protection can lead to darkening and hyperpigmentation of these scars. The Singapore sun is at its strongest between 11am to 3pm, so be sure to reapply your sunscreen and avoid direct sunlight during these hours.
When it comes to finding the right sunscreen for your skin, Dr Isaac recommends looking out for sunscreen that covers both Ultraviolet A (UVA) and Ultraviolet B (UVB) as well as blue light! Blue light is the light emitted from laptops, phones as well as computers and is one of the biggest causes of pigmentation. This is another crucial factor to take note of, as you are probably working more regularly from home now.
If you are keen to try this simple treatment for your acne scars, begin by applying a tiny amount on the affected area and wait for a few days to evaluate your tolerance. If your skin gets red and flaky, try mixing it with some moisturiser before testing it again. If you don’t get a reaction from it with or without the moisturiser, then it should be safe to practice this treatment more regularly. Dr Isaac recommends using it once or twice a week for a start – and depending on how your skin reacts to it – gradually apply it onto the target areas every other day or three times a week.
What exactly is retinol then?
Retinol is a derivative of Vitamin A, and its applied to make skin cells grow and function effectively. Non-prescribed retinol is usually used to avoid cystic acne, and can be easily found on the shelves. Cystic acne blemishes penetrate deep into the skin and cause permanent acne scars when they heal. Retinol works by unblocking clogged follicles, getting rid of the bacteria that causes cystic acne, besides reducing the possibility of further outbreaks. On top of that, it also boosts collagen production that will reduce the formation of acne scars.
There are different types of retinol in the market, and they can come in the form of gels, creams or lotions with varying potency. Do the step-by-step tests and observe the outcome as suggested, because Retinol can cause some side effects such as dry, flaky skin and irritation. Ultimately, it’s always best to get guidance from an expert, such as Dr Isaac, for an appropriate treatment plan specifically catered to your skin.
4. Collagen Stimulator
Before we dive into how collagen stimulators (fillers) can help improve acne scars, we need to first understand how hypertrophic acne scars are formed. As your acne heals, tough scar fibers can form and pull the skin downwards, causing a dent when the cells do not regenerate evenly.
Here come collagen stimulators to the rescue! – these fillers are injected into the skin in small amounts usually after a subcision process (a method aimed to break and loosen tough scar fibers that cause the indentations) – to prevent the scar tissue from sticking back.
According to Dr Isaac, injecting a dose of collagen stimulators immediately during the subcision process prevents the scars from “sticking back” and stimulates collagen production in the scar cavity to encourage proper repair and healing. It also “resurfaces” the scars making them less deep due to the collagen formation from the collagen stimulators.
Also known as Radio Frequency (RF) micro-needling, this treatment consists of using a device with insulated micro-needles that deliver high-intensity RF energy that stimulates collagen production and remodeling, beneath the deeper layers of the skin. This treatment usually results in 2 to 3 days of downtime but still works better than fractional CO2 or more ablative lasers as it causes lesser damage to the skin.
Dr Isaac tells us that this treatment is best suited for moderate to severe boxcar scars in combination with the collagen stimulator procedure because deep acne scars require deeper penetration of the micro-needles to reach the scars.
6. Resurfacing procedures: Laser
You may not be comfortable with the idea of doing a procedure with 2 to 3 days of downtime, but the good news is, there are other options of laser treatments that target varying severity of acne scars with minimal downtime. Pico laser is one of them!
It is a form of laser that uses incredibly short laser pulses to target scar tissues with a massive amount of pressure to stimulate focal points of collagen production by the skin. Skin treated with this laser produces consistent results and smoother skin. “It does not cause damage to the superficial layer of the skin barrier as the laser is intelligent enough to avoid the top layer and penetrate deeper into the skin where collagen production is needed the most,” explains Dr Isaac. As compared to traditional lasers, it is a more ideal treatment option that requires no downtime, with minor side effects like flushed skin that will disappear in a couple of hours. PicoSure treatment with Focus Lens is definitely the latest no downtime skin “resurfacing” procedure for depressed acne scars.
So, have you discovered what’s missing in your acne treatment routine?
Active acne is the bane of many of us, due to the scarring it leaves on our faces, but fret not, with the above recommended therapies, you can conquer acne as well as acne scars and have youthful smooth skin again! You could opt for the above machine-based therapies (microneedle RF, PicoSure) once a month, or the injectable therapies once every 2 years.
Sometimes all it takes for us to get the desired results, is to find the appropriate treatment for our skin. If you’re struggling to understand what’s right for your skin, consider seeing an expertphysician like Dr Isaac Wong for a thorough consultation.You can also read more about these treatments and other options in removing acne scars at The Artisan Clinic’s official website.
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