Active acne is distressing at any age and acne scars can remain for years. I’ve received numerous questions on different types of scars and now superstar dermatologist Dr Gary Goldenberg of Mount Sinai Medical Center has provided great solutions. Today I am starting with the most common acne scars– those red or brown spots.
Question: I’m 27 and finally got my acne under control, but now I have dark red spots on my cheeks and chin. How can I get rid of them? And does the redness mean that acne scars will come back?
Answer: Those dark red spots are called Post Inflammatory Hyperpigmentation or PIH. They are the sign of a persistant inflammation that is located deep in the dermis. The body has to reabsorb this damaged tissue– a process that takes 6-12 months. Because they are formed in the lower layers of the skin, exfoliating scrubs and superficial peels will not really help. Retin A can speed up the process somewhat but for quicker, permanent results, Dr Goldenberg uses the Fraxel duel laser. He can set the depth of the laser to reach the dark spots without damaging the other tissue.
Dr Goldenberg starts by numbing the skin with lidocaine gel. One hour after lidocaine application, the skin is so numb the proceedure is virtually painless. Right after the one hour Fraxel treatment, the skin will look and feel like a sunburn– red with some swelling. This usually last 2-3 days and an ice pack can relieve the buring sensation. Dr Goldenberg also recommends putting your moisturizer in the refrigerator so that when its applied, it literally cools and hydrates the skin. After the redness subsides, peeling will start and last for about 2 weeks. After the abnormal skin has peeled off, you will start seeing fresh , spot-free skin.
Acne Scars in Women of Color
In darker skin tones, PIH can look dark brown and black rather than pink or red. Over the counter skin lighteners with Koic Acid ( eg Clinique Even Better) can slowly lighten them. These very dark areas can also be zapped with the Fraxel duel laser. However the heat of the laser may trigger more inflammation and pigmentation. To prevent problems, Dr Goldenberg pre-treats skin of color with hydroquinone to slow down pigment forming cells before firing up the Fraxel laser. Acne can seem like the gift that keeps on giving. In addition to PIH, acne can leave saucer shaped depressions, enlarged pores and even lumpy raised areas. That’s the bad news. The good news? There are tools and treatments for all of them.