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Daily Question #007: What Can Be Done At Home for Acne Scarring?

Posted Aug 10 2011 1:00am
Acne by Jason Craft
Acne , a photo by Jason Craft on Flickr.

 

I have acne scars on my cheeks, ice pick type scars – not discoloration, and would like to smooth them a bit. I do not want to go to the dermatologist but instead would like to find an at home treatment. Do you know of anything that would help these that I could do at home?

Sincerely,

Hannah

Dear Hannah,

First and foremost, I must refer you to my disclaimer – I’m not an M.D. yet, nor do I give medical advice through this site – only generalized “beauty” advice, like any other beauty blogger. :-)

With that said, as purely “beauty” advice, different treatments are recommended for raised ice-pick type acne scars versus flat, saucerlike acne scars ( Acne: Diagnosis and Treatment , 2000):

Raised Scars: Retinoic acid (available only by prescription), steroid cream (available only by prescription), intracisional triamcislone (available from a dermatologist)

Retinoic acid is one of the only agents that has been shown to reduce the appearance of raised or hypertrophic scars. In one study in the British Journal of Dermatology , the appearance of scars was reduced by 77-79% with daily application of 0.05% retinoic acid. The results were confirmed as retinoic acid has been shown to produce a decrease in fibroblast collagen production and proliferation within the dermis of the skin, resulting in less scar formation ( Journal of the American Academy of Dermatology , 1986).

Considering the fact Neutrogena Healthy Skin Anti-Wrinkle Cream contains only about 0.025% retinol (from my best guess), imagine what other, more potent formulas could do! Some of my favorites of these include Green Cream Level 6 (with 0.6% retinol) and Skinceuticals 1.0 (with 1.0%) retinol. Keep in mind, however, that retinol can cause redness, flaking, and itching upon initial use, and should be kept to use every other day until your skin comes to tolerate it. As always, however, check with your dermatologist first.

Non-raised Scars: Microdermabrasion, bovine collagen (available only from a dermatologist), local excision (available only from a dermatologist)

The advice makes perfect sense. According to Dr. Audrey Kunin, M.D. , microdermabrasion is only used for flat “saucerlike” acne scars, as microdermabrasion superficially sandpapers the skin, sloughing away the surface layers. This means microdermabrasion is to be used for jagged ice-pick type scars or raised scars, as the irregularity would not be improved, and could actually be made worse. Microdermabrasion products I have tried and loved include Lara Beauty Microdermabrasion Scrub ($25.00, LaraBeauty.com) and Avon Anew Clinical Dermabrasion System ($28.00 retail). Again, however, you still must check with your dermatologist.

Scarring is a serious business, and dermatologists have many more tools at their disposal than we do at home to deal with it. Nevertheless, if you have a raised scar – i.e., keloid scar, or an “ice-pick” type scar like Hannah – you use microdermabrasion and would benefit more from over-the-counter retinol. Conversely, if you have a flat scar, you would benefit more from microdermabrasion. At any rate, while other agents, such as alpha hydroxy acids and salicyclic acid, may refine the skin, these have not been documented to improve scarring like retinoic acid for raised scars and microdermabrasion for flat scars. As always, consult with your dermatologist!

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