Ep 78: How to Prevent and Treat Acne Scars
Acne marks or scars are a common concern. This podcast episode goes in depth into the types of acne, how exactly acne scars form, and different types of scars that can develop. Join in the discussion on how best to prevent and treat acne scars in this masterclass brought to you by Eucerin International.
Acne scar prevention starts with understanding acne
There are a few broad categories of acne. First, physiologic acne, also known as teenager acne is the commonest type of acne. Second, adult acne or hormonal acne. Hormonal acne usually affects women and tends to coincide with certain times and their menstrual cycle. Another category of acne is known as steroid induced acne. These are acne bumps caused by the use of medications such as oral or topically applied steroids. Maskne is a form of acne mechanica, a type of acne caused by occlusion. This means that acne forms over areas where the skin is under occlusion, either by comedogenic creams or physically by materials. For example, face masks or sports helmets.
Acne scarring is one of the main reasons why dermatologists advocate early treatment of acne. The key here is that a correct diagnosis of acne is equally important. Many conditions such as rosacea, eczema and fungal folliculitis (inflammation of the hair follicles) can lead to redness, bumps and scars on the face as well. However, they are different from acne and must undergo treatment with certain prescription medications. Once your dermatologist diagnoses you with acne, they may offer prescription medications for moderate to severe acne cases. The focus of this podcast episode is on over-the-counter skincare options that can be an effective complement to your acne skincare regimen. Specifically, skincare that can treat and prevent acne scars.
Early diagnosis, prevention and treatment is the best way to prevent acne marks
The reason is that the longer acne goes on the more severe it gets. The acne scarring that occurs also gets worse if acne is left to flare. Acne and acne scars can severely affect the quality of life of individuals who suffer from pimples. It is a misconception that one can just grow out of acne. This is the reason why the American Academy of Dermatology always recommends parents bring their child to a dermatologist for acne treatment rather than waiting for their child to “grow out of it.”
A dermatologist’s viewpoint: “growing out” of acne does not always happen and is a bad choice
Acne is genetic in its roots. These genetics drive inflammation, which together with a surge of hormones during puberty that leads to oil production, results in acne. While it is true that physiologic/teenage acne generally settles after puberty, the resulting scars may stay for life. Advanced acne scar treatments such as lasers by dermatologists may not guarantee clearance of acne scars. Co2 laser resurfacing may help to even out textured acne scars, but will not restore skin to 100%. This is why we must prevent mild acne from getting worse. Skincare is also an effective early stage acne scar prevention and treatment. Also, many adult patients continue to have acne past their teenage years.
How do I know if I am at risk of developing acne and acne scars?
The risk factors for developing acne include a family history of acne. Especially when oral medications were a requirement for treatment- this means that moderate to severe acne was present. In addition, women who have irregular menstrual cycles should undergo screening for polycystic ovarian syndrome (PCOS). As there are some cases of adult hormonal acne that are due to PCOS- these cases should be under joint management with a gynaecologist.
Acne scars and marks are caused by inflammation of skin tissues
Acne itself is linked to the process of inflammation. Genetics drive inflammation, resulting in blackhead and whitehead formation. This is the process of comedogenesis. If you’ve heard of blind pimples, these are essentially whiteheads or closed comedones. Whiteheads, blackheads, inflamed acne bumps and cysts are actually all different manifestations of acne. They are treated similarly.
How bacteria causes and worsens acne flare ups
An important aspect of acne is actually bacterial infection. If you notice pus coming out of your acne bumps, this is because of a secondary bacterial infection known as to gram negative folliculitis. The bacteria Cutibacterium acnes directly affects acne. Individuals with acne have a high proportion of this bacteria on their skin which is directly links to acne outbreaks.
The influence of oil on acne
Oil/sebum production is an important aspect of acne formation. Oil directly stimulates inflammation and is a risk factor for acne formation. Hormonal fluctuations affect sebum production during puberty. In adult women, hormonal fluctuations during the menstrual cycle account for hormonal acne. At certain points in the menstrual cycle, there is a surge in the male hormone testosterone which causes skin to be oily. This then leads to acne in acne-prone individuals.
How to identify different types of acne scars and marks
There are two main types of acne scars. There are scars that are due to post inflammation hyperpigmentation, PIH for short. Also, deeper acne scars such as icepick or boxcar type of scars. PIH is a form of pigmented acne mark that occurs shortly after the acne bump has resolved.
What are the stages of acne scar development?
Post-inflammatory erythema or redness is usually what is seen in the early stages after a pimple resolves. Quickly after that, the redness then develops into pigmentation.
Acne scars and marks are more obvious in skin of color
Acne scars are more prominent in skin of color because of the higher amount of melanin present in skin. For example, Asians in Singapore naturally have more pigment in their skin. We measure pigment by phototypes in dermatology. For example, Singapore’s ethnic populations are of phototypes 3,4 and 5. Skin of color has more severe post-inflammatory hyperpigmentation compared to their western Caucasian counterparts.
Another type of acne scar is deeper and may not be reversible once formed
Ice pick and boxcar-type scars are a form of dermal scarring. PIH occurs at the topmost layer of skin— the epidermis where there is a deposition of melanin as a reaction to inflammation. For dermal scarring the ice pick and boxcar type scars mean that inflammation has gone deeper. This is at the level of the dermis. Usually, if you have an acne cyst or a very angry acne bump, it has the potential to develop into an icepick or a boxcar type of scar.
How do I know if I will develop deep indented acne scars?
If you have family members who have severe acne scarring, you should also take good care of your acne marks because there is often a genetic tendency for poorer outcomes of acne scars.
This brings me to the most important part of this podcast.
Acne scar prevention and treatment
The critical aspect I want to highlight for the treatment of acne marks and scars is this. Prevention is key. Certain skincare ingredients are readily accessible and effective for acne scar prevention and treatment.
Once you have a pimple that has developed, an anti inflammatory acne serum or acne cream helps to quickly quell the inflammation. The Eucerin Pro-Acne solution Triple Effect Serum contains Thiamidol, a patented ingredient that has been proven to improve acne marks and prevent reappearance.
Thiamidol is a gentle ingredient that works well for PIH caused by acne marks.
Specifically, thiamidol is effective in the treatment of post inflammation hyperpigmentation caused by acne scars. The Triple Effect Serum also contains Lichocalcone A, derived from the roots of the Chinese licorice plant. Lichocalcone A is a powerful antioxidant with anti inflammatory and skin soothing properties.
Sun exposure causes darkening of acne marks: here is how the Triple Effect Serum helps to build resilient skin
An important aspect of this ingredient is its ability to promote skin resilience. This means that it can strengthen skin so that it is less susceptible to changes in the environment. For example, Lichocalcone A can protect cells from excessive UVB and UVA rays. This helps to reduce pigmentation in acne marks. Specifically, it is incorporated into the Triple Effect Serum as a way to protect the deeper epidermal skin cells from UV related hyperpigmentation.
Additional mattifying and oil control properties of the Triple Effect Serum
On top of that mattifying pigments in the Triple Effect Serum help to deliver a cosmetically appealing effect on the skin. This is important for those who suffer from oily skin in a humid country like Singapore. Oily skin can be very uncomfortable and even socially embarrassing. The anti shine, sebum regulating technology in the Triple Effect Serum helps to give a long lasting dry and matte finish.
The science of the Triple Effect Serum
Let’s have a look at the studies conducted by Eucerin. In a clinical study involving 40 individuals, there was up to 80% improvement in the appearance of acne marks in just two weeks of use. Results were promising as users consistently demonstrated improvement in up to three months of regular use. In particular, these studies paired the Triple Effect Serum with the Day Bright Mattifying SPF30 for optimal results.
This brings us to the next important aspect of acne scar prevention and treatment.
Sun protection. I want to zoom in on the importance of effective sun-protection when you are trying to prevent acne marks and acne scars. Once the acne bump has formed, the key is to minimize the chance of it becoming a bad scar. Sunscreen is a fundamentally important aspect of any good skincare routine. Moreover, an excellent sunscreen can actually protect your skin from developing worse acne marks due to sun-induced skin damage.
Active ingredients for acne scar prevention and treatment
The active ingredient in the Day Bright Mattifying SPF30 includes Decanediol which is a moisturizing ingredient with additional antibacterial properties. It is known to fight bacteria such as cutibacterium acnes, which is involved in the development of acne, and also bad bacteria that colonizes the skin of individuals who have eczema, such as Staphylococcus aureus. This is how the Day Bright Mattifying SPF30 works. Firstly, it targets acne marks and scars. The SPF 30 UVA and UVB filters protect from sun induced darkening of post inflammatory acne marks and this also prevents their reappearance. It also has antibacterial Decanediol that helps to prevent pimples from worsening and secondary bacterial infections. Lichocalcone A present is also an additional effective anti inflammatory agent that helps to calm skin. This plant root extract can also block the production of cutibacterium acnes.
Finally, both these products by Eucerin incorporate mattifying pigments. This helps to reduce excessive oil production and has an appealing anti shine effect.
An ideal addition to your skincare regimen to treat acne scars and marks
Overall, these two star products of Eucerin’s ProAcne range are synergistic in the management of acne marks and scars. The active ingredients used are gentle and suitable for sensitive skin. In particular, Eucerin’s research on Thiamidol show that it is highly tolerable in terms of its ability to treat acne pigmentation, even in very sensitive skin. This is coupled with the development of a sunscreen that can optimize both the user experience and also deliver scientific benefits such as oil control, antibacterial properties, as well as treating acne marks itself.
This podcast episode is sponsored by Eucerin Singapore as a joint collaboration to create scientific educational content relevant to skincare and dermatology. Images produced as part of editorial collaboration consistent with site policy.