A Simple Guide To Acne Scars and How To Tackle Them At Home (w/ Before-and-After Photos)

I don't know which was more annoying - an actual red angry spot on my cheek or the mark that was left behind for weeks to come. I've talked about my acne journey on this blog, but little how to clear marks, scars, pigmentation whathaveyou that are left behind. Today I'm writing a simple beginner-friendly guide what are possible pigmentation issues and what are the options in treating them.

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Different types of "acne scars"

Most common types of "acne scars" can be divided to three types:

  • Post Inflammatory Hyperpigmentation (PIH)

  • Post Inflammatory Erythema (PIE)

  • Atrophic scars

Post Inflammatory Hyperpigmentation (PIH)

Hyperpigmentation occurs when the skin overproduces melanin and there are several forms like freckles, age spots, birthmarks, melasma and PIH. PIH is temporary hyperpigmentation caused by inflammation; when a wound or irritation becomes inflamed the skin naturally heals itself by producing melanin, a protein that gives skin its color. These causes of inflammation can be acne, rash, injuries, chemical peels etc.

All skin types can get PIH but it's more prevalent in dark tones of skin because of overactivity of cells that produce melanin. PIH usually looks like red, pink, brown or dark discoloration depending on the skin tone and depth of discoloration. Although the sun doesn't cause PIH it can darken the marks and prolong the fading time.

Post Inflammatory Erythema (PIE)

PIE are pinkish red spots that can also be result by acne, injuries, sun exposure, etc traumas. The color is different as this is not a melanin-induced problem, but caused by broken capillaries (small vessels) under our skin. This triggers the increase of blood flow to heal the wound.

There's a DIY (non-accurate) test to determine if your marks are PIE: apply pressure on the wound to see if the pink spots temporarily disappear. PIH or rosacea is not affected by this, but often people may have the combination of both PIE and PIH.

Atrophic Scars

Sometimes called icepick, boxcar or rolling scars, atrophic scars are indentations left behind by acne, chicken pox or inflammation. Atrophic scars are loss of tissue that may look like dents, uneven skin tone, enlarged large pores or holes. These scars are often permanent or difficult to treat without professional help.

A Simple Guide to Acne Scars | Laura Loukola Beauty Blog

I don't have many pictures of my acne, but I found old iPad selfies from ~4 years ago. 

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And here's me today (with cat fluff on my face haha) with zero makeup. Read more about my acne journey.

How to treat acne scars At Home?

First of all, you should see a dermatologist if the pigmentation changes it's shape, size, color or itches/bleeds. If you're prone to moles, getting them checked once a year doesn't do any harm! Treating pigmentation and scaring at home with over-the-counter products isn't an instant process and might take several months to fade, For more abrasive (prescription) ingredients, vascular lazers and chemical peels, again, check your dermatologist or even local GP. Here's what I've learned to be effective at home:

1) Sunscreen. If sunscreen isn't already a part of your daily routine please consider adding it! Sun protection can protect and even prevent from many health and pigmentation issues. Also, if you choose to exfoliate your skin the 'fresh' skin underneath is more prone to sun sensitivity and burning. I've told many of my friends that it's a waste to spend big $$$ in wrinkle serums or pigmentation treatments if you neglect sunscreen.

2) Increasing the cell turnover. Alpha hydroxy acids (AHA), especially glycolic acid, are excellent for treating pigmentation. Acids exfoliate the surface of the skin by loosening up the dead skin cell bonds on the epidermis, leaving skin feeling fresh, more even and smooth. Faster your cells renew the quicker you can get rid of PIH. Personally I like using a gentle daily toner with AHA, natural fruit enzymes and humectants. Sometimes I opt for a stronger mask.

3) There are prescription ingredients (Hydroquinone, Azelaic acid, Retinoids), that inhibit tyrosinase aka an enzyme that catalyses the production of melanin, but personally I prefer gentler ingredients with "skin lightening" properties that have high antioxidant content such as licorice root, Arbutin, Niacinamide and Vitamin C. Perhaps look for a serum that has a high concentration of these ingredients.

4) Don't pick, pop or abrasively scrub and monitor your skin's irritation. You don't want more inflammation, bacteria or further damage the skin!

5) Take your time, be kind to yourself. Frustrating advice, yes, but don't get depressed as most scaring is not permanent. (Meanwhile there's always concealer..).

Share your thoughts!

Have you battled with acne scaring? What has improved your skin the most? Also, is there anything acne related you'd like me to talk about next? Click here to read my previous posts if you fancy.

And finally, happy September! To be honest I'm baffled that August is gone. Just a moment ago we were whining about the heatwave in Europe and then the weeks just flew by! I love it how bright it is in Helsinki during the Summer time, I can't stand the idea the mornings are going to be dark soon. Sigh. 

My acne journey, Accutane and AM skincare routine

This post is going to be a lengthy one, I hope you're into a more personal update. First, big thank you for everyone participating the giveaway - I love your post suggestions! Some of you requested my skincare routine and obsessed with Asian skincare I gladly write about it. Except, I'm on Accutane and not following my regular routine. Maybe this post will serve as a documentation of my skincare journey and interest others with troubled skin. I will review the products I use more in depth in the future posts, if they are good or interesting.

Background

Growing up I had unproblematic skin. I didn't have any major break outs as a teenager nor remember suffering from a very dry skin. In my mid twenties my skin started to change. When I moved to Japan in 2014 I had a very bad diet, and a lot of small whiteheads and impurities started to appear. The break outs weren't massive deep cystic ones, but my cheeks looked very angry and covered with small red pimples. I had to quit hot yoga as my body skin got itchy and irritated.

First actions

After a year I moved back to Finland and gave up gluten and dairy again, my skin started to clear up a bit and became less angry looking. The itchiness vanished completely. I still had whiteheads and impurities on my forehead and on my cheeks, bigger pimples left a red scar for months. I educated myself about skincare: acid toners, exfoliant, lotions and potions. I'be listed my first tips for mild acne here. I find Paula's Choice salicylic acid and a retinol serum helped me as the larger break outs surfaced less frequently, but wouldn't go away nor did the smaller impurities.

Trying medications

After +2 years of struggling I went to see a doctor who prescribed me topical a gel with retinoid and benzyl peroxide (not a common ingredient in Finland). The impurities and small whiteheads disappeared from my forehead, cheeks and chest in an instant. However, the gel made me extra dry, very flakey and easily irritated although I had stopped using exfoliators and paid extra attention to moisturising. It didn't stop the larger pimples outs or scaring, I kept breaking around chin and cheek bone area, could be hormonal(?). 

Then, I got described Accutane/Roaccutane, an oral Vitamin A medicine. I'm taking it for about two months. I was mentally prepared for even drier skin, dry eyes, flakey lips and sensitivity to sun and light. It took about couple of weeks until I noticed any side effects at all. Not using my regular BHA/AHA I got blackheads on my nose and once tried an acid on them.. not my smartest moment, as a result my skin literally peeled off. After a month on the medication, my arms got tanned during a holiday and the skin turned extra parched and dry. I look like a lizard vigorously slapping body butter and sunscreen on my skin. But my face has started to clear up - so far I've had only 1 pimple on Accutane.

Focus on hydration

Before taking Accutane I was all about acids, peels and exfoliating. Now they're on a break, shyly in the corner of my skincare cabinet. I've been extra focused in nourishing, moisturising and using a sun block. You can read more about necessary sun care in my earlier post here. These are steps I've always done, but now with extra care. I use a gentle facial wash in the mornings, pat dry with a towel and prep my skin by layering Niod Copper Amino Isolate 1.00%, layered with hydrating Estée Lauder Micro Essence and moisturising lotion Hadalabo Gokyjyun (しっとり =moist version). The Esteé Lauder essence is lighter than the Hadalabo lotion, which is why I use it first in my attempt to make my face a moisture sandwich. 

Serums

These are my current serums I rotate or use together for day time. I was lacking actives in my routine opted for Mad Hippie Vitamin C serum. Gotta say, I'm not crazy about it. The price is reasonable and the ingredient list is nice, I've read it having 10% sodium ascorbyl phosphate, but I haven't seen much effectiveness and I'm almost finished with the bottle. I have similar feelings about Hylamide, but I haven't made up my mind quite yet. At the moment, all the hydration is welcome, but I wish I could see more improvement on fine lines and texture issues.

Eye care

NIOD Fractionated Eye Contour Concentrate* has the same parent company as Hylamide, all three products I've shared here share the similar bottle and watery consistency. I feel it's a good eye serum, keeping the visible signs of my ageing at bay with antioxidants and peptides. No effect on my genetically dark under eyes or hooded lids, but I don't expect it from anything. It's hydrating, but on Accutane I crave for more moisture around my eyes, so I top the concentrate with Kiehl's Creamy Eye Treatment with Avocado. It's a classic, heavy and creamy moisturiser. Good, but doesn't do much else.

 

My favorite step

Moisturiser, sunscreen and coffee. Yep, having a cup of joe after my routine is a necessary part of relaxation and recharging for the day. Don't they all say skincare should be "me"-time? I'm in love with this January Labs Revitalizing Day Cream*. Very fluid, very pleasant to use, packed with niacinamide, antioxidants and moisturising ingredients. Equally in love with this Innisfree Eco safety perfect sunblock SPF50+ PA+++. It's a heavy duty physical sunblock, which does leave some white cast if you don't massage it in, but my dry skin loves this stuff. I'm on my 5th? 6th? tube of this.

After thoughts

To a blush addict it's a nightmare to break out around the cheek area, and I'm afraid medication won't totally prevent it in the future. Despite the dryness, I'm quite happy with how my skin looks. It's not angry, bumpy, inflamed. I don't feel the need to roll in concealer. I can't wait my medication to end, go back to my acids, testing new products and see how things go. I'll be talking a lot about skincare in the future: routines, knowledge and product reviews.

Have you suffered from troubled skin? What kind of skincare have you used?

Related posts:
My comprehensive sunscreen post
5 simple ways to battle break outs

This post contains products (*) that were generously provided for consideration. Regardless, my opinions are my own honest and unbiased views. The links are for your convenience and do not contain ads.