Acne, those traces to erase

Is acne now a memory? One could even forget that we had suffered if there were not, to remind us, conspicuous signs of his passage on the face. Here’s how to remedy it.

Acne can go away as it came. Or, and unfortunately it often happens, leave marks and deep wounds of its passage: scars and showy dark spots distributed on the forehead, cheeks, chin and neck.

Thick holes that today, fortunately, can be attenuated thanks to a series of modern treatments that can improve the appearance of the skin. Although it would also be useful to intervene on the prevention plan before this happens with simple measures such as not crushing pimples, cleansing the skin every day, treating acne immediately and avoiding DIY instead.

Of course, the dermatologist will determine the most appropriate treatment for the type of scar: the more the face has remained marked by acne, the deeper and more incisive the treatment to be used will be.

In addition, the correction process must be gradual and well planned, preferably during the cold season; and may require the combination of various methods to obtain the best possible aesthetic benefit and return to having a smooth skin.

The types of scars and possible treatments

The possibility of clearing acne scars depends very much on their characteristics. In general, the more superficial they are, the easier it will be to eliminate them.

In most cases post-acne scars go deep. If they are superficial, they may appear similar to spots due to the darker color (hyperpigmentation) that the skin assumes. There are also hypertrophic or keloid scars, fortunately rarer, which have a raised appearance with a rosy color.

The size of the scars is also very varied, usually ranging from a few millimeters to one or two centimeters.

In general, it is possible to improve the appearance of the skin by leveling the reliefs of hypertrophic scars and lowering the edges of depressed scars or lifting the bottom. There are several aesthetic dermatology techniques that can be used to eliminate scars. The choice of the most valid treatment should be made by evaluating the individual case after a careful dermatological examination.

To promote skin renewal you can intervene, for example, with superficial peels or radiofrequency. In the presence of shallow scars, specific peelings can also be carried out to promote skin regeneration. The treatment of scars that allows to obtain better results, however, is undoubtedly the laser, usually used for both superficial and deep scars. If the scars are very visible and hollowed out, they cannot always be erased, but thanks to the action of the laser it is possible to greatly improve their appearance.

Let’s find out together the characteristics of the main treatments available.

Resurfacing, to reduce imperfections

The term resurfacing indicates all those techniques that smooth and level the skin surface. The most dated, and today little used, is mechanical dermabrasion, which consists in smoothing the skin with a small cutter. Dermabrasion is a real cosmetic surgery that removes the superficial layer of the epidermis. The intervention, depending on the areas of the body to be treated, can be performed under local or general anesthesia. If the lesions are numerous, it must be done over a large area or over the whole face, with the exception of the eyes of course. As you can imagine it is an aggressive method, which is why it has been replaced by microdermabrasion over time.

Microdermabrasion

Microdermabrasion is a treatment that uses aluminum oxide crystals to remove dead skin cells and stimulate the formation of new ones. It is performed in an outpatient setting through the use of an instrument that conveys the abrasive particles directly onto the skin, so that they act where necessary, and then suck them up immediately afterwards, together with the dead cells that have been removed by the action of the crystals.

Before undergoing a microdermabrasion session, avoid exposing the skin to the sun, waxing the areas to be treated and using products to exfoliate the skin. After this deep cleansing treatment it is useful to apply a soothing mask and moisturize the skin well. The removal of the superficial layers of the skin causes an increase in cell turnover and therefore stimulates cell repair and regeneration, improving the appearance of the skin surface, which will be smoother, brighter and more compact. Fast and non-invasive, this technique is recommended for small and superficial scars and requires several sessions. In general, five to ten sessions are required to obtain appreciable results, to be done about one or two weeks apart from each other. Microdermabrasion is generally a gentle and painless procedure that does not cause major side effects. However, sometimes small bleeding, redness, irritation and sensitive skin can occur.

Under the laser beam

In the most severe cases, the scars of acne resemble small craters that recall the lunar landscape, composed of depressions and valleys. If the scars are deeper and more evident, the most suitable procedure is the ablative fractional laser resurfacing. The best results are obtained with the carbon dioxide (CO2) one: during the first session the superficial skin layer is removed, in the following sessions the laser stimulates the production of collagen, improving the “texture” of the skin.

In particular, the fractional carbon dioxide laser treatment acts through the so-called selective photothermolysis: the light is transformed into heat which creates a controlled damage only of the tissues affected by the specific wavelength of the laser beam. This type of laser therefore acts on very small areas of skin, leaving the surrounding tissues intact. This promotes the healing process thanks to the production of new epidermal cells, collagen and elastin.

After surgery, a reddened area (erythema) appears in the treated area, which usually regresses within a few days. To relieve this discomfort it is recommended to use a soothing cream to be applied to the skin after treatment. Treatment with fractional CO2 laser is not recommended for dark phototypes as it could cause the formation of skin spots. At the same time it is contraindicated in case of Herpes simplex, taking cortisone, autoimmune diseases, radiation therapy, pregnancy and lactation.

The erbium laser is also quite widespread, useful, however, for small post-acne scars.

From micropeeling…

For several years, the marks from pimples and pustules have been addressed with deep chemical peels, using various compounds, from glycolic acid to trichloroacetic acid to phenol. Performing a chemical peel basically means practicing a chemical exfoliation of the skin, thus promoting cell turnover. Deep chemical peels are able to reach the deepest layers of the skin, reaching the dermis, where they create necrosis (i.e. cell death) and inflammation. Peeling not only effectively eliminates acne scars (depending on their depth), but is also used in aesthetic medicine to eliminate wrinklesand fade skin spots resulting from skin aging. But there are also less aggressive peels: the new frontier now is represented by micropeeling, which involves the use of a lotion with glycolic acid and low concentration salicylic acid to be rubbed into the affected areas of the face. In doing so, the skin begins to exfoliate and, by continuing the treatment for a few months, the comedones (whiteheads and blackheads) and any microcysts are eliminated. If the acne is more severe and the scars are deeper, you can opt for micropeeling combined with retinoic acid, the same contained in the anti-acne Pill tags. Basically, once a week lotion with retinoic acid is applied, a derivative of vitamin A that stimulates healthy skin growth.

… to photodynamics

The results are more evident when micropeelings are combined with photodynamic therapy, a modern form of treatment based on delta-amino-levulinic acid (Ala) and LED light. 

Ala is applied to the area of the blemish and the area is covered with an occlusive film for a couple of hours before proceeding with the irradiation of the red diode laser.

This treatment is particularly effective even in the phase of active acne.

A filling for scars

It’s called filling, and it’s a technique that consists of skin micro-injections of “filler” substances, such as collagen and hyaluronic acid, which lift the bottom of very deep scars (exactly like wrinkles). The injections of these substances in fact cause a relaxation of the subcutaneous tissue which leads to the disappearance of any depressions left by the scar. The result is satisfactory, but short-lived: these substances, in fact, are reabsorbed in 6-8 months.

Corrective camouflage

The scars left by acne can finally be hidden with corrective camouflage. This treatment has an important psychological role because it allows you to camouflage the imperfection by improving self-esteem. Makeup doesn’t make acne worse, as long as you choose products suitable for this type of skin that produces an excessive amount of sebum and tends to be infected by bacteria. With the right tricks it is possible to make dilated pores and scars less visible. Anti-imperfection skin make-up involves the use of primer, matte foundation, fixer and highlighter in particular.