Acne Scars

How to get rid of black acne scars or Post-Inflammatory Hyperpigmentation?

Post-Inflammatory Hyperpigmentation (PIH) means the dark marks or spots you get when a pimple heals or when it has completely gone away.

These dark spots occur when there is an overproduction of melanin to replace the damaged tissue caused by the pimple or acne. People with darker skin tones (4 to 6 skin types) are at more risk of getting hyperpigmentation from acne.

Red marks are easier to treat than brown marks.

The only way to treat black acne scars is to treat acne early and effectively. There are many skincare ingredients out there that can help with pigmentation and acne.

  • Retinol: Retinols are OTC (over-the-counter) products that have anti-aging properties, it is also suitable for acne-prone skin.
  • Retinoids: These are different from retinol. Retinoids are medical prescriptions that are more powerful than retinol. First-generation retinoids (tretinoin) & second-generation retinoids (adapalene) are less powerful and have less skin irritation than third-generation retinoids (tazarotene).
  • Niacinamide or Vitamin B: Niacinamide is a form of vitamin B-3. It helps with acne and hyperpigmentation.
  • Azelaic acid: This is another acid that can be replaced with retinol and itamin C if you have sensitive skin. This is an acid that is found in the human skin’s microbiome.
  • Vitamin C or L-ascorbic acid: Vitamin C is also a great acid for aging as well as pigmentation. Not ideal for sensitive skin.

Other Ingredients include:

  • Arbutin: Arbutin is a tyrosinase inhibitor and helps with pigmentation. It also acts as an antioxidant and is a derivative of hydroquinone.
  • Kojic acid: This acid is used for skin clarity and skin whitening. It also acts as a tyrosinase inhibitor, decreasing melanin production. It can also be used to mix with AHA/ alpha hydroxy acids.
  • Hydroquinone: This is also a great ingredient for pigmentation. It’s used to treat PIH and melasma. It can also be used to combine with ascorbic acid, vitamin A, salicylic acid, and many more.
  • Tranexamic acid: This acid is mainly used for dealing with skin conditions like hyperpigmentation, age spots, melasma, and pigmented acne scarring.
  • Cysteamine: It is a skin-lightening agent that is used to treat skin conditions that include melasma, post-inflammatory hyperpigmentation.
  • Licorice extract: licorice is derived from the licorice plant, and it can act as an antioxidant and also a pigment corrector.
  • Soy extract: soy extract can also help with pigmentation and it also acts as an antioxidant.
  • AHA’S/BHA’S: BHA’S are good for acne and oily-prone skin whereas AHA’S are more for anti-aging. Glycolic acid, lactic acid, and salicylic acid are good for exfoliating pigmented skin cells.

How can you incorporate them into your skincare routine?

  1. Go for a normal and gentle cleanser, one that’s not harsh on your face.
  2. Choose a good and cheap moisturizer.
  3. You can start off with Niacinamide or Azelaic acid if you have sensitive skin. If that doesn’t work, then use retinol or vitamin C (in lower concentrations).
  4. If you still have pigmentation, then try using hydroquinone, arbutin, licorice, or kojic acid.
  5. You can also add in AHA/BHA/PHAs.
  6. Choose the best sunscreen.

If none of the methods above work, then it will be time to go and see a dermatologist.

What treatments will dermatologists recommend?

Methods such as test spots, lower laser energy, longer wavelengths, increased pulse duration, increased pulse intervals, epidermal cooling, skin priming, post-procedure mitigation, correct selection of laser, and chemical peel concentrations can reduce PIH.

It is easier to prevent than to treat.

Other Methods:

  • Pigment lasers: Pigment lasers that are used are nanosecond lasers and pico lasers. Nanosecond lasers are used for pigmentation and are less aggressive than pico lasers. Pico lasers are more aggressive than nanoseconds and they cost more. Pico lasers will actually speed up the process than nanosecond lasers. If pico lasers are used too aggressively, it causes more pigmentation.
  • Microdermabrasion: it’s a technique to remove skin cells on the upper layer of skin. This can improve dull skin and pigmentation, and also possibly improve the visual appearance of acne scars.
  • Microneedling: it’s a form of collagen induction therapy and provides collateral damage to abnormal collagen.
  • Fractional lasers: Fractional lasers can boost collagen production and skin texture, it also helps with pigmentation. Nd: YAG laser can also help.
  • Chemical peels: Dermatologists would start with an AHA such as glycolic acid from 15% to 20%, then increase it to 35%. You can also use salicylic acid to reduce pigmentation.
  • TCO peels: It is better to use 10 to 15% TCO peels, as these peels are very strong. TCO peels are done to remove the dead skin cells and stimulate cell turnover.
  • Retinoid peels: These peels can actually exfoliate your face and increase collagen production making it good for PIH.

These are all methods you can do to reduce post-inflammatory hyperpigmentation and acne.