Acne Scars

How to get rid of Red Acne scars or Post-Inflammatory Erythema?

Red acne scars or Post- Inflammatory Erythema refers to the pink, red marks or discoloration you get when a pimple fully heals or when it has completely gone away.

This occurs when the blood vessels close to the skin’s surface are damaged. PIH is frequently encountered with acute acne as well as chronic acne including hormonal acne, adult acne, and jawline acne.

People with lighter skin types (1 to 3) are more at risk to get Post-Inflammatory Erythema or PIH. Redness can last beyond 12 months.

Red acne marks are much easier to treat than black acne marks or PIH. The only way to treat red marks is by treating acne early and effectively, applying your sunscreen twice a day, and using vascular lasers.

There are many skincare ingredients or topical products you can use to reduce the red marks:

Note: Remember to test patch the product on your skin before applying it on your face.

Topical Treatment

Tranexamic acid: Tranexamic acid is an ingredient for those dealing with skin conditions like hyperpigmentation, age spots, melasma, and pigmented acne scarring. It can also be used as a skin brightener.

It’s safe for all skin types and skin of colour. Tranexamic can also be combined with Vitamin C. These ingredients together can reduce dark spots and brighten the skin.

For Skin barrier repair:

  • Ceramide: Ceramides are naturally occurring compounds that keep the skin hydrated. Ceramides are the fatty molecules that hold the upper layers of the skin. Ceramides can decrease as we age and it’s essential to replenish them. By increasing hydration in the upper layers of the skin, skincare actives such as retinol, niacinamide, AHA, etc can penetrate the deeper layers of the skin. It helps to reduce TWL (Transepidermal water loss) and also improves fine lines and wrinkles.
  • Fatty acids: fatty acids like omega-3s and omega-6s are the building blocks of healthy cell membranes. These fats also help produce the skin’s natural oil barrier. These acids can actually make your skin look good and repair the skin barrier.
  • Cholesterol: Cholesterol is naturally present in our body and it makes up the brick and mortar of our skin. Using skincare products containing cholesterol won’t do any harm to your body
  • Niacinamide: Niacinamide has an anti-inflammatory effect on the skin, It’s able to provide hydration, control sebum production, improve the skin barrier, acts as an antioxidant, and also helps to treat hyperpigmentation.

For Anti-inflammatory:

  • Azelaic acid: This is an acid found in the human biome. It is anti-inflammatory and anti-bacterial. It is a tyrosinase inhibitor perfect for acne-prone skin. It’s also used to treat rosacea and post-inflammatory hyperpigmentation. It can also be used during pregnancy and can normalize skin shedding, hence its effects on acne scarring. This acid can be used if you’re not able to tolerate Vitamin A and Vitamin C.
  • Green tea: Green tea can work as a great antioxidant and free radical scavenger. It helps to reduce the dark circles under the eyes and it also helps to treat acne. It also reduces oil production and enlarged pores.
  • Allantoin: Allantoin is an ingredient used in Korean skincare products and it is also good for sensitive skin. Allantoin is another antioxidant that you can use in your skincare.
  • Panthenol: Panthenol is also known as Vitamin B-3. It can help retain moisture in the skin and it also has anti-inflammatory properties. It also helps in healing wounds.

For Antioxidant:

  • Resveratrol: Resveratrol is another antioxidant that is used in skincare. It has many benefits such as:
    • It is anti-inflammatory and anti-microbial.
    • It helps to even skin tone.
    • It helps to stimulate collagen production
    • It helps with hyperpigmentation
  • Astaxanthin: This is also another antioxidant that helps to protect us from sun damage and also improves fine lines and wrinkles.
    • It helps to protect us against UV rays.
    • It helps to moisturize the skin.
    • Perfect for sensitive skin.
    • It helps to fight free radicals.
    • It helps with hyperpigmentation
  • Ascorbic acid or Vitamin C: Vitamin C is the most common antioxidant used in skincare products. Just like other antioxidants, vitamin C also helps with fine lines, wrinkles, and hyperpigmentation.

Prescription Timolol for post-inflammatory erythema:

Prescription timolol has also been shown to treat and reduce post-inflammatory erythema. A clinical study was conducted was also done to prove this.

An acne patient with significant post-inflammatory erythema and atrophic scars was used to treat with topical timolol.

She was advised to apply topical timolol maleate 0.5% ophthalmic solution (it is available in the US as a topical gel formulation) on post-inflammatory sites at bedtime.

For breakthrough acne, she was allowed to apply clindamycin gel. After 12 weeks, she had significant improvement in her post-inflammatory erythema, leaving behind shallow rolling scars without any pigmentation.

Medical treatment:

  • Vascular lasers: Vascular lasers such as Pulsed-dye lasers, alex, diode lasers, and long pulse Nd Yag lasers can help. These lasers work by reducing the damaged areas of blood vessels under the skin, which reduces inflammation and discoloration. It helps to boost collagen production and reduce redness and acne. Other lasers are:
    • Pulseddye laser: A vascular laser with 585nm or 595nm wavelength is safe
    • Intense pulsed light: These are multiple rays coming at different wavelengths.
    • Potassiumtitanylphosphate: The potassium-titanyl-phosphate (KTP) laser emits green light that is absorbed by both melanin and oxyhemoglobin.
    • Diode lasers: It is done at a wavelength of 577nm.
  • Micro-needling (medium): Micro-needling helps to improve collagen production, fine lines and wrinkles, acne scarring and improves enlarged pores.
  • Radiofrequency: This helps to boost collagen production and also improves acne and pores when the micro-needling version is used.