Acne scars are the result of pimples that have become inflamed or haven't healed properly. While some women are more prone to scarring because of heredity or skin color, there are precautions you can take to prevent scars and treatments available to significantly reduce their appearance.
There are two types of acne scars: pigmented scars, which leave behind a purplish-brown mark once the blemish goes away, and ice pick scars, which leave a small depression in the skin. The average whitehead is not likely to cause a scar because it's not inflamed. Having said that, don't pick at any pimples -- if you do, you run the risk of introducing bacteria that could cause infection.
Pigmented acne scars result from the collection of pigment cells in a blemish during the healing process. Darker-skinned women are more prone to this type of scar because their skin has a significant amount of pigment in it already.
The treatment options for pigment scars vary from over-the-counter products to more aggressive in-office treatments, depending on the severity of the scars. Bleaching creams, like Porcelana, that contain two percent hydroquinone, used in conjunction with glycolic acid-based lotions, are ideal for reducing the appearance of mild scars. It will take at least six weeks to see any noticeable improvement because, unlike sunspots, which are on the epidermis (the uppermost layer of skin), acne scars lie deeper under the skin.
If you don't see any improvement after two months, your doctor can prescribe a stronger hydroquinone-based bleaching cream to be used in conjunction with a retinoid cream like Retin-A or Tazorac. The retinoids will help prevent further acne breakouts and will exfoliate skin cells deep within the dermis, where the scars form.
More severe scarring usually responds well to a series of chemical peels over the course of three to four months. Your doctor will most likely start with a 35 percent glycolic acid peel and gradually work up to a 70 percent peel. If you are experiencing severe breakouts in addition to the scars, she may choose a salicylic acid peel, which will help clear up acne while treating the scars. It will take three to four months (on average) to see results.
Ice pick scars, which leave crater-like impressions in the skin, are more common in lighter-skinned individuals. They usually result from more severe pustule-like acne, which can cause an indented scar if not treated quickly.
Ice pick scars are best treated with dermabrasion or lasers. Dermabrasion involves manually smoothing out the scar and surrounding skin with a diamond stone or small wire brush, and is commonly used on ice pick scars that don't respond to topical retinoids. Results are usually seen after one treatment, but to maintain them you will need to use a broad-based sunscreen daily along with a retinoid cream. In more severe cases, a scar may have to be surgically removed before being smoothed out with dermabrasion.
As alternatives to dermabrasion, laser treatments are ideally suited to ice pick scars. The laser burns away the scar tissue, and the treated area will be red and tender for a few days. While it has also shown good results in the removal of pigment scars, laser treatment is not recommended for darker-skinned women because they have a strong chance of experiencing hyperpigmented spots. Instead, women with dark skin tones should stick to chemical peels and retinoids for the most effective results.