Toronto Star: How do I fix my acne scars? | March 23, 2020
Ask the Kit: How do I fix my acne scars?
What can I do about my acne scars? It seems like the older I get, the more I notice them! —Shauna, Toronto
We’re always told that we’ll feel good in our skin when we’re older. It’s a message of empowerment that is frustratingly often delivered with a cold smile that translates the sentiment into something that feels more akin to “be grateful that, at your age, you no longer have to care anymore.”
Grappling with cystic acne (the type of blemishes that typically cause scarring) as a teen is often just one of the many sucky parts of that stressful stage of life, when trivial issues can take on the same importance as life-shattering events.
When we get older, however, I don’t think many of us are able to let go. Rather, we seem to refine our ability to focus on the parts of ourselves that cause us pain, waiting for the promised freedom from self-judgment to arrive before we feel used up and disposable. But that relief doesn’t come swinging into your life like Jennifer Lopez on a stripper pole. (Yes, she’s 50; no, it’s not normal to look that way; yes, we’ll all be OK.) Rather, you have to work for the confidence, much like JLo no doubt worked to refine those swizzle-stick moves.
A positive attitude can be tough, though, when you look at the situation reductively: It’s not that your scars get worse after 40, it’s that the overall condition of your skin does. Dr. Lisa Kellett, who runs the well-respected DLK on Avenue dermatology clinic in Toronto, hears that complaint from many of her patients. “You’re losing structure and collagen in your skin, so the scars appear more distinct.”
Collagen, like youth, is also wasted on the young. “People can be quite self-conscious — especially, for example, in an elevator, where light comes down from above and makes scarring more obvious,” Kellett adds.
But the situation is not actually dire and should not cause you grief, so let’s take a step back and gain some perspective.
“The issue is that acne scars are poorly understood and you have to understand something before you treat it,” she explains. “Acne scars are actually caused by inflammation, unlike a traumatic scar from a cut, so underneath the skin there are fibrous adhesions pulling the scar down, which is why you see divots and pits.”
Because acne scars tend to be so “bound down,” as Kellett describes, it’s difficult to treat them at home with over-the-counter creams and harder still to cover them up with makeup, as you likely have learned. (Avoid makeup with glitter, by the way, which can highlight texture like scarring; I don’t think adults should often wear glittery makeup anyway, so it’s not a huge loss.)
“The best thing to do at home is to prevent the acne so you’re not causing any additional scars,” says Kellett, because you can’t treat the damage caused by blemishes until you get them under control. Also, I know we’ve all heard this a zillion times, but I’ll add in another refrain one more time for the cheap seats in the back: Do not pick! Like, not at all! It will not feel satisfying even though our lizard brains tell us it might.
“In general, I tell my acne clients to use an exfoliating cleanser, a topical benzoyl peroxide, no creams, no lotions, no oils, no liquid foundations, all of which can contribute to acne,” says Kellett. “Use gel-based moisturizers and sunscreens that are alcohol-based, as well, since you don’t want to use anything that will make you break out. You can also use topical vitamin A such as topical 1 per cent retinol, which you can get over the counter because it’s good for acne as well as wrinkles.”
So that’s your homework, if you still have active acne. But if that’s in the past for you, there are certainly in-office treatments that can improve the look of your bothersome scars. Though it’s unreasonable to assume deep pits will be erased, Kellett says her patients are normally happy with the results.
One of the newest treatment options available is laser-resurfacing, which “burns the surface of the skin and also goes underneath to help improve collagen regeneration.” Micro-needling — which, let’s just say it, needs a cuter and cuddlier name — is well suited to ice-pick scars because the doctor can use a small needle to stimulate the collagen in a very precise way.
Kellett often opts for the subcision technique, however, when dealing with scars, in which she uses a fine needle to cut the fibrous adhesions that are pulling down on the skin and causing the puckering. “You can actually feel them as you break through them,” she explains. The benefit is that the results are permanent.
“There are always possible side effects,” says Kellett, since it’s considered to be a very mini surgical procedure, and they include scarring, infection, pigment change and bruising. “But they are rare.” Injectable filler such as Restylane Skinboosters dispersed in tiny droplets across the scarred area afterwards can further improve the texture of the skin.
So if cutting the ties that bind down a few of your little scars will help you to also release some of the burden you’ve been carrying with you, then talk to an experienced doctor and see if it’s right for you. Whatever you decide, it’s time to feel good in your skin — and not because you’re too old to care, but because you’re too young to miss out on any of life’s pleasures.
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