Acne treatment has advanced significantly in the last several decades. For this reason, there is a generational gap in patient expectations when it comes to acne. Many parents believe that acne treatments don’t work because it didn’t work for them. Times are different, and the treatments are different today.
Acne is a near-universal problem and certainly not new. Acne has a hereditary component. If both of your parents had severe acne, it’s likely that you also will carry this unfortunate trait. Their views concerning treatment may, however, be very different from yours. By any standard, acne treatments were not nearly as effective 30 years ago. Acne is not a life-threatening condition but one that was objectively challenging to treat in the past. It was reasonable for patients to take the stance of suffering through it, but the medical reality is changed in today’s world. There are safe and effective treatments for severe acne, and there aren’t many good reasons to ignore acne.
Update your knowledge about what is possible with current acne treatments if you are a parent and dealing with a teenager with acne. With acne specifically, treatment efficacy and safety have improved substantially over the last few decades.1 Finally, acne is an inflammatory condition that often leaves permanent scars. Treating scars is a challenging task, and the best treatment by far is to treat the underlying acne in the first place.
Although often underestimated by the public, acne’s impact on a patient’s quality of life is well established in the literature.2 Acne, like other visible skin conditions, has many psychosocial effects on patients. With acne, the face is the most common site that is affected, and it’s an area of the body that is uncovered and the focus of people’s gaze. Parents should encourage and support their children to seek treatment when they voice concerns about their acne.
One crucial complication with acne that isn’t typical with other skin conditions is its tendency to produce scars. Acne is an inflammatory condition, and the skin will respond by creating scar tissue. While scarring is a natural defense mechanism, they are notoriously difficult to reverse and can be lifelong if it isn’t treated. For patients with moderate to severe inflammatory acne (pimples and pustules rather than blackheads and whiteheads), acne scars are likely. The best way to deal with acne scars is to get the underlying acne under control quickly. Once acne scars form, they are notoriously difficult to treat. Scarring is a response to inflammation and damage. Treatment for scarring can create new scars because the treatment also involves cutting or inflammation. Even with successful treatment, they rarely return to their pre-scarring state.
Treating Existing Acne Scars
Treat the underlying acne before treating the acne scars. Acne is an inflammatory condition and can lead to scarring if the inflammation damages the deeper tissues. If acne isn’t well managed, new outbreaks will cause scarring again, negating the efforts to treat existing acne scars. Thankfully, there are many effective treatments to manage acne of any severity today.
Acne scars have several subtypes. Broadly, acne scars are either raised or depressed scars. The raised scars typically form on the back and the chest area, while the depressed scars usually form on the face. Different types of scars will respond better to different kinds of treatments.
These are some conventional treatments for acne scarring:
Acids: Alpha hydroxy acids, lactic acid, and salicylic acid are commonly used to treat acne scars. They help to remove dead skin, which clogs pores, and can also make scars less visible. These are usually the first line of treatment and are available over the counter. They have little to no risk outside of minor irritation and can be used on all scar types. Salicylic acid deserves special mention as it is the most commonly used treatment for acne itself and is also effective for acne scars.
Retinoids: Retinoids speed up the skin’s regeneration. Topical retinoids can treat several skin conditions. Some retinoid products are available over the counter, but the ones with higher concentrations will be prescription only.
Dermabrasion, Chemical Peels, Lasers: These are physical interventions that can exfoliate the skin’s top layer. They help reduce the appearance of scars and are available at home or an office with varying effectiveness. We recommend that you see a dermatologist.
Dermal Fillers: Fillers are very effective at covering up depressed scars. Unfortunately, they only last 6-9 months on average, making treatment rather expensive to maintain.
Surgical procedures: For prominent scars, surgery is an option. The procedure will produce new scars, but plastic surgeons have techniques to minimize this and reduce the size of the new scars.
Treating the underlying acne quickly and aggressively is the best intervention when it comes to acne scars. Prevention is still the main priority, and treatment for acne scars can’t begin until the underlying acne is under control. Finally, when treating acne scars, be vigilant with sun protection to minimize the chance of hyperpigmentation.