This client started Acne Bootcamp right after graduating from college and starting her first job in the city. She had been battling acne and what she described as acne scars since she was just 10 years old, although the "scars" she was referring to were actually dark marks caused by post-inflammatory hyperpigmentation. Her acne manifested mostly in the form of papules that you can see on her chin in the pictures. These red, swollen lesions are a form of inflammatory acne and they can be sore and sensitive and will eventually turn into pustules if the inflammation is not controlled and pus develops (learn more about the different types of acne here).
I put together a treatment plan that included biweekly facial treatments, dietary adjustments (mainly due to her love of cheese), and a homecare regimen that included benzoyl peroxide and mandelic acid. I chose these ingredients because they both contain antibacterial properties that reduce inflammation and we needed to first get her inflammation under control so that we could extract the lesions on her face without causing further inflammation and ultimately, more pigmentation. I also had her ice every day and night to further help reduce inflammation. Once the inflamed lesions were under control, we used the exfoliating properties of mandelic acid and mild chemical peels to help purge the non-inflamed comedones out of the follicles. 6 acne treatment facials later voila, our bootcamper was clear!
Once she graduated acne bootcamp, we shifted gears to work on the pigmentation. Since she had been using our lightening 8% mandelic acid serum already for 3 months, we had a head start and the pigmentation had already lightened significantly. I chose a combination of peels with lightening and exfoliating properties to help lift the rest of the pigmented cells out of the skin. I started each peel session with a lightening lemon enzyme boosted with a 20% lactic acid peel, both ingredients chosen for their lightening properties. Then, I followed with a chemical peel that contained a super mix of exfoliating agents including trichloroacetic acid (TCA), kojic acid, and azelaic acid. It only took 3 peels for all of the dark marks to fade and now her skin is not just smooth and clear but it has an even tone.
If you are struggling with acne or dark marks leftover from acne, make an appointment if you are in the San Francisco Bay Area or get in touch with us for a free product consultation to have a customized product kit shipped to you.
The red zit that occupied your face for a week has finally calmed down but months have passed and the dark spots that took it’s place makes it seem like it never went away at all. Luckily, the dark “scars” left over from acne are not actually scars at all. Post-pimple red and brown spots are actually caused by a condition called Post-Inflammatory Hyperpigmentation (PIH) and they are usually a temporary side effect of those red, angry zits called inflamed acne. Read on to learn more.
ACNE MARKS ARE DIFFERENT FROM ACNE SCARS
Scars, by definition, are permanent marks caused by changes to tissue resulting from an injury. True acne scars show up as textural changes in the skin and usually appear as raised (hypertrophic) or indented/depressed (atrophic) marks commonly described as “pock marks”. Dark marks are also a defense mechanism triggered by inflammatory acne but they are the result of melanin (pigment) being injected into skin cells, not changes to the tissue.
SOME FACTORS THAT LEAD TO DARK MARKS ARE OUT OF YOUR CONTROL
Genetics and skin tone largely determine whether or not you are prone to develop post-inflammatory hyperpigmentation and unfortunately, there is not much you can do to control these predisposing factors. Darker skin tones in particular are more prone to develop PIH due to the increased levels of melanin.
AND SOME FACTORS ARE WITHIN YOUR CONTROL
Sun exposure and picking are two ways to make PIH darker and last longer. If you are prone to PIH, it is important to wear sufficient sun protection and stay away from UV rays as much as possible so that the dark spots do not get darker. Also, you probably already know that picking is bad for acne but picking also increases the likelihood of developing dark marks.
PREVENTING DARK MARKS IS EASIER THAN TREATING THEM
PIH occurs once acne has reached an inflammatory stage so if you can prevent acne lesions from becoming inflamed, the chances of developing dark marks are minimized. To help keep inflamed lesions at bay, stick to gently exfoliating products that also contain antibacterial ingredients like benzoyl peroxide, salicylic acid, and mandelic acid. Applying direct ice to pimples can also help reduce swelling and inflammation.
IF IT’S TOO LATE TO PREVENT DARK MARKS, HERE IS HOW TO TREAT THEM
There is no magic eraser that will instantly get rid of PIH and it usually takes a few months to over a year for them to go away whether you treat them or not. However, there are a number of things you can do to speed up the process. A combination of professional treatments and a consistent product regimen at home is usually the best bet for getting results. A skincare regimen that includes products with lightening and gently exfoliating ingredients like mandelic acid, azelaic acid, and hydroquinone can also help lift dark spots faster but you want to stay away from abrasive exfoliation methods like microdermabrasion or the clarisonic which can cause further trauma to the skin and trigger more PIH, making dark spots worse. Also, chemical peels that include both lightening and exfoliating ingredients will help shed the pigmented cells out of the skin and can help speed up the lightening of stubborn dark spots. Schedule a consultation to meet with an AES skin specialist who will put together a comprehensive treatment plan that combines a pigment fighting product kit customized for your skin type and a series of specialized peels to get rid of dark spots.
Read this acne bootcamp story to learn how we got rid of one clients acne and dark spots.
This months column was inspired by all of my recent clients who have been picking! Learn some practical tips to keep your fingers away from your face on How To Stop Picking Your Face up today on The Penny Rose!