“If topical treatment alone does not improve acne, or if acne is severe or extensive, oral medications are the best option. If you’ve tried several topical medications without success, or if your condition is severe, oral acne medications are usually the next step in the treatment process. Treatment usually includes oral antibiotics and applying a prescription gel or topical cream to the skin. Depending on people with acne, treatment may include using prescription creams to prevent acne, taking antibiotics to kill bacteria that contribute to acne, or, if acne is severe, taking stronger medications such as like isotretinoin, or even minor surgery. Even if you have tried topical acne treatments such as creams or gels without any lasting results, laser therapy may be the right solution for you. While I would like you to try natural remedies first, if you are not seeing improvement and severe hormonal acne is making your quality of life worse, other treatments can make a real difference. While it may take a while, treating hormonal acne from the inside out until your hormones are in their natural, happy balance will allow your skin to truly heal. While my approach isn’t an instant solution, and won’t replace everyone’s multi-drug regimen, hormonal acne can be very sensitive to a more holistic approach, which means less medication and more patches. While the studio treatments offered by Carolina Skin Care can be very effective in treating acne, patients should also commit to taking care of their skin at home. Multiple topical treatments, whether it’s steroids for eczema or topical antibiotics for acne, topical treatments may help in the short term, but in the long run, it can damage the skin, making you more likely to take it in the future.
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Don’t pop it: As tempting as it might be, popping a giant pimple can cause more harm, leading to scarring or even infection. It’s best to leave it alone to heal naturally.
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Use a warm compress: Applying a warm, damp cloth to the pimple for about 10-15 minutes several times a day can help reduce swelling and draw out pus. It can also relieve pain or tenderness.
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Spot treatment: Use an over-the-counter acne treatment that contains ingredients like benzoyl peroxide or salicylic acid. These can help reduce inflammation and kill bacteria. Be careful not to overuse them, as they can dry out the skin.
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Avoid harsh scrubbing: Harsh exfoliating or scrubbing can irritate the skin further. Stick to gentle cleansing with a mild cleanser and avoid touching or rubbing the pimple.
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Try ice for swelling: Applying an ice cube wrapped in a clean cloth for a few minutes can help reduce swelling and redness, providing temporary relief.
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Use non-comedogenic products: Make sure your skincare and makeup products are labeled “non-comedogenic,” meaning they won’t clog your pores.
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See a dermatologist: If the pimple is very large or painful, or if you’re prone to recurring cystic acne, it might be worth seeing a dermatologist for stronger treatments, such as corticosteroid injections or other medical treatments.
1. Topical Treatments
- Retinoids: Retinoids, like tretinoin (Retin-A), help increase skin cell turnover, which can improve the appearance of scars over time. They stimulate collagen production and promote smoother skin.
- Silicone Gels or Sheets: These can help flatten and reduce the appearance of scars. Silicone treatments are often recommended for hypertrophic scars (raised scars).
- Vitamin C: This antioxidant can help fade dark spots and hyperpigmentation from acne scars by promoting skin healing and collagen production.
- Alpha Hydroxy Acids (AHAs): AHAs, such as glycolic acid, help exfoliate the skin and promote skin renewal, which can gradually improve the appearance of scars.
- Salicylic Acid: This beta-hydroxy acid (BHA) helps unclog pores and reduce the appearance of acne scars over time.
2. Chemical Peels
Chemical peels involve applying a chemical solution to the skin to exfoliate the surface layer. This promotes new skin growth and helps to fade discoloration and improve texture. Stronger peels may be more effective for deeper scars, but they should only be done under the guidance of a dermatologist.
3. Microneedling
This treatment involves tiny needles that are used to create micro-injuries in the skin, stimulating collagen production and helping to smooth out scar tissue. Microneedling can improve both the texture and tone of the skin and is often used for deeper scars.
4. Laser Treatments
- Fractional CO2 Laser: This laser is effective for reducing the appearance of deep scars. It works by resurfacing the skin and stimulating collagen production.
- Pulsed Dye Laser: This laser targets redness and can help with scars that have a reddish or purple appearance, particularly effective for post-inflammatory hyperpigmentation.
5. Dermal Fillers
For certain types of scars (such as rolling scars), dermal fillers (like hyaluronic acid) can be injected under the skin to raise the scar tissue, making it blend more smoothly with the surrounding skin.
6. Platelet-Rich Plasma (PRP) Therapy
PRP involves using your own blood to extract platelets and growth factors, which are then injected into the scarred area. This stimulates collagen production and promotes skin healing.
7. Sunscreen
It’s crucial to wear sunscreen daily when trying to treat acne scars. UV exposure can darken scars and make them more noticeable. Look for a broad-spectrum sunscreen with SPF 30 or higher, and apply it regularly.
8. Consult a Dermatologist
If your scars are severe or you’ve tried over-the-counter treatments without success, it’s best to consult a dermatologist. They can recommend more advanced treatments, such as subcision (a minor surgical procedure for deeply indented scars) or steroid injections for hypertrophic scars.
1. Laser Therapy (Fractional CO2 Laser)
Solution: Fractional CO₂ lasers resurface the skin and stimulate collagen production, making scars less visible over time.
Treatment:
- Reduces deep, rolling, and boxcar scars.
- Requires multiple sessions for best results.
- May cause mild redness or irritation post-treatment.
Reference: - PMC – Laser treatments for acne scars
2. Microneedling
Solution: Microneedling uses tiny needles to create micro-injuries in the skin, which stimulates collagen production and smooths out scars.
Treatment:
- Suitable for atrophic (indented) scars.
- Typically requires 3-6 sessions spaced 4-6 weeks apart.
- Minor redness post-treatment.
Reference: - PubMed – Microneedling in acne scar treatment
3. Chemical Peels
Solution: Chemical peels use acidic solutions to exfoliate the skin, removing the upper layers to reveal smoother skin.
Treatment:
- Helps with hyperpigmentation and shallow scars.
- Works best for lighter skin tones and mild scarring.
- Requires professional application for strong peels.
Reference: - Wiley Online Library – Chemical peels for acne scars
4. Dermal Fillers
Solution: Hyaluronic acid or collagen-based dermal fillers are injected under the skin to temporarily raise depressed scars, improving their appearance.
Treatment:
- Best for rolling or boxcar scars.
- Results last for 6-12 months, depending on the filler.
- Non-invasive with no downtime.
Reference: - Mayo Clinic – Dermal fillers
5. Subcision
Solution: A needle is inserted under the skin to break up the fibrous tissue causing deep scars, allowing the skin to heal and become more even.
Treatment:
- Effective for deep, tethered scars (such as ice-pick scars).
- Often combined with other treatments like laser or fillers.
- Results are permanent, but multiple sessions may be required.
Reference: - SAGE Journals – Subcision for acne scars
B. Topical Treatments
1. Retinoids (Tretinoin)
Solution: Retinoids accelerate skin cell turnover and promote collagen formation, helping to reduce the visibility of scars.
Treatment:
- Apply a pea-sized amount at night, gradually increasing frequency.
- Works best for atrophic scars (indentations).
- May cause dryness and irritation, so start slowly.
Reference: - JID – Retinoids in acne scar treatment
2. Silicone Sheets/Gels
Solution: Silicone sheets or gels are applied to the skin to flatten raised scars, improving texture and appearance.
Treatment:
- Effective for hypertrophic or keloid scars.
- Apply sheets or gel for 12+ hours a day for several weeks.
- Non-invasive and easily available.
Reference: - PubMed – Silicone gel for scar treatment
3. Vitamin C
Solution: Vitamin C brightens hyperpigmentation and aids in collagen production, which can help fade dark spots and scars.
Treatment:
- Use a stable Vitamin C serum once daily (morning).
- Combine with sunscreen for better protection.
- Helps with discoloration but is less effective for deep scars.
Reference: - NCBI – Vitamin C for scars
4. Sunscreen
Solution: Sunscreen protects scar tissue from further UV damage, preventing hyperpigmentation and darkening.
Treatment:
- Apply broad-spectrum sunscreen with SPF 30 or higher daily.
- Reapply every 2 hours if exposed to direct sunlight.
- Prevents new scars from darkening and helps healing.
Reference: - Mayo Clinic – Sunscreen for scar protection
C. Home Care
1. Gentle Cleansing
Solution: Use a mild, non-comedogenic cleanser to avoid irritation and prevent new breakouts.
Treatment:
- Wash face twice daily with a gentle cleanser.
- Avoid over-cleansing, which can irritate scars.
Reference: - American Academy of Dermatology – Acne cleansing tips
2. Moisturizing
Solution: Hydrating the skin promotes healing and reduces scarring.
Treatment:
- Use a non-comedogenic, hydrating moisturizer.
- Apply after cleansing to keep skin barrier intact.
Reference: - American Academy of Dermatology – Moisturizing for acne
3. Avoid Picking
Solution: Picking at acne can worsen scars and cause infection.
Treatment:
- Hands off! Let the skin heal naturally.
- If you must, seek professional extractions.
Reference: - Harvard Health – The importance of not picking at acne