Acne Marks Treatment Guide

How to treat acne marks

• Acne clears up, but the marks it leaves behind? They're often the real problem. Whether you're dealing with dark spots that won't budge or textural changes that catch the light in all the wrong ways, post-acne marks can stick around long after your last breakout.
• The good news is that these marks aren't permanent. But here's what most people get wrong: not all acne marks are created equal, and that drugstore serum promising 'dramatic results' probably isn't going to cut it for stubborn pigmentation or scarring.

The three types of acne marks you need to know

• Before diving into treatments, let's get clear on what you're actually dealing with. Acne marks fall into three main categories, each requiring a different approach.

Post-inflammatory hyperpigmentation (PIH)

• These are the dark brown or gray spots that appear after acne heals. PIH happens when your skin produces excess melanin in response to inflammation—think of it as your skin's overenthusiastic attempt to protect itself.
• PIH is more common in people with darker skin tones and tends to be most noticeable on areas that get regular sun exposure. These marks can take months or even years to fade naturally, which is why targeted treatment makes such a difference.

Post-inflammatory erythema (PIE)

• PIE shows up as pink or red discoloration that lingers after acne heals. Unlike PIH, these marks are caused by dilated or damaged capillaries under the skin, not excess pigment.
• You'll typically see PIE in people with lighter skin tones, and it's particularly stubborn—often taking longer to fade than PIH. The key difference? PIE marks often disappear temporarily when you press on them, while PIH stays visible.

Atrophic scars

• These are the textural changes—the indentations and uneven skin surface that develop when acne damages collagen and elastin in the deeper layers of skin. Atrophic scars come in three main types:
• • Ice pick scars: Deep, narrow marks that look like tiny puncture wounds
  • Boxcar scars: Wider, rectangular depressions with defined edges
  • Rolling scars: Broader depressions that create a wave-like texture
• Unlike PIH and PIE, which are purely cosmetic discoloration, atrophic scars involve actual structural changes to the skin. This makes them the most challenging type of acne mark to treat.

Why prescription treatments are worth considering

• Over-the-counter products have their place, especially for mild discoloration. But when you're dealing with persistent marks or deeper scarring, prescription treatments offer ingredients at concentrations that simply aren't available in drugstore products.
• The difference isn't just about strength—it's about efficacy. Prescription treatments have clinical research backing their effectiveness for post-acne marks, while many over-the-counter products rely more on marketing than solid evidence.

Tretinoin: the gold standard for skin renewal

• Tretinoin, a prescription vitamin A derivative, is widely considered the most effective topical treatment for post-acne marks. Here's why it works so well:
• Accelerated cell turnover: Tretinoin speeds up the natural process of skin cell renewal, helping to push out damaged, pigmented cells and reveal fresh skin underneath. This process typically takes about 28 days naturally, but tretinoin can reduce this to around 14 days.
• Collagen stimulation: Regular use of tretinoin boosts collagen production in the deeper layers of skin. This not only helps smooth out textural irregularities but can also soften the appearance of shallow scars over time.
• Enhanced penetration: One of tretinoin's lesser-known benefits is its ability to improve how other treatments penetrate the skin. This makes combination therapies—using tretinoin alongside other active ingredients—significantly more effective.
• Enhanced penetration: One of tretinoin's lesser-known benefits is its ability to improve how other treatments penetrate the skin. This makes combination therapies—using tretinoin alongside other active ingredients—significantly more effective.

Hydroquinone: targeted pigment reduction

• For stubborn dark spots, hydroquinone remains the most effective prescription option available. It works by inhibiting tyrosinase, the enzyme responsible for melanin production.
• Hydroquinone is particularly effective for PIH, often showing visible results within 6-8 weeks of consistent use. However, it's typically recommended for short-term use (3-4 months at a time) with breaks in between to prevent potential side effects.
• The prescription strength (4%) is significantly more effective than over-the-counter versions (2% or less), but it also requires more careful monitoring and sun protection during use.

Combining treatments for better results

• The most effective approach to treating post-acne marks often involves combining different prescription treatments. A dermatologist might recommend tretinoin for overall skin renewal alongside hydroquinone for targeted pigmentation, or incorporate other ingredients like azelaic acid or kojic acid for additional brightening effects.
• This combination approach allows you to address multiple aspects of post-acne marks simultaneously—speeding up results and often achieving better outcomes than any single treatment alone.

What to expect from prescription treatment

• Realistic expectations are crucial when treating post-acne marks. PIH typically shows improvement within 6-8 weeks of consistent treatment, with significant fading by 3-4 months. PIE can take longer—often 6-12 months for substantial improvement.
• Atrophic scarring requires the most patience. While prescription treatments can help smooth shallow scars and improve overall skin texture, deeper scarring may need additional interventions like chemical peels, microneedling, or laser treatments.
• The key is consistency. Prescription treatments work gradually, and skipping applications or stopping too early can significantly impact results.

Getting started with prescription treatment

• If over-the-counter products haven't delivered the results you're looking for, it might be time to consider prescription options. A dermatologist can assess your specific type of acne marks and recommend the most appropriate treatment plan.
• That’s where ilik comes in. With ilik, you don’t have to spend hours researching or second-guessing your symptoms. Our platform connects you with licensed dermatology professionals who specialize in acne care. Through a super simple online process, you can upload photos, share details about your skin concerns, and get a detailed evaluation—all from the comfort of your home.
• What’s even better? ilik takes it a step further by personalizing your prescription treatment. Based on your unique skin type and acne marks, our dermatologists recommend the exact regimen you need to see results. No one-size-fits-all solutions—just top-notch care tailored 100% to you. Easy peasy!
• Remember, treating post-acne marks is a marathon, not a sprint. But with the right prescription treatments and consistent use, those stubborn marks don't have to be permanent reminders of past breakouts.