Erasing the unsightly signs of youth: Get rid of your teenage acne scars

Most people turn to plastic surgery to wind back the hands of time, giving themselves a fresh and youthful appearance. What about using plastic surgery to erase the signs of youth left behind?

No, not the days of choosing the wrong boyfriends or staying up too late cramming for a big exam. We mean a youth spent trying to tackle acne and avoid the embarrassment of going to school with a face full of pimples. We mean targeting acne scars, pits and hyperpigmentation.

Acne is unsurprisingly one of the most common skin conditions in the United States. Nearly 50 million Americans annually count themselves as acne sufferers. While acne can strike anytime and at any age, significant acne flare-ups tend to impact individuals entering puberty, especially those in their teens and young adults.

If you ask anyone who has suffered an acne breakout, they'll tell you it can be painful and embarrassing. Even when the inflammation subsides, many people are left with red marks, discoloration and sometimes scars that do not fade.

Fortunately, some treatments can help erase the signs of youth and diminish the appearance of hyperpigmentation and acne scarring.

What causes acne scarring?

Acne is inflammation. It is a skin condition characterized by inflammation caused by pores or hair follicles clogging with oil or dead skin cells. The result can be whiteheads, blackheads and pimples. Severe acne, like cystic acne, can cause large and painful bumps to swell under the skin.

Inflammation caused by deep acne breakouts and picking or popping pimples can damage the skin, leaving behind acne scars and hyperpigmentation.

There are several types of acne scars. The first is atrophic scars, which are depressions or "pits" in the skin. Hypertrophic scars, on the other hand, are raised and can sometimes extend beyond the boundary of the original pimple or blemish.

Finally, you can also get hyperpigmentation or dark marks and discoloration left behind by a blemish after the swelling goes down and the blemish heals. Hyperpigmentation can occur due to increased melanin at the sight of the inflammation.

How do you erase acne scars?

Some treatments are available that can help diminish the signs of acne scarring and discoloration. Think of these treatments as a way to erase the unsightly signs of your youth. Finding the proper treatment means identifying your skin type and main skin issues because different procedures work for different people.

ASPS Member Surgeon Smita Ramanadham, MD, suggested microneedling for texturing abnormalities and scaring.

"I like microneedling because it is colorblind," said Dr. Ramanadham. "You can be pretty aggressive with it, and it doesn't matter if you are tan or darker." 

Microneedling improves skin texture by creating "micro-injuries" in the skin. These injuries stimulate the body to repair the damage and produce new collagen, diminishing the signs of acne scars and other texture issues.

ASPS Member Surgeon Katerina Gallus, MD, FACS, also recommended microneedling to tackle the marks and scars left behind by old acne. She noted that chemical peels, laser resurfacing and radiofrequency microneedling effectively treat acne scars.

For deeper scars and pits in the skin, Dr. Ramanadham also recommended laser treatments. Yet, laser treatments are not always appropriate for certain skin tones. The effectiveness of laser treatments also depends on the strength and power of the laser.

Subcision may be necessary for deep, significant scars.

"The doctor breaks up the scar under the skin with a needle, or the use of certain injectable fillers can be used to improve the appearance of acne scars," said Dr. Gallus.

Acne scars don't disappear in a day

Microneedling and laser treatments can help improve the skin's texture and appearance but don't expect your acne scars to disappear overnight. It can take several treatments to achieve noticeable results.

"In general, most patients require three to six treatments, again depending on the severity," said Dr. Gallus. "The most important takeaway to keep in mind is that no matter what the treatment plan, usually multiple treatments are required, and there is no 'quick fix.' Most treatments rely on inciting tissue damage that stimulates your skin to build collagen and remodel the scars, which takes months."

Maintaining realistic expectations is critical for patients, as it's important to stick to the treatment plan and not get discouraged after just one treatment.

"You are not going to see much of anything after one treatment," said Dr. Ramanadham. "Results will be minor, and you may need additional treatments."

She also recommended avoiding acne scar treatments when you have existing breakouts. Before rushing in to tackle your old scars, Dr. Ramanadham suggested managing your acne as best as possible.

"I think you have to have active acne controlled first," said Dr. Ramanadham. "Once that is controlled, it is beneficial to address the scarring."

Quality skin care and medical-grade products not only help control acne, but they can also improve the appearance of some scarring.

"Mild or moderate scarring can be greatly improved with proper skin care and a good treatment plan," said Dr. Gallus.

Antibiotics or birth control can also help control active breakouts, according to Dr. Ramanadham, in addition to products with benzoyl peroxide or salicylic acid. She said retinol and skin-brightening topicals can also help address issues like discoloration and hyperpigmentation.

"It is important to have a comprehensive acne treatment plan that includes early treatment, avoiding picking or popping the pimples and wearing sunscreen," said Dr. Gallus. "If the acne is mild, over-the-counter products can be effective. If severe, seeking a treatment regimen from a skin care specialist using prescription medications is indicated."

Your youth may have scarred you, but you can take charge and erase the signs of your past. Maybe not the cringy ex-boyfriend or girlfriend, but at least the signs of your acne. See a board-certified plastic surgeon who is an ASPS member for a consultation to determine what treatments will work best for your skin type.

To find a qualified plastic surgeon for any cosmetic or reconstructive procedure, consult a member of the American Society of Plastic Surgeons. All ASPS members are board certified by the American Board of Plastic Surgery, have completed an accredited plastic surgery training program, practice in accredited facilities and follow strict standards of safety and ethics. Find an ASPS member in your area.