Acne scars, which vary in appearance from dark spots to deep skin discolouration, can lead to pigmentation that can damage an individual’s self-esteem. Dr Smriti Shrestha, a dermatologist at Anova Skin and Hair Clinic, explains the formation of acne scars and shares her insights into preventing them.

What are the most effective treatments for different types of acne scars?

Ice pick, boxcar, and rolling scars are the different types of acne scars. The same person can experience various kinds of acne scars. Usually, these scars are amenable to dermapen, microneedling, exosomes, lasers and RF. Specifically, Ice pick scars respond to TCA, cross peel and subcision. Similarly, rolling scars respond to laser and microneedling with PRP. In the case of Boxcar scars, it is more challenging and requires surgical management.

Are there any natural or home remedies that effectively reduce acne scars?

Every skin has a dent that needs to be filled by stimulating collagen. Collagen induction treatments cannot be treated by home remedies; they need to be treated by a professional. Therefore, it is a myth that home remedies can prevent acne scars.

Can you outline a proper skincare routine to prevent or reduce these scars?

A skincare routine containing cleansers, antioxidants, sunscreen, exfoliants, and pH-balancing moisturisers can improve skin quality. However, acne is a medical condition with inflammation. Hence, the general consensus is that acne scars will not stop forming unless we treat them permanently. Combining a skincare routine with medical supervision has a pivotal role in preventing new scars.

With this routine, we target reduced sebum formation with Retinol and niacinamide. Niacinamide also helps reduce acne redness and eventually minimises inflammatory acne. Likewise, infrequent use of gentle exfoliants like glycolic acid and salicylic acid helps unclog the pores. But one needs to make sure not to over do these acids.

Similarly, sunscreen prevents skin from sun damage. Along with it, good foaming face wash can be alternated with gentle cleansers. One can stick to the routine of “skin cycling” meaning using products alternatively to avoid harsh barrier damage yet providing good exfoliation and oil control.

How can one avoid mistakes that may worsen acne scars during the healing process?

Anybody experiencing acne scars must avoid skin picking. It is the single most important factor that can worsen the acne during its healing process.

Can lifestyle factors, such as diet or stress, impact the effectiveness of treatments for this skin disorder?

It is proven consistently that dairy, sugar, and chocolates, including dark chocolate and spices, worsen acne in acne-prone individuals. Stress can also worsen acne by virtue of raised steroid levels.

How do hormonal changes or medications influence the development and treatment of acne scars?

Hormonal issues like PCOS cause acne that is difficult to treat conventionally. In 2018, I published a study, 'Correlation of hormones in adult female acne,’ in a Pubmed-indexed journal. International data shows that after 25 years of age if one gets new or persistent acne, they have to check their hormones, cholesterol, sugar, thyroid, and allergies.

Are there specific cosmetic procedures or dermatological treatments that you recommend for treating acne scars?

There are different procedures and methods for treating acne scars. As a dermatologist, I recommend microneedling, PRP, subcision, exosomes, nanofat grafting, skin booster and left atrium lymphadenopathy local anaesthetic (LA) for treating acne scars.

Can this be prevented entirely, or is some level of mark inevitable for most people?

Acne scars are definitely preventable if one starts treating them during their teenage years. However, there are medications that help reduce scars permanently in the long term.

Are there any new or innovative treatments for acne scars?

The latest treatment for acne scars is exosomes. It is an mRNA-based injectable that helps in skin repair significantly.