Post-acne: What you can do with acne scars and spots
If you want to do this
According to statistics, about 80 % of the world's population has experienced acne. Although most of the spikes occur to be at puberty and the age of thirty, recently cases of this disease among people over thirty, forty and even fifty has increased. No matter at what age you may have caught up it, the treatment takes from six-eight weeks to several years. At the same time, even after the inflammation has passed, it can be reminded by consequences, so called post-acne in the form of spots and scars, for a long time.
With severe acne and lack of timely treatment, these gifts can remain for life. And this is normal: acne is a complex disease that can be caused by a variety of external and internal causes, and certainly not a reason for shaming yourself and others. If post acne does not cause you psychological discomfort, then it is not necessary to deal with it. If spots and scars on the face regularly spoil the mood, then you should start treatment with a dermatologist. I try to understand how post-acne appeares and what you can do with it.
Why do spots form
To understand how post acne spots are formed and why they look like this, you need to understand the pimple life from the very beginning to the end. Inflammation is a programmed sequence of skin reactions, the purpose of which is to destroy the infection. This process can be compared to emergency protection, which should prevent bacteria from entering the systemic bloodstream and destroy the infection after localization in one place. Pimple is also a small inflammatory process, and it is characterized by all the same laws.
First the vessels in the focus of inflammation spasm, then expand, there is an increase in local temperature (then we see that the pimple matures). In response, protective cells, the so called white blood cells, gather in this zone. After they have destroyed the infection, the integrity of the tissue is restored, new vessels are formed. Congestive post acne spots are both an area with impaired blood circulation after the inflammatory process, and newly formed vessels necessary to restore the damaged area. In fact, post-acne spots are just a cluster of expanded capillaries.
Very often red and purple spots (the darker the color — the longer the inflammatory process) are called post-inflammatory pigmentation, but these are different things. There is no pigment in red spots, only blood clots, so the term "post-inflammatory erythema", or simply "congestive spots", is most often used. Post-inflammatory pigmentation, which can also occur after a pimple is just a real pigmentation, as there is the accumulation of melanin.
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In contrast to the pigmentation resulting from ultraviolet radiation, it depends on the individual characteristics of the person. In particular, violation of melanogenesis is typical for patients with endocrinological diseases and with a phototype higher than the third. Sometimes, these two types of spots are formed simultaneously after a pimple. In the deep skin layers, dilated capillaries, and higher is a pigment. In addition, there is a group of people who are prone to the formation of congestive post acne spots, these are patients with tender skin, prone to swelling, bruising, redness, with fragile vessels.
The appearance of age acne spots is also affected by untimely treatment, including medication. Be sure to do the tests that the doctor will prescribe, since pigmentation can be caused by internal processes, including hormonal disorders, pathologies in the ovaries, adrenal glands, and pituitary gland." The violation of melanin synthesis can be affected by the weakening of skin protection. In particular, it becomes less resistant to inflammatory elements and more susceptible to melanin production after exfoliation, sunburn, and aggressive care products and procedures.
Can the spots pass on by their own?
Congestive blood spots will eventually pass by themselves, but the longer and more intense the inflammatory process, the more time it will take. From a small pimple, the trace passes in ten days, from an injured one up to two months. "Sometimes girls try to crush the pimple, so that it passes faster, but most often they do not succeed. This leads to an increase in rehabilitation time, and as a result, the injured spot will be noticeable much longer. I see patients who press the same elements for months, bringing them to scarring. They think that hyperemia (overflow of blood vessels) at the healing stage is a new beginning inflammation.
The reason for such behavior lies in psychological discomfort. Very often such a "picking up sores" is a way to cope with a sense of anxiety, an opportunity to give vent to excitement, fear or anger. In this case, compulsive sores tearing brings a sense of calm. The same thing happens in situations when a person experiences a loss of himself, and then picking the skin helps to feel better through body contact. "In order to get rid of this habit, you first need to notice it: you should understand exactly what you are doing and at what moments, to notice the almost reflex impulse to touch your face. It is necessary to notice what kind of feeling you are experience: anxiety, anger, confusion and try to find another way to cope with emotions or return to the feeling of your own body. You can walk, draw or write something on a piece of paper. The main task is to learn to live your feelings in a different way.
Post-inflammatory pigment spots can pass by themselves, because the pigment is removed together with the skin cells during the renewal process. This process speed directly depends on the amount of pigment and it depth, it can take from several months to a year or more. "Of course, in order to prevent the appearance of new spots and with a tendency to pigmentation ingeneral, you need to protect yourself from factors that provoke hyperpigmentation, in particular to avoid UV damage. Use a high-protection sunscreen every day and try to spend as little time in the sun as possible. But even if you diligently protect your skin from UV rays, the spots themselves can only pass if they do not come with scars.
What do medicine and cosmetology offer?
Since congestive spots and post-inflammatory pigmentation have different natures, they also need to be affected in different ways. The same remedies work against age acne spots, as against pigmentation of other origin, for example, due to UV skin damage. These can be products that accelerate cell renewal, lighten the pigment and prevent its accumulation in various ways: hydroquinone, acids, retinoids, vitamin C, Niacinamide, arbutin, licorice and soy extracts. Among cosmetic procedures fractional photothermolysis, photodynamic therapy and neodymium laser are allocated.
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Age spots formation preventive lotion Dr. Barbara Sturm Brightening Face Lotion
The difference in the congestive spots treatment is that there are pigment lightening agents, but there are no "anti-vascular" creams. Since these traces occur due to local circulatory disorders, any technologies that improve microcirculation are suitable for solving the problem, and it is worth paying attention to photodynamic therapy, such as super-powerful Heleo4, LED lamps and microcurrents." The most effective one is IPL laser technology. From cosmetics that improve microcirculation, gel with badyaga is popular, but there is no scientific data to support its effectiveness. You should be careful with badyaga, it can leave a chemical burn, especially on thin sensitive skin. Also look for Arnica, Centella,and Niacinamide. These components are also present in complex mesotherapy products, this delivery method, of course, will work faster.
Among the available tools for improving microcirculation I should highlight Jacques pinch massage and home cryotherapy. It can be made as with ice cubes, and with gadgets, after holding them in the freezer. If congestive spots are combined with pigmented, then methods against both conditions are combined.
Why do scars occur?
In the issue of post-acne appearance and scar formation, the depth of damage is crucial. Erythema and pigmentation occur due to epidermis injury, whereas scars due to dermis injury. This often happens with a severe and prolonged disease, when the inflammation reaches a deeper layer of the skin. Scars can also appear due to improper inflammation treatment, including the use of too aggressive means that damage the structure of the tissue and do not allow the inflammation to heal.
So, if the inflammation reaches the dermis, not only the capillaries begin to grow, but also the fibroblast cells try to actively produce collagen and remodel the skin layer. Sometimes the process is dragged on for weeks or even months. To restore the dermis, fibroblasts and keratinocytes synthesize many different enzymes that determine the architecture of the future tissue. At the same time, the number of different types of enzymes depends on genetics, so we can not influence the scars that remain after inflammation. So, some of the enzymes stimulate the destruction of old cells, and some — the formation of new collagen fibers. Due to a genetic imbalance in the enzymes work, while restoring the tissue surface, not enough skin may grow (such scars are called atrophic) or, vice versa, too much skin may grow (such scars are called hypertrophic, people with dark phototypes are more prone to them).
What can be done with scars?
If the relief is not significantly disturbed, it is recommended to use acid peels and retinoids for atrophic scars. So you can gradually level the skin surface, but in more complex cases, only a specialist will help. For light atrophic scars, cosmetologists advise combining median peels with a mesoroller, and in more serious cases — laser resurfacing for gradual thinning of the skin, needle radiofrequency lifting to seal and tighten the scar, as well as products based on collagen or amino acids — on the contrary, to increase its volume. It is important to understand that the scar is "minus the tissue", and in order to minimize it, you need to either reach its bottom or lift it to the skin surface.
In complex cases of atrophic scars, a fractional CO2 laser is used, which is also called a surgical laser. It is most effective in the post acne treatment, but it is important to understand that one procedure will not be enough. It is recommended to combin a CO2 laser with PRP therapy, i.e. plasmolifting. You can apply the plasma immediately to the laser-treated skin, as the dermal channels are open. PRP accelerates regeneration and protects against possible side effects.
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Among the lasers that damage the upper skin layer, erbium one is also used, and among non-ablative lasers there are niodim and diode. Dermabrasion is still done, when the skin is mechanically thinned with silicon or diamond-coated attachments, but it does not have the same bright effect as from lasers, and it does not work on all forms of atrophic scars. Another popular technique is subcision, when the connective tissue is cut with a tool or needle, and as a result it is straightened out. This procedure can be done simultaneously with a hyaluronic acid filler. Such techniques are best suited for circular scar depressions. There are trichloroacetic acid usage innovations: during the CROSS TCA technique, the doctor applies highly concentrated acid solutions (from 60 to 100 %) to align the scars. This technique requires a highly qualified doctor.
The most popular method of treating hypertrophic scars that require getting rid of excess tissue is applying silicone gel to the scar, but the mechanism of this method is not fully understood. Corticosteroid injections, liquid nitrogen cryotherapy, pulsed dye lasers and, of course, surgical removal have proven to reduce the size and volume of scars.
While the only correct ways to work with post-acne manifestations do not exist, each case requires an individual approach and, as a rule, a combination of different protocols. So first of all, it is important to find a dermatologist who you will trust. Before starting treatment, you should discuss all possible options, their pros and cons, and find out the opinion of a specialist about the methods that interest you. At the same time, you don't have to agree to the proposed procedures: most of the cosmetic methods are expensive, and do not give a visible result immediately. Perhaps, specialists of various profiles, including a psychotherapist, will help you in this situation. Whatever you choose, weigh your decision carefully. And don't forget that you always have the option to change it.