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Difference Between Acne Scars and Discoloration

Acne is a common condition in people of all ages. Not only are acne breakouts concerning for people, but so is what is left on the skin after a breakout such as irregular texture and color.

What is the difference between an acne scar and a discoloration?

While both irregular texture and color after acne breakouts are commonly referred to as acne scars, true acne scars are only the textural irregularities in the skin. These are the indentations (atrophic scars) that can be felt on the skin when passing a finger over it. Dark spots left over are called PIH, which stands for post-inflammatory hyperpigmentation. It is important to distinguish between acne scars and PIH because they are treated differently.

How do acne scars form?

Acne scars commonly form after acne breakouts. Usually this happens when the pimples are picked at or popped. Proper extraction can remove the pus from the skin, calm down the skin, and make the breakouts go away faster. However, if the pimple (comedone) is popped inside the skin, the pus is not able to come out and it is released into the skin. The skin detects this as an insult and a reaction is formed to address it. This leads to the breakdown of collagen, the protein that keeps the skin firm and tight. This results in the indentations we see called acne, or atrophic, scars.

How does PIH form?

PIH stands for post-inflammatory hyperpigmentation. Hyperpigmentation is when the skin gets darker. Post-inflammatory hyperpigmentation, therefore, is when the skin gets darker after inflammation. And inflammation can occur for various reasons such as sun exposure (which leads to tans), cuts, burns, acne, laser treatments, etc. People with darker skin have more natural pigment and are at an increased risk of developing PIH.

How do you treat acne scars?

Acne scars are best treated with fractional lasers such as the Fractional CO2 laser or the Pro Fractional Therapy. These laser treatments form tiny holes in the skin. This leads to microscopic levels of inflammation in the skin, causing the skin to form new, fresh, and healthy collagen. So the damaged collagen that is in the scars is replaced with normal collagen, which provides a smooth appearance on the skin surface. The areas around the holes are left untreated; this allows for faster recovery times. Often times a series of three to six treatments are required. Treatments can be done every four to eight weeks. It is important to understand that collagen does not form overnight, it forms slowly. So results are not seem immediately and patience is important. It could take up to a year or sometimes more to see full results.

How do you treat PIH?

PIH is best treated by preventing it in the first place. The risk of PIH can be minimized by using a good skin care regimen such as the A E Skin products. The A E Skin Brightening Cream contains hydroquinone and kojic acid, which brighten the skin and prevent PIH. It also contains retin-A which stimulates cell turnover, keeping the surface fresh. The A E Skin Exfoliating Serum removes the dead skin cells from the surface, which allows for any pigment to be exfoliated. The A E Skin Triple Antioxidant Serum contains vitamins C and E to prevent discolorations, provide a glow, and stimulate collagen. The A E Skin Hydrating Serum contains hyaluronic acid which draws water into the skin to counteract dryness that can occur from the other products. It is important to recognize those at risk for PIH and pre-treat such people’s skin with these products for one to two months prior to a treatment. Those with darker skin types are at a higher risk for PIH. PIH can be further treated with chemical peels and laser treatments such as the Forever Young BBL IPL photofacial.

Do you suffer from acne scars and PIH? Contact us for a free consultation with Dr. Alex in our Encino, CA or Beverly Hills, CA offices. Dr. Alex has performed over ten thousand cosmetic treatments with many satisfied patients.

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