Post-Acne Marks and Scars
Post-acne is the name for the skin changes that acne leaves behind: scars, lasting redness, congested marks, darker or lighter patches, enlarged pores and uneven texture. These marks can bother patients as much as the breakouts did. They are hard to correct and often do not go away by themselves, so it makes sense to plan the work on them with a doctor.
If acne is still active, it gets treated first. The aim of correction is to improve how the skin looks and to prevent new damage. An honest doctor will not promise that scars, especially deep ones, will disappear completely, but skin can be improved when the method matches the type of mark.
At the Trichology Institute in Kharkiv, post-acne is managed by doctors of the cosmetology department and the dermatology department. The head of dermatology, Yulia Kachuk, a dermatovenereologist and cosmetologist, uses her own techniques in combined post-acne correction and has described her experience in a professional publication.
When to see a doctor
Any mark left by acne that bothers you is a good enough reason. People most often come in when:
- the skin is left with pits or raised bumps;
- red or congested marks will not fade;
- darker or, on the contrary, lighter patches have appeared where the breakouts were;
- pores have become wider and the skin uneven;
- they are thinking about a peel or injections but do not know what would suit them.
When not to put off a visit
- New deep, painful nodules keep appearing, or breakouts will not settle: this is active inflammation, and it can leave new scars.
- A scar is growing, spreading beyond the original spot, itching or hurting.
- A dark spot changes in size, shape or color, or it bleeds. It may not be an acne mark at all, and a spot like this is checked with dermatoscopy.
- Breakouts come together with irregular periods, excess hair growth on the face and body, or hair loss.
- After a procedure, pain and swelling are getting worse, pustules appear or you run a fever.
Make an appointment
Why acne leaves marks
Acne is one of the most common skin diseases and affects the oil glands and hair follicles. Once the acne period passes, the skin enters a state of post-inflammatory changes. That is post-acne.
Acne inflammation involves the oil glands and the space around them, so the dermis, the deeper layer of the skin, takes the most damage. Long-lasting inflammation wears out the cells of the dermis and disrupts its metabolism. This leads to different consequences: when microcirculation suffers, redness and congested marks stay; when the skin's repair weakens, its color and texture suffer; and damaged tissue heals with a scar.
What determines how marked post-acne is
- the patient's age;
- how promptly acne treatment began;
- how severe the inflammatory lesions were;
- how long the disease lasted.
Everyday habits can make marks more visible too: squeezing breakouts injures the skin, and sun exposure makes pigmented marks darker.
Sometimes there is a hormonal reason behind the acne itself. For example, it is among the signs of excess prolactin, as described in the publication Hormones and hair. A condition like this is not corrected with procedures: it needs a workup with an endocrinologist or gynecologist.
What post-acne looks like
One person often has several changes at once, and each calls for its own approach.
Redness and congested marks
Lasting redness, dilated capillaries and congested marks where breakouts used to be. They result from inflammation and impaired microcirculation. The skin's surface is usually not altered.
Pigment changes
Post-inflammatory hyperpigmentation leaves darker patches, and depigmentation leaves lighter ones. These are not scars either, but they can last a long time.
Scars
Atrophic scars are pits in the skin. The hardest of these are ice-pick scars, which are narrow and deep. Less often, raised hypertrophic and keloid scars form. Your doctor needs to know about any tendency to these before procedures begin.
Pores and texture
Enlarged pores, uneven texture, oily skin, flaking and a feeling of discomfort.
Your assessment at the Trichology Institute
The doctor's first question is whether acne is active right now. The second is what kind of marks remain and how deep they are. The answers decide what to do and in what order.
- A consultation with a dermatologist or a cosmetologist. The doctor asks how your breakouts began and developed, what treatment you have had, about other health conditions and skin diseases in your family, then examines the skin.
- Digital dermatoscopy on FotoFinder equipment. This lets the doctor assess individual areas without damaging the skin, and it matters most when a spot looks doubtful.
- Luminescent examination and dermatological tests if needed.
- Lab tests. The list depends on your situation. They are needed, among other things, during systemic treatment and when a condition is chronic.
- A biopsy only when a growth on the skin needs a more exact diagnosis.
What you should always tell your doctor
- what medications you take or have taken recently, especially retinoids and antibiotics;
- whether you are pregnant, breastfeeding or planning a pregnancy;
- whether you have ever had keloid or hypertrophic scars;
- whether you have allergies, autoimmune disease or cancer, or take immunosuppressants.
It also helps to talk through what you expect: the doctor will compare it with what a method can really do. Chemical peels and mesotherapy protocols are also part of the practice of cosmetologist Vladlena Kalashnikova.
Correcting post-acne
The method is chosen individually, according to the type and severity of the changes. No systemic acne treatment sufficiently removes damage that is already there, so procedures are added to treatment, often in combination.
Active acne comes first
If there are fresh inflammatory breakouts, the doctor treats them first: with topical therapy and, usually in moderate or severe cases, systemic therapy. Do not stop prescribed medication or start new medication on your own.
Chemical peels
In a chemical peel, the doctor applies a preparation that causes controlled exfoliation, after which the skin renews itself. As part of combined acne and post-acne therapy, a peel helps normalize oil gland activity and even out texture, and in hyperpigmentation it helps lighten the skin. The clinic's list includes superficial and medium facial peels. The type is chosen according to the state of your skin, your schedule and social commitments, and the indications and contraindications.
Mesotherapy
Mesotherapy means injections into the skin with very fine needles, most often of a cocktail of hyaluronic acid, vitamins, amino acids and antioxidants. It is used in combined therapy for post-acne and scarring, and to even out facial color in hyperpigmentation. The effect is usually cumulative. Contraindications include pregnancy and breastfeeding, skin infections, and a tendency to keloid and hypertrophic scars; the full list is on the procedure page.
Photodynamic therapy
Photodynamic therapy combines a photosensitizer based on 5-aminolevulinic acid with light from an LED lamp. Its indications include acne, hyperpigmentation and scarring, including post-acne scars. The procedure takes about an hour and a half. It is contraindicated in pregnancy and breastfeeding, porphyria, allergic and photo reactions, and in anyone under 18, and it is not combined at the same time with retinoids, including isotretinoin, or tetracycline antibiotics.
Deep methods
In dermatology and cosmetology generally, post-acne is also treated with lasers, phototherapy, microdermabrasion, mechanical dermabrasion, laser resurfacing and deep phenol peels, and sometimes plastic surgeons help. This is general practice, not a list of our procedures. Deep methods are possible only once inflammation has fully settled and scarring is complete. If your scars need this kind of treatment, your doctor will say so at the consultation and advise which specialist to see.
Create a treatment plan
What to expect and how to keep the result
Post-acne is corrected gradually, and some changes may stay for life. So the honest goal is smoother skin and less visible marks, not skin that has never had acne.
At follow-up visits the doctor compares your skin with how it was at the start and changes the plan if needed. If acne comes back, it is treated first again.
Between procedures, follow your doctor's skin care advice, do not squeeze breakouts and protect your skin from the sun. After photodynamic therapy, temporary redness, swelling and light sensitivity are possible: keep sun exposure to a minimum for 48 hours, go outside with SPF 50 sunscreen, and in summer keep using it for two more weeks.
Post-acne affects quality of life too, so wanting to correct it is not vanity.
We see patients by appointment at 17 Danylevskoho St, Kharkiv. Consultation fees are in the price list.
Related pages: Hormonal Hair Loss, Hair Loss in Women, Androgenetic Alopecia.
Doctors
Prices
| Consultation with an aesthetic medicine doctor | 1000 UAH |
Frequently Asked Questions
First the doctor assesses how active your acne is. While inflammatory breakouts continue, treating them is the priority, because it lowers the chance of new scars and marks. Deep methods are used only after inflammation has fully settled.
That said, chemical peels and mesotherapy are also used in combined acne therapy, so these stages are sometimes combined. The doctor decides what is possible in your case at the examination.
No one can promise that. Post-acne is hard to correct, and some changes often stay for life. The realistic goal is smoother skin and less visible marks.
Narrow, deep ice-pick scars are the hardest to change. Your doctor can tell you what to expect after examining your skin.
A mark changes the color of the skin, while a scar changes its surface: it is a pit or a bump. Marks can fade with time, but not always, and congested or pigmented ones sometimes last a long time.
There is no need to wait for years. At the examination the doctor will work out what you have and whether a procedure is needed.
There is no single plan: the doctor sets the number and frequency after the consultation, based on the type of changes and the method. The effect of mesotherapy is generally cumulative, so one session usually does not give the full result.
Be sure to tell your doctor about any retinoids, in pills or on the skin, and about antibiotics. Photodynamic therapy is not combined at the same time with retinoids, isotretinoin or tetracycline antibiotics. When other procedures can begin is for the doctor to decide, based on the drug and how long you took it.
Do not stop the medication on your own to get to a procedure sooner. That decision belongs to the doctor who prescribed it.
As part of combined therapy, a peel helps even out skin texture, and in hyperpigmentation it helps lighten the skin. Professional reviews describe glycolic and trichloroacetic acid peels mainly for mild to moderate acne and post-acne scars.
For pronounced scars, a peel alone may not be enough. The doctor chooses the type of peel, since the state of your skin, the indications and the contraindications all matter.
Mesotherapy is used in combined therapy for post-acne and scarring, and to even out facial color in hyperpigmentation. It means injections into the skin with very fine needles, and the effect is usually cumulative.
It does not suit everyone: contraindications include pregnancy and breastfeeding, skin infections, and a tendency to keloid and hypertrophic scars. Your doctor decides whether mesotherapy is right for you.
Laser resurfacing, mechanical dermabrasion and deep phenol peels are deep methods. They are used only after inflammation has fully settled and scarring is complete. This page describes them as general practice, not as our procedures.
The first step is to find out what type of scars you have and what could help them. If you need a method like this or a plastic surgeon, your doctor will say so at the consultation.
Mesotherapy and photodynamic therapy are contraindicated during this time. For other procedures and any skin products, ask your doctor first and do not start them on your own. Correction is usually planned for after pregnancy and breastfeeding.
Tell your doctor if you are only planning a pregnancy too, because it can affect the choice of procedures.
A tendency to keloid and hypertrophic scars is a contraindication to mesotherapy, so tell your doctor about it before a method is chosen. Even if the scar was long ago and not on your face, this is important information.
If a scar is growing, itching or hurting right now, book a separate consultation with a dermatologist.
The clinic's dermatologists see adults and children. Teenagers often still have active acne, and that should be treated first, since prompt treatment affects what marks remain.
The doctor discusses procedures for minors with their parents. Photodynamic therapy is contraindicated in anyone under 18.
It is better not to try this on your own. Home acids and whitening products used without an examination can irritate the skin, and squeezing breakouts injures it and can leave new marks. Creams will not remove existing scars.
Topical products are chosen individually, and the doctor decides how long and how often to use them. See Topical treatment of dermatoses.
