Accutane Cured Acne but Left Scars

Question

I've had acne off and on now for the past 4 years. I recently finished using Accutane and now my acne is gone but i have some ugly scars that I didn't have before. They are not that deep but they do have some depth. They are brownish at the bottom. Any idea why they just showed up out of nowhere or how i can get rid of them?

Hooman Khorasani, MD · Answer

The depressed ares are most likely due to the acne. Acne scars can be very distressing and effect how we feel in the presence of others.  I understand your frustration and would recommend that you look into either laser (such as Deep Fx/Active Fx) or non-laser treatment (needle subcision).  However, the most important thing to reduce scarring is prevention of further acne with a good skin care regimen.  Finally, for the scar redness, which can catch the eye, consider vascular lasers such as pulse dyed laser (more affordable than most other laser treatments).  Make sure prior to starting that you have been off accutane for 6 months to prevent further scarring from treatment.  I would recommend a consultation with a board certified dermatologist who has some training or expertise in lasers and/or scar treatment.

Raffy Karamanoukian, MD, FACS · Answer

Accutane is a go-to medication for patients with recalcitrant cystic acne. It can reduce pore size and also reduce sebum production in your skin, making it less oily; and in turn, dryer. Accutane can be used to control acne, but patients receiving the medication should be carefully monitored. In terms of skincare, always wear an appropriate sunscreen and reduce direct sun exposure. In my patients, I recommend a good ceramide moisturizer such as Elevase whenever they are on Accutane. This will keep the skin hydrated and reduce the oiliness of the skin that is associated with oil-based moisturizers.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best, 
Dr. Karamanoukian 
Realself100 Surgeon

William Ting, MD · Answer

If you had not taken Accutane, it may be possible that you could have more scarring as you might continue to have more inflammatory lesions. Accutane can bring about abnormal wound healing from any concurrent surgery but by itself, it does not scar

Otto Joseph Placik, MD · Answer

There are many different options for acne scar revision but most physicians would reoommend waiting at least 6 months up to 2 years after completion of Accutane before trying any scar revision procedures. Brown pigmentation may be a secondary response to post-inflammatory hyperpigmentation. Consider the use of Triluma or other skin bleaching preparations.

Steven L. Greene, MD · Answer

Textural scarring from nodulocystic acne is due to damage of collagen in the skin induced by longstanding inflammation.    Accutane merely re-educates the sebaceous glands to settle down and work more correctly.    Scarring is collateral damage from the primary acne process.I hope this is helpful.Steven L. Greene MD, Advanced Dermatology and Laser Institute of Seattle

Supriya Tomar, MD · Answer

Most likely these scars have been there for an extended amount of time but went unnoticed by you due to the inflammation that acne causes. This masked the depressed (scared) areas. Now that your acne is no longer active you are able to see the tissue damage it has left behind. 
You will have to be evaluated by a practitioner for proper recommendations for a tailored treatment, however, most patients with acne scaring benefit from a series of microneedling. This procedure helps to degrade the scar tissue and promote new collagen growth which will result in a smoother texture of the skin. Patients typically need between 4 to 6 treatments for optimal results. 
You also mentioned a darkening of the skin in these areas which could be a condition called post inflammatory hyperpigmentation. This is also a condition that may be treated with topical creams

Ryan Ramagosa, MD · Answer

Accutane has not been reported to cause scarring, but you may just be noticing your acne scars more now that there are no inflammatory or cystic lesions to mask them. Once you have been off of the therapy for a year, you can look into some fractional ablative lasering or dermabrasion to improve the cosmetic appearance of your facial scars.

Dina D. Strachan, MD · Answer

If you were on Accutane, it is likely that you had severe acne. Severe acne can result in scarring because the inflammation results in destruction of the surrounding tissue which leaves depressed areas. When acne is active and there are many lesions on the face it can sometimes be difficult to see scarring. When your acne cleared after a successful treatment of Accutane, all that remained were the scars. Accutane is a retinoid and retinoids can improve the appearance of scars as they cause remodelling of the skin. After you have been off Accutane for about 6 months, talk to your dermatologist about options for treating the scars, such as chemical peels and lasers.

Corey L. Hartman, MD, FAAD · Answer

Accutane is a great treatment for both acne and the scarring that acne can cause. Not only can accutane prevent acne scarring, but it can reverse some of the signs of damage caused by the painful nodules of severe acne. While I would certainly beware of laser skin resurfacing in a patient with darker skin tones, chemical peels are an excellent method of slowly and gently correcting the scarring while causing collagen remodeling and smoothing the skin's surface.

Margaret Weiss, MD · Answer

Accutane is the most effective treatment for cystic acne. Accutane is usually able to bring acne to a halt, but the acne itself is what causes scarring. Fortunately, there are good treatments for acne scarring such as laser resurfacing that can be done six months after stopping Accutane.

Accutane Cured Acne but Left Scars

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