Best Treatment for Acne Scars on Dark Skin

I am 56 years old, have very bad acne scarring on my face. My skin tone is bad, and I have dark skin. I went to a dermatologist years ago, and he told me because of my skin color treatment would make my acne scars look worse. Is there anything I can do?

Doctor Answers 3

There is hope

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Some very dark-skinned individuals can respond very well to treatment, but unfortunately, some do develop significant lighter skin permanently, or temporary (months to years) of darkening. A test spot should be done first to test your pigment response. This can be done behind the ear so that if the reaction is not favorable it would not be seen on your face. If that test works well, then a second test can be done on the face prior to treating the whole face. If the test shows a poor response, then you wouldn’t have the treatment, but if both tests produce a good result it doesn’t guarantee that you wouldn’t have a problem when the whole face is treated. Schedule a consultation with a physician who has significant experience in acne resurfacing. Don’t give up, see a few consultations and don’t rush in. Learn as much as you can first. There is hope.

Manhattan Dermatologic Surgeon
4.9 out of 5 stars 39 reviews

You have safe and effective options.

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Acne scarring on skin of color is a complex issue to address and resolve quickly. It requires patience on the part of the patient and the provider. There are no short cuts and steady progress is the goal. It goes without saying that your provider should have experience treating your skin type and your specific issue.

Acne sufferers with skin of color typically have post-inflammatory hyperpigmentation (PIH), which results in darkening of the skin at the location of the pimple. Insult can be added to injury when pitting or puck marks occur as well.

For best results your treatment should include steps to even your skin tone and complexion as well as control breakouts if you still get them, so you minimize further scarring and pigmentation. I recommend a combination of at-home treatment skin care as well as in-office procedures. I prefer to use hydroquinone 4% or greater, by itself or in combination with a retinol as part of a comprehensive regimen. I customize it so it works for you and your lifestyle.

In terms of office treatments I think the tried and true still work very well. Graduated peels with or without microdermabrasion, performed in a series of treatments, can be very beneficial to gently resurface your skin and allow for better absorption of at-home products, which improves their effect.
There are lightening peels available that give you the benefits of a series of peels after just 1 treatment.

Laser resurfacing can be beneficial in the right hands and with expert pre- and post- treatment care.

Be sure to have a consultation with several providers to find one who understands your skin care goals and has the know-how to get you there.

You have options jaydee.

Who Would Want Acne Scar Treatments to Make Them Worse?

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Darker skin patients DO have to make more careful choices. The dermatologist at the time you saw him might not have had access to the technologies we do today that is far more friendly to darker skins.

It's important to understand that darker skins are much more reactive regarding pigmentation. The original lasers may have helped scars, but the heat delivery methods used pretty much guaranteed that dark skin would have increased pigmentation - sometimes for a long time and at unacceptable levels.

We still have to treat darker skin with great care, but now we have ways of generating new collagen that doesn't turn your pigment cell activity into a raging discoloration party.

Micro needling, both with and without radio frequency, are new options that are much much kinder to dark skins while still improving skin smoothness and lessening acne scars.

Patients with dark skin need to be aware that actual lasers can make pigmentation considerably worse and see out other treatment types.

Do some research in your area and try to locate a dermatologist who has considerable experience with mixed ethnic and dark skin. That experience gained over time makes them far more able to help you achieve improvement without making your skin look worse with post-treatment pigment.

Rebecca Fitzgerald, MD
Los Angeles Dermatologic Surgeon
4.1 out of 5 stars 22 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.