How to get rid of post acne marks? (photos)

I recently got on birth control which caused my skin to break out. I have managed the break out, but on one side of my face i have two or three red marks that won't seem to go away. I have been using Retin- A prescribed by a doctor and I have also tried to use hydroquionone, but I don't think it's working. I have only been using the Retin - A about two weeks so maybe it hasn't had time to work, but will it work? I feel hopeless. I don't wear a lot of make up and I'm being forced to now to cover this up.

Doctor Answers 9

Post acne marks

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Thank you for your question.  It can take 2-3 months of regular Retin A use to see a significant improvement.  Also, being kind to your skin helps.  Avoid harsh scrubbing, manipulating, or picking at these areas.  In addition to topical Retin A, there are many procedures available to help fade the pigment faster, micro needling, laser peels, chemical peels, etc.  These treatments should be recommended after a thorough evaluation of your skin type.  In the meantime, be kind to your skin and wear diligent sun protection to avoid darkening to the pigmented areas.

To be sure, see two or more board-certified providers in your area for a complete evaluation to make sure you are a good candidate and that it is safe for you to have treatment.

Post-acne marks and Retin-A

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Retin-A works very well to minimize scarring, but by two weeks of use you won't see much of a change. To see maximal results I'd give it 6 months to 1 year.

Acne Scarring

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Yes, your acne scars can be treated. You need to see a Cosmetic Dermatologist used to treating scarring from acne. There are many treatments that would work. From looking at your photos I would think Photofacial (IPL) would greatly help your problem.
Please find someone reputable and I think you will do just fine.

Red marks and Acne

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First you need to have your skin analyzed and find out if there is a hormonal reason why your acne is so bad. I would recommend consulting a dermatologist who has expertise in acne and scars.  A combination of V-Beam laser and peels will improve the skin color.  This is a situation which can be easily remedied.


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Thank you for the question and pictures.

Acne is a very common condition and yet one of the most common under or mistreated condition.  To effectively treat acne one has to first address your skin flora, or bacteria on your skin, that may be causing infection.  Second one has to address skin oil deposit on your skin and skin oil production by your skin.  Third one has to address the inflammation in your skin that may be causing the redness in your acne case.  Fourth one has to address the post acne hyper pigmentation and pitting scars.

I suggest you see a Drmatologist or Plastic Surgeon that is experienced in acne treatment to get started maybe on accutane. If you are a candidate (accurate most of above but with a lot of side effects) or get stared on oral low dose antibiotics, good cleansers of oily skins, a lactic acid based exfoliant and benzal Peroxide, a hydro quinone and tretinoin which you are already on and a sunblock.  Another option is to look into and switch around your oral contraceptive and consider spironolactone to control the hormonal responsive acne.

Once you do all of that than consider du vision and laser resurfacing for your deep acne scars.  Be patient and make sure you continue to follow up with your physician to adjust and monitor your treatment,

Best regards

Nagi T Ayoub MD, FACS 

Acne Scarring -- Requires a Combination of Fractional Laser Resurfacing, Fillers Like Bellafill, Subcision and Eclipse Micropen

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You need a cosmetic dermatologist who specializes in acne scarring/pigmentation and does a combination of treatments including: surgery, subcision, or TCA cross for deep or pitted "ice pick" scars; fillers like Bellafill or Sculptra or Radiesse for broad "boxcar" or "rolling" scars; Eclipse Micropen for all types of scars and improvement in texture and tone; lasers such as co2 laser resurfacing or Fraxel/Clear+Brilliant or radiofrequency such as Venus Viva to improve the scars and give long term collagen production. There are many options but you want someone who can customize a regimen for your short and long term goals based on your individual situation. Best, Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 203 reviews

Laser Options for Red Scars

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Hi Saints.  For red acne scars, your best bet is pulsed dye laser treatments.  Q-switched lasers treat dark pigment and fractional lasers (although they may work) usually have some downtime.  Pulsed dye laser are specifically designed to treat vascular conditions like yours.  

Give the Retin A a few more weeks and if you do not feel it is working out, consider seeking out a practitioner experienced in treating red acne scars with pulsed dye lasers.

To see an example of a patient that was treated with pulsed dye lasers for red acne scarring, click on the link below.

Harold J. Kaplan, MD
Los Angeles Facial Plastic Surgeon
4.4 out of 5 stars 7 reviews

Post acne pigmentation

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In my opinion you have post acne pigmentation. It is difficult for me to assess if these marks are also depressed. The regimen that your dermatologist gave you is a good one. It will take a little time for the bleaching cream and Retin A to work. To speed this up you may want to add a salicylic acid wash. If this does not get you to the point that you're satisfied, some mild chemical peeling is also helpful. The key question is whether these marks are depressed. If they are slightly depressed adding microneedling would speed up the process. We often do this an co juction with platelet rich plasma. Hope this helps. Good luck

Jeffrey Rapaport, MD
Englewood Dermatologic Surgeon
4.7 out of 5 stars 43 reviews

Fractional laser vs Q Switch lasers

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Post acne staining or PIH (Post inflammatory hyper pigmentation ) is very common, and can take months or even years to resolve- especially in darker skin types. 

You have several options to speed up clearance. One is with Picosecond or Nanosecond Q switch lasers. I like using the Picosure FOCUS fractional as it has little, if any downtime. You will need 3-4 sessions. Long pulse 1064 Nd Nanosecond lasers can also work. 

Fractional laser resurfacing can be effective. In this case, I would use a light resurfacing laser, Fraxel 1927, or Pearl. You have the option for CO2 or Erbium, but these lasers have longer downtime. 

All the best 

Dr Davin Lim 
Laser and aesthetic dermatologist
BRISBANE, Australia. 

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.