Usually after the inflammatory acne has healed, it can leave a red mark on the area of acne breakout. This is normal and may last from weeks to months for some patients. The redness results from the fine blood vessels that occur under the skin and is part of the healing process of the skin. If no more acne lesions develop in the same area, the skin will continue to heal. You may also observe that the redness may be more pronounced and visible after being out in the hot sun for a long time or after you have used any topical cream that may irritate the skin.
There are no topical medications that will make the redness go away, and most of the time, post-acne redness will clear on its own. Patience is the key! Certain practices like daily application of a sunscreen, and protecting your skin with hats when you are outdoors may help facilitate the healing process though as unprotected exposure to the sun may cause more skin damage. Also avoid picking on the acne scabs, but allow them to peel off on its own as scabs actually form to protect the skin. Premature picking will aggravate the area of healing and prolong the appearance of redness. If you do not have the patience to wait it out though, therapy by IPL may speed up the process of healing. But several sessions may be required and is often costly.
For some people, pigmentation may develop over sites of previous inflammation. The likelihood of pigmentation forming varies individually, but usually deeper and more severe acne tends to leave more pigmentation compared to more superficial and smaller acne lesions. If the acne is subjected to unnecessary picking and squeezing, the tendency of pigmentation also increases. Use of certain oral antibiotics such as minocycline may also cause pigmentation.
Pigmentation will usually clear in weeks and months, but if you are concerned about it, you can get lightening creams that may help a bit. What is more important is to keep your acne in control to reduce the possibility of further post-inflammatory acne on the same breakout sites. Chemical peeling, IPL therapy and lasers are not recommended as they may in fact injure the skin and cause further pigmentation.
What most acne patients worry about is the appearance of acne scars. Scarring is a process where collagen within the skin is damaged and leads to permanent texture changes in the skin. That is why it is important to treat your acne as early as possible as permanent scarring can occur if the inflammation gets too severe. Unfortunately, current treatments for acne scars are costly and only partially improve the scars. It is not 100% effective and the patient should be realistic to know that scarring is permanent and treatments such as dermabrasion, laser resurfacing, etc, can only improve their skin texture, but will not restore it to their pre-acne levels. Scar treatment should be considered only when their acne problem is well controlled or dormant.
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