Scars and dark spots are common side effects of acne. While there are lots of products and treatments available, not all of them are best for skin of color. Here’s what to know about how to treat and hide acne scars on black and brown skin.
Types of Acne Scars on Dark Skin
About 80% of people between ages 15 and 30 will get acne, and 1 out of 5 will have scars. Acne scars are usually atrophic scars that sit just below the surface of your skin and look sunken or pitted. Anyone can get an acne scar, but some types are more common in dark skin.
Dark spots. Also called post-inflammatory hyperpigmentation (PIH), dark spots aren’t technically scars. These are purple or brown patches of melanin that show up after your acne clears and can sometimes last longer than the acne itself. Your skin releases melanin, or skin pigment, in response to acne inflammation. Dark spots are more common in skin of color and will fade on their own with time.
Ice pick scars. These types of scars are the most common acne scars. They’re named after an ice pick because they cause a wide hole at the surface of the skin and narrow to a point deep in your skin, like a V.
Boxcar scars. Boxcar scars are the next most common and can be deep or shallow. These scars are round or oval and have sharp edges. They look like a U with a wide base.
Rolling scars. Rolling scars have a sloped edge, which causes a shadow and makes the skin look wavy or rolling.
Keloid scars. Keloid scars are raised, shiny scars that show up after a minor skin injury. These usually first look red or purple and fade to a brown or pale color. They can appear on your head, shoulders, neck, and upper chest, but you can get them anywhere. Anyone can get a keloid scar, but they’re more common in skin of color.
At-Home Acne Scar Treatment for Black Skin
You can treat dark spots at home with skin care products. In most cases, dark spots will go away on their own with time, but you can speed up the process and improve the appearance of your skin.
Vitamin C. Your body uses an enzyme called tyrosinase to convert and make melanin in your skin. Vitamin C blocks tyrosinase activity, which interferes with melanin production and lowers the amount of melanin formed. It might work best along with other ingredients like soy or licorice because of its unstable nature.
Retinoids. Retinoids are vitamin A-based products that turn over your skin cells and improve skin tone. Retinoids can cause irritation, which can raise your risk for more dark spots. To avoid this problem, use small amounts and moisturize.
Glycolic acid. Glycolic acid turns over surface skin cells and promotes exfoliation, which helps fade dark spots. It can cause irritation and sun sensitivity, so you should start with a low concentration every other day and wear sunscreen daily.
Kojic acid. This acid comes from a fungus and can help slow melanin production. It might raise your risk of sunburn the longer you use it, so you’ll need to wear sunscreen every day, reapplying every 80 minutes..
Sunscreen. Some acne treatments can make you more sensitive to the sun, which can complicate your post-acne skin tone. One of the best ways to protect your skin and lower your risk for more dark spots is to wear 30+ SPF sunscreen every day. Try a tinted sunscreen to avoid a white cast.
Makeup. If your skin texture bothers you, you can also use makeup to hide acne scars and dark spots.
Medical Acne Scar Treatment for Brown Skin or Skin of Color
Icepick, boxcar, and rolling scars are harder to treat and there’s no guarantee they will completely heal. Treatment can make scars look smaller, though. You’ll need to see a dermatologist who has experience treating darker skin and can recommend the best medical treatment.
Fillers. Dermal fillers are temporary treatments where your doctor injects collagen or other substances under your skin. These plump up your skin and fill the dips and valleys, making your rolling or boxcar scars less noticeable. You’ll need to have injections every 6 to 18 months to maintain your results. Subcision with a needle under your skin to break up the scar fibers is usually done when fillers are being injected.
Salicylic acid peel. Your doctor can do a chemical peel with salicylic acid. It’s one of the best-peeling agents for acne scars and is safe for all skin types. Higher concentrations of salicylic acid break down the bonds between your skin cells, which causes them to shed deeper layers. Mild and temporary side effects like dryness and redness are common.
Microneedling. Also called collagen induction therapy, microneedling is where your doctor rolls a device with hundreds of tiny needles across your skin. The needles cause tiny injuries to the surface of your skin, which stimulates a cascade of growth factor hormones and collagen. Your skin changes over a few months as your body slowly makes new collagen. It’s safe for all skin types and has a short recovery time.
You can buy dermarollers for home use, but these can do more harm than good. It’s best to let your doctor do this treatment.
Nd:YAG laser. Lasers work well for scar treatment. For a long time, experts thought laser treatment was unsafe for darker skin, but these concerns came from old information. Nonablative laser, like Nd:YAG laser, treatment resurfaces the skin and stimulates collagen production without causing physical injury to the surface or changes to pigment. With extra collagen, acne scars improve, and the overall texture and appearance of your skin improve.
There are many other medical treatments that can help improve your acne scars, including fat transfers to plump and smooth the skin, punch grafts to repair wounds, and subcision to loosen scar fibers with a needle.
Scar Prevention and Treating Acne for Black Skin
All types of acne can cause scarring, including cysts, nodules, and blackheads. If it’s left untreated, your acne can worsen and lead to deep, painful pimples and permanent scars. The best way to prevent these scars is to treat acne early. If you have acne or acne scars, talk to your doctor about the right treatments for your skin.