Individuals with darker skin types can develop dark spots after acne, skin rashes or any injury to the skin. The medical term for this change is post inflammatory hyperpigmentation. It is the way dark skin responds to injury. The good news is that it is not scarring, rather, it is a temporary change and can be easily improved. The most common treatment for pigmentation is a prescription fading cream, hydroquinone 4%. For best results, it is combined with an exfoliating agent such as tretinoin (prescription strength vitamin A cream) which enhances penetration.
Another color change of the skin is redness. This change can occur after acne as well as in surgical scars. Typically red scars will fade within 6 months. If they don’t fade as expected, one or two treatments with a pulsed dye laser can significantly eradicate redness.
Acne scars or chicken pox scars are usually indented. They may look like someone poked holes in the skin. Fortunately, the newer lasers for skin smoothing; Fraxel or Fractionated CO2, can improve this type of scar by 50-75%. Fraxel laser may require a series of 4-5 treatments with a short healing time of 2-3 days. Fractionated CO2 takes a week to heal but can achieve results in 1 or 2 sessions.
Keloid scars are raised, thickened scars. Keloids can occur after ear piercing, surgery, severe acne or burns. Treatment with injections of cortisone into the lesion can soften and often flatten this type of scar. Laser treatment using the pulsed dye laser may also be used to flatten the scars and to reduce redness. Scar dressings or gels containing silicone such as Ketocote scar gel may also aid in flattening scars. How these gels or dressings work is a bit of a mystery but they do work for some patients. When keloids are resistant to these treatments, surgical excision, combined with cortisone injection is an option. For large or resistant keloids, low dose radiation therapy may be used after surgery to prevent recurrence.
The good news is there are successful treatments for all types of scars. Most scars will be significantly improved and some can be made almost invisible.