Brown and White Acne Scars on the Back and Chest

Brown and white acne scars on the back?

Doctor, I often get acne on my back and chest, and the scars are difficult to heal.
I also have raised spots that look like acne but are brown in color; they don't hurt when pressed and don't have any pus-like material, resembling scars.
The most troubling part is the small brown acne scars that look like freckles; I don't understand why there are so many, even though they are small.
Will they eventually heal over time? Should I increase my vitamin intake or apply any medication?

~~, 10~19 year old female. Ask Date: 2016/08/08

Dr. Wu Yuxin reply Dermatology

It could be hypertrophic scarring.
Without actually seeing the lesion, it is impossible to confirm.
If it is very bothersome, please seek medical attention as soon as possible.

Reply Date: 2016/08/08

More Info

Understanding the appearance of acne scars, particularly brown and white scars on the back and chest, can be a complex issue that involves various factors including skin type, acne severity, and individual healing processes.
Acne scars can be classified into two main categories: atrophic scars (which are depressed or sunken) and hypertrophic or keloid scars (which are raised). The brown spots you are describing could be post-inflammatory hyperpigmentation (PIH), which is a common occurrence after acne lesions heal. This happens when the skin produces excess melanin in response to inflammation, leading to dark spots that can resemble freckles. These spots may take time to fade, often several months to a couple of years, depending on the individual’s skin type and the severity of the inflammation.

On the other hand, the white scars you mentioned could be indicative of atrophic scars, which occur when the skin loses collagen during the healing process. These scars can appear as small depressions on the skin and may require different treatment approaches compared to hyperpigmented scars.

Here are some key points to consider regarding the management of these scars:
1. Time and Healing: Many acne scars, particularly those that are brown, can fade over time. The skin has a natural healing process, and with proper care, you may notice gradual improvement. However, this can vary significantly from person to person.

2. Topical Treatments: There are several topical treatments available that can help with both hyperpigmentation and atrophic scars. For brown spots, products containing ingredients like hydroquinone, retinoids, vitamin C, or alpha hydroxy acids (AHAs) can be beneficial. These ingredients help to exfoliate the skin, promote cell turnover, and reduce the appearance of dark spots.

3. Sun Protection: It is crucial to protect your skin from sun exposure, as UV rays can worsen hyperpigmentation. Using a broad-spectrum sunscreen with an SPF of 30 or higher daily can help prevent further darkening of the scars.

4. Vitamin Supplementation: While a balanced diet rich in vitamins and minerals is essential for skin health, specific vitamin supplementation (like Vitamin E or Vitamin C) may help in skin repair. However, it’s best to consult with a healthcare provider before starting any supplements.

5. Professional Treatments: If the scars are persistent and bothersome, you might consider consulting a dermatologist for professional treatments. Options include chemical peels, microdermabrasion, laser therapy, or microneedling, which can significantly improve the appearance of both brown and white scars.

6. Avoid Picking: It’s important to avoid picking at acne lesions, as this can lead to further inflammation and increase the risk of scarring.

7. Patience and Consistency: Treatment for acne scars often requires time and consistency. It’s essential to follow a skincare routine and be patient with the healing process.

In conclusion, while brown and white acne scars can be frustrating, understanding their nature and exploring various treatment options can lead to improvement over time. If you have concerns about the severity of your scars or the best treatment options, it’s advisable to seek guidance from a dermatologist who can provide personalized recommendations based on your skin type and condition.

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