What to do about hyperpigmented scars?

To treat these marks and prevent any recurrence, a number of treatments are available, most of which rely on key ingredients that act on melanin synthesis to slow its production. There are also products that do not directly affect melanogenesis but are still beneficial for treating post-inflammatory hyperpigmentation (PIH). Among them are:

• Arbutin Acid : This compound is a derivative of hydroquinone but without the latter's side effects. Indeed, it is better tolerated by the skin. Just like hydroquinone, it inhibits the activity of tyrosinase, an enzyme responsible for the production of melanin in the skin. It is beneficial to use it in conjunction with azelaic acid.

• Azelaic Acid:This is a dicarboxylic acid that can help reduce hyperpigmentation by inhibiting the activity of tyrosinase. It also allows for the anti-proliferation of abnormal melanocytes. It is generally well tolerated, but may cause redness, burning, irritation, or allergic reactions.

• Vitamin C Derivatives:These active ingredients have a direct effect on hyperpigmentation by regulating the action of melanocytes. Indeed, they react with the copper ions present at the tyrosinase site, thereby reducing its activity and thus blocking the melanin synthesis pathway. They are also known for their antioxidant properties.

• Chemical exfoliant (glycolic acid,lactic, mandelic, PHA...): These peeling agents work to break down the bonds between the most superficial skin cells in order to reorganize the epidermis by accelerating the process of skin peeling and inducing the rapid dispersion of melanin granules within the keratinocytes.

• Niacinamide : Also known as Vitamin B3, it works by blocking the transfer of melanosomes (vesicles that transport melanin) from the melanocytes in the deeper layers of the epidermis to the more superficial layers. Generally, it is very well tolerated by the skin.

• Retinoids (retinol and its derivatives) : These are derivatives of Vitamin A that can also help to reduce hyperpigmentation, particularly by increasing cell proliferation and differentiation (shortening the cell regeneration cycle) and decreasing the expression of tyrosinase. However, retinoids can induce adverse effects (redness, dryness, and irritation) and increased sensitivity to the sun.

• Thelicorice extract : Known by its I.N.C.I. name "Glycyrrhiza Glabra Root Extract", licorice extract contains 95% of glabridin, a compound that operates at several levels to regulate the phenomenon of hyperpigmentation. It significantly reduces the amount of endothelin-1 (a mediator involved in the pigmentation process) released by keratinocytes after UV exposure. Additionally, it inhibits the activity of phospholipase A2 (PLA2), an enzyme released by epidermal keratinocytes after UV exposure or during inflammation that stimulates tyrosinase activity and therefore melanogenesis.Other active compounds, such as glabrene, isoliquiritigenin licuraside, isoliquiritin, and licochalcone A, isolated from licorice extracts, have also demonstrated tyrosinase inhibitory activity.

To eliminate hyperpigmented scars, there are other options. These range from topical medicinal solutions to lasers and chemical peels:

• Pulsed Light: This non-invasive and non-ablative treatment uses high-intensity light pulses. To eliminate brown spots, pulsed light targets the melanin on the skin's surface to fade discoloration.

• Chemical Peeling: The principle of peeling is somewhat similar to that of exfoliation. It involves applying a chemical substance (glycolic acid, salicylic acid, trichloroacetic acid, etc...) in various concentrations to the skin to trigger a controlled peeling of the epidermis, and with it the melanocytes and the marks left by pimples. Indeed, blisters form and eventually peel off, leaving behind smooth skin without hyperpigmentation. This procedure should be performed by a dermatologist, preferably in the fall or winter.

• Low-energy Pigment Laser Therapy: The goal is to destroy hyperpigmented skin cells using high-energy light so that new, flawless skin can emerge. However, this treatment may cause minor damage (burning sensation, irritation...).

• Kligman's Trio: Dr. Kligman developed a formula based on the unique synergy of three components: hydroquinone (a tyrosinase inhibitor), hydrocortisone (anti-inflammatory action), and retinoic acid (accelerates cell renewal). Together, they have demonstrated a depigmenting power at different stages of the melanin cycle. The effects of depigmentation appear after 3 to 5 weeks of treatment. However, this solution can cause irritations and sensitivity. Moreover, it does not rule out a recurrence of brown spots.
  

In order to prevent the onset of acne marks, it is crucial to avoid inflammation. To do this, we recommend consulting a dermatologist to treat your acne as early as possible with a tailored treatment plan. Also, remember to properly hydrate your skin with a face cream that is suitable for your skin type. This promotes healing. Moreover, to avoid exacerbating inflammation and spreading the infection, refrain from popping or scratching your pimples. Lastly, the sun intensifies acne marks, thereby extending the time needed for them to fade. Therefore, ensure to protect yourself daily by applying a broad-spectrum SPF sunscreen and also limit your exposure to the sun.