In general once an acne lesion is traumatized, it will take longer to heal and will be more likely to leave behind a mark. We may notice that sometimes lesions that are not traumatized may also take weeks or months to resolve with the possibility to leave red or brown marks too. What that means is that through no direct fault of us, i.e. didn't pick at it, but of our skin more genetically prone to acne scarring or hyperpigmentation (i.e. darkening of skin caused by higher amounts of melanin in a particular spot). Also, different skin types respond differently to acne during and after a breakout and that breakout may last longer in some people than in others, and some people tend to have red or brown marks left behind for sometimes months after an acne lesion has cleared. In fact, there are factors beyond genetics and skin type that remain unknown.
Usually people with fairer skin often have red marks that remain red for a long time before they clear up and turn brown, whereas those with more olive or darker skin tones will start with increased pigmentation when the acne finally clears. We may notice that there are also many people have an overlap with some of both kinds of marks.
If one of the above describes us, we shouldn’t worry much as those red and brown marks left from our acne lesions is just discolorations and not true acne scars. Hence, if there is no accompanying acne scarring resulted from depression of the skin or change in texture of the skin, the discoloration will eventually go away, or lighten significantly over time though we may choose to treat it to expedite the clearing.
The good news is there are creams that are designed to lighten the skin; this is especially useful for hyperpigmentation that resulted from acne. Also, laser and other treatments can help the redness too. Nevertheless, it is important for us to prevent new acne lesions and to treat early any lesions that occur to minimize new marks.
We may want to know that the active ingredient found in most lightening creams is a class of chemicals called hydroquinone. Those over-the-counter and prescription acne formulations may combine hydroquinone with glycolic acid, tretinoin (the active ingredient in Retin-A), sunscreens, antioxidants (i.e. a substance that binds to free radicals to prevent skin cells from damage), moisturizers, and many other proven ingredients to make their form of hydroquinone better and more appealing. The main difference between those over-the-counter versus prescription acne medications is that the former can have a maximum of 2% hydroquinone while the latter can use up to a 4% concentration of hydroquinone.
Do you worry that those lightening agents will bleach the color of our skin and make us look like Michael Jackson? The answer is not at all if the concentration we are using is to a maximum of 4% and that we used the products as advised that shall include for a specified amount of time, generally 4 to 6 months before taking a break. Other products used to help lighten the skin include licorice extract, yeast ferment, rosmarinic acid, glucosamine, vitamin C, and chamomile extract. What follows are some of the prescription lighteners for reference:
Alphaquin HP - Hydroquinone, glycolic acid, sunscreen
Eldopaque Forte - Hydroquinone, sunscreen
Eldoquin Forte - Hydroquinone
Epiquin - Hydroquinone
Glyquin - Hydroquinone, glycolic acid, sunscreen
Lustra - Hydroquinone, glycolic acid
Lustra AF - Hydroquinone, glycolic acid, sunscreen
Melanex - Hydroquinone
Solaquin Forte - Hydroquinone, sunscreen
Tiluma - Hydroquinone, Retin-A, hydrocortisone
We will notice that most of the above lightening products contain 2% to 4% hydroquinone along with other agents such as up to 10% glycolic acid, a sun protection factor (i.e. SPF) of 15 in those containing sunscreen as well as they all come in various forms (from creams to lotion to solutions) to make them appealing to different skin types. However, some formulations may be more irritating than others. In fact, these products take time to work, and results typically begin to be noticeable approximately 1 month after starting treatment.
Should we use the product on our entire face, a larger area or as spot treatment? It is good to use it on our entire face or a larger area in order to avoid the "halo" effect (i.e. a ring of lighter skin around the spot though it is usually reversible but often disconcerting as it often take weeks to months to resolve by itself).
The complications from using hydroquinone products are minimal and uncommon and usually have to do with the product ingredients rather than the hydroquinone. In general, glycolic acid and retinoids can be irritating to the skin, not to mention the liquid or gel that comes with it.
Nevertheless, an uncommon complication called exogenous ochronosis from using hydroquinone have been found more commonly in African Americans and those with longer-term use of hydroquinone or higher concentrations of the product. Exogenous ochronosis is a condition of the skin that leaves dark brown or black spots that are mostly in the areas of treatment. It often reverses when the treatment is discontinued but can in some cases be permanent. Another noticeable reaction when using higher concentrations of hydroquinone (i.e. at 10% or higher) for an extended period of time often resulted in permanent and unpredictable bleaching of the skin.
So, do you now have some ideas on how to prevent acne scarring or help your acne scars heal faster?
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