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Q&A / FAQ; POST INFLAMMATORY ERYTHEMA (PIE), POST INFLAMMATORY HYPERPIGMENTATION (PIH), HYPOPIGMENTATION SOLUTIONS - Red / Brown / White Wounds & Marks>>READ BEFORE POSTING

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HYPERPIGMENTATION (reds, browns and other colors, PIE, PIH), Hypopigmentation (white), TEXTURE, DRYNESS, & COVERING UP (makeup)
<If You Have Updates / Hints/ Tips for This Thread, or Questions, Please PM Me>
:smileys_n_people_105:Special Thanks for Contributors : Dan Owner of Acne.org, Dr Davin Lim, Dr Dray, Robertitoo, DeLovely  :smileys_n_people_105:

Disclaimer: The information below is provided as a courtesy to address general questions. As we are not medical professionals, we cannot be held responsible for the accuracy of this information. By reading this information, you agree not to hold us liable for any damages that may result in your use of this information. This information should not replace information that your Doctor, Dermatologist,  or Plastic Surgeon provides you. Please keep in mind that this is for general information only and results will vary for each individual and their bodies ability to heal.

TABLE OF CONTENTS:

1. HYPERPIGMENTATION GENERAL OVERVIEW
2. POST INFLAMMATORY ERYTHEMA - PIE (REDS)
3. POST INFLAMMATORY HYPERPIGMENTATION - PIH (BROWNS & OTHER COLORS)
4. HYPOPIGMENTATION (WHITES)
5. MAKEUP GUYS & GIRLS
6. TEXTURE, EXTREME DRYNESS, & COVERING UP SPOTS, LARGE / SCARED PORES
7. SKINCAREADDICTION - REDDIT DISCUSSING PIE TREATMENTS
 
** Please Note: Acne Scars (pits), see this Mega Guide, Hyperpigmentation is not scarring. 
 

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1. HYPERPIGMENTATION GENERAL OVERVIEW

06-hyperpigmentation.jpg.2ffe753516f82198d9e2dc94b9147b41.jpg
 

Q: Where do I start?
A: Hyperpigmentation takes a long time to heal. You can try to simply wait it out...but it never hurts to try and heal your spots naturally:

  • Aloe vera gel + honey and vitamin K (gets rid of bruises and red) keeps the spots moist creating quicker healing.


OR

  • You can use Emu oil or triple antibiotic cream to keep your wounds moist (Note: this breaks out some people so please spot test). In the morning you use cool water to cleanse your face. Use diluted white vinegar and pat (not rub) the face to sterilize it. Moisture with a pure 100% Hyaluronic Acid Serum, this avoids skin irritation.
  • Fresh lemon has helped some people fade their spots and also topical green tea.
  • Topical Vitamin C serum can help some fade their reds and browns and in others it has irritated their skin. Always wear sunscreen. In the morning you use cool water to cleanse your face. Use diluted white vinegar and pat (not rub) the face to sterilize it. Moisture with a pure 100% Hyaluronic Acid Serum, this avoids skin irritation. These spots can take months to heal being irritated wounds, the remnants of acne or other skin issues.


If this doesn't work stronger treatments are below>>

 
 
 

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2. POST INFLAMMATORY ERYTHEMA - PIE (REDS) 
- red spots that turn white after being pressed on
   

 

  

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Q: What Is Post Inflammatory Erythema (PIE)? 
A: Post Inflammatory Erythema (PIE) describes pink to red discoloration after an inflammatory acne lesion. Patients with lighter skin types (I-III) the post-inflammatory dyspigmentation is often not hyperpigmentation, but instead discrete erythematous macules (PIE). Acne may not be the only cause of post inflammatory erythema, as any resolving cutaneous inflammatory process may have residual erythema.

  • Treatments (ranked most effective to least): V-beam, or IPL, or Excel V, or 1064nm (vascular laser can help these areas quickly by making the body dissolve the trapped red blood / surface veins), steroid creams from the derm,  Retin-A Cream, Bactroban cream, Silicone Sheets and topicals (known as scar gels), 2.5% hydrocortisone twice per day (only for a weeks time - it thins the skin), triple antibiotic. Some find light (%) peels helpful like Salicylic Acid or Glycolic (Acne.org has an excellent one in the store)... Your skin must not be raw, overly thin, or any allergy to aspirin (Sali) . Please do not use Scrubs, Harsh Soaps or Exfoliants that prolong the wounding. Emu Oil, Honey, Aloe Vera, and Green Tea are soothing / healing. Visine aka red reducing eye drops temporarily reduces the red and concealer (makeup), while you heal.
  • Sunless Tanner helps mask discoloration (higher % the darker, can do application over 3 days), use alcohol based toner over the area first to get off oils and residues, wear gloves, moisturize boney parts as they pick up tanner more. 
  •  Picosure is a great treatment (non - ablative). IF you have Ethnic Skin (Asian, Indian, Mediterranean, Black/African,etc...), it works well because you have more collagen in your skin. Works perfect for your skin type. This promotes new collagen, is a alternative to vascular laser for lighter skin types, and gets rid of the PIE.

tattoo-removal-procedure-1024x446.jpg


How to care for Erythema
First, get your skin completely clear from active acne. This way you are preventing any future Erythema. Once you are clear, you can try a Erythema treatment above to reduce the marks you might have. Topical treatments are the first choice for treating Erythema. The treatments most commonly prescribed by dermatologists are Steroids.

hyperpigmentation-image-2.jpg

Erythema is common among people of Caucasian descent. Erythema can also occur in darker skin, albeit less frequently. UV light – the light from the rays of the sun – can make Erythema worse and cause it to remain longer. However, it is not clear whether UV light worsens acne itself, as research studies have reported that UV radiation can both increase6 and decrease7 acne. Regardless, for all skin types, it is important to take appropriate steps to protect your skin from excessive sun in order to avoid worsening of Erythema and allow any Erythema you currently have to heal as fast as possible.

How to prevent Erythema
Picking at acne lesions is the worst culprit when it comes to creating Erythema. Absolutely do not pick at acne lesions. Properly pop a pimple only when it is ready to be popped, and then leave the lesion alone. Also, while it may seem intuitive to scrub marks away, harsh scrubbing will only prolong their duration and should be avoided. Be sure to wash gently. Next, as mentioned, keeping Erythema skin out of the sun when possible is a huge help in allowing these marks to fade as quickly as possible. Wearing a sunscreen is important as well.

The best way to prevent hyperpigmentation is to treat the acne itself, thus preventing future acne lesions and any Erythema that they might leave behind.10 Acne is treated the same regardless of skin color and responds extremely well to proper topical treatment with benzoyl peroxide. When acne is severe, widespread, and deeply scarring, Accutane (isotretinoin) is also an option.
 
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3. POST INFLAMMATORY HYPERPIGMENTATION - PIH (BROWNS & OTHER COLORS) 
- brown spots or red that stay after being pressed on

 
Q: What Is Post Inflammatory Hyperpigmentation (PIH)? 
A: Post Inflammatory Hyperpigmentation (PIH) is related to brown spots, and permanent red spots. The discolorations are caused by an excess production of melanin. Vitamin C, Glycolic, Hydroquinone (skin bleaching cream) are all great tools for inhibiting melanin which will fade the discoloration. PIH is more common in darker skin types (Fitzpatrick IV-VI), although it is not limited to any skin type.
  • Treatments ( ranked most effective to least): V-beam, or IPL/ photofacials, or Excel V, or 1064nm, or QuadroStar Pro Yellow Laser (vascular laser can help these areas quickly by making the body dissolve the trapped red blood / surface veins), Alpha Hydroxy Acid peels: glycolic * good also for smaller pores, TCA, Mandelic (Acne.org has an excellent one in the store), Skin bleaching creams (aka hydroquinone or Kojic cid w/ Arbutin), Retin-A Cream for cell turnover, Vita-K cream for Blotchy Skin .
  • Sunless Tanner helps mask discoloration (higher % the darker, can do application over 3 days), use alcohol based toner over the area first to get off oils and residues, wear gloves, moisturize boney parts as they pick up tanner more.  
  • Picosure is a great treatment (non - ablative). IF you have Ethnic Skin (Asian, Indian, Mediterranean, Black/African,etc...), it works well because you have more collagen in your skin. Works perfect for your skin type. This promotes new collagen, is a alternative to vascular laser for lighter skin types, and gets rid of the PIE.

tattoo-removal-procedure-1024x446.jpg

d4181-melasmaforehead.jpgaha-16.jpg

How to care for hyperpigmentation
First, get your skin completely clear from active acne. This way you are preventing any future hyperpigmentation. Once you are clear, you can try a hyperpigmentation treatment from above to reduce the marks you might have. Topical treatments are the first choice for treating hyperpigmentation. The treatments most commonly prescribed by dermatologists are hydroquinone (HQ) and retinoids.

Hyperpigmentation sun exposure
Hyperpigmentation is common among people of African, Asian, and Latino descent, as well as other forms of non-Caucasian skin.1-5 Hyperpigmentation can also occur in Caucasian skin, albeit less frequently. UV light – the light from the rays of the sun – can make hyperpigmentation worse and cause it to remain longer. However, it is not clear whether UV light worsens acne itself, as research studies have reported that UV radiation can both increase and decrease acne. Regardless, for all skin types, it is important to take appropriate steps to protect your skin from excessive sun in order to avoid worsening of hyperpigmentation and allow any hyperpigmentation you currently have to heal as fast as possible.

How to prevent hyperpigmentation
Picking at acne lesions is the worst culprit when it comes to creating hyperpigmentation. Absolutely do not pick at acne lesions. Properly pop a pimple only when it is ready to be popped, and then leave the lesion alone. Also, while it may seem intuitive to scrub marks away, harsh scrubbing will only prolong their duration and should be avoided. Be sure to wash gently. Next, as mentioned, keeping hyperpigmented skin out of the sun when possible is a huge help in allowing these marks to fade as quickly as possible. Wearing a sunscreen is important as well.


The best way to prevent hyperpigmentation is to treat the acne itself, thus preventing future acne lesions and any hyperpigmentation that they might leave behind.10 Acne is treated the same regardless of skin color and responds extremely well to proper topical treatment with benzoyl peroxide. When acne is severe, widespread, and deeply scarring, Accutane (isotretinoin) is also an option.

Hydroquinone 

hyperpigmentation-image-4.jpg

Hydroquinone is the first choice of treatment for hyperpigmentation.12 It is normally used at a concentration of 4%. In higher concentrations it can cause "spotted halos," which appear as lighter colored ring around marks. Hydroquinone treatment results in a marked improvement or complete clearing of PIH in 63% of the patients.4 The efficacy of hydroquinone may be increased by the addition of a retinoid and a low potency corticosteroid, such as hydrocortisone.13 Side effects of hydroquinone include burning, redness, and itching in 30% of the patients.12 The addition of ascorbic acid (Vitamin C) to a topical hydroquinone treatment may help minimize side effects.2-3 Hyperpigmentation starts to subside after 4 weeks of hydroquinone treatment, but maximum results usually require 8 to 12 weeks of treatment. Be certain to work closely with your physician or dermatologist if you decide to use hydroquinone to ensure proper dosage and reduction of side effects.

Tretinoin/Adapalene/Tazarotene/Differin


hyperpigmentation-image-5.jpg

Tretinoin (Retin-A®), Adapalene (Differin®), or Tazarotene (Tazorac®). Retinoids are vitamin A analogues that are typically used together with hydroquinone. Retinoids are topical treatments that can help fade marks and treat acne at the same time. According to the Journal of the American Academy of Dermatology, “Of particular significance to skin of color patients is the ability of retinoids to treat both acne and PIH. By increasing epidermal turnover, these agents facilitate melanin dispersion and removal.” A study published in The New England Journal of Medicine on people with skin that was darkened by hyperpigmentation showed that daily retinoid treatment resulted in “much lighter” skin in 53% of participants and in “somewhat lighter” skin in an additional 33% of patients.

If retinoids are used alone and not in combination with hydroquinone, dermatologists often prescribe a topical corticosteroid in order to reduce the irritation and potential worsening of PIH that retinoids can cause when they are used alone. An expert opinion in Skin Therapy Letters sums it up: “The use of retinoids as monotherapy is not recommended as an irritant reaction may cause inflammation that induces paradoxical hyperpigmentation; a similar concern exists over the use of HQ as monotherapy at very high concentrations (i.e., 8-20%).”

Retinoids typically take 8 to 12 weeks to produce maximum results. The frequency and concentration of retinoid therapy depends on the severity of hyperpigmentation and should be determined by a dermatologist.


Niacinamide, also known as Nicotinamide.
hyperpigmentation-image-6.jpg

Niacinamide is a B vitamin that can be administered topically, and is currently being investigated as a potential therapy for hyperpigmentation. A study published in the journal Cutis in 2015 showed that a topical cream containing 4% niacinamide in combination with the other pigment-lightening and anti-inflammatory compounds arbutin, bisabolol, and retinaldehyde reduced hyperpigmentation due to melasma by 34% over a period of two months. Melasma is a common skin problem where brown marks appear on the face due to pregnancy or sun exposure.15 To date, there exists no published research that has investigated whether niacinamide is also effective in treating PIH, but studies are currently in progress.

Azelaic Acid


hyperpigmentation-image-7.jpg
Azelaic acid is another topical acne prescription that is sometimes used for PIH that works by slowing down the production of melanin. It is a gel that doctors normally prescribe in 20% concentration for PIH, applied twice a day. Azelaic acid is safe and effective for the treatment of both acne and PIH conditions in darker skin types. Common side effects include mild redness, scaling, and burning.16 Due to the mechanism of action of azelaic acid, results are not seen for the first few months of azelaic acid treatment, but results are eventually seen after six months.

Gentle Chemical Exfoliation


hyperpigmentation-image-17.jpg
Over-the-counter glycolic acid products are available in strengths up to 10% and can provide gentler chemical “peeling,” which is better described as gentle chemical exfoliation. At lower percentages in over-the-counter products, glycolic acid does not cause the skin to visibly peel off in sheets like professionally administered chemical peels do, and instead provides exfoliation of only the surface cells of the skin. This is a slower and safer way to achieve the skin turnover required to reduce hyperpigmentation and can be used on a more frequent basis when compared to chemical peels. Most people find that they can tolerate over-the-counter 10% glycolic acid products every two or three nights, or every night when mixed ½ and ½ with moisturizer.

Acne.org AHA+ & Alpha Hydrox Enhanced Lotion

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4. HYPOPIGMENTATION (WHITES)
     - white spots (loss of pigment)

Q: What Is Hypopigmentation? 
A: Hypopigmentation is: Vitiligo, pigment loss due to burns, scars, skin discoloration.

  • Sunless Tanner helps mask discoloration (higher % the darker, can do application over 3 days), use alcohol based toner over the area first to get off oils and residues, wear gloves, moisturize boney parts as they pick up tanner more. 
  • Treatments: XTRAC Excimer Laser at 308nm or Light Box phototherapy treatments UV-B lamp, Melgain (Decapeptide - Basic Fibroblast Growth Factor), and microneedling at home. Clinics use costly Recell which only has a small percentage of working on scars. A new spot treatment is LATISSE (bimatoprost ophthalmic solution) to darken the hypopigmentation and and cause "some" pigment to slowly return. Checkout the link below for how a member fixed his hypopigmentation. If nothing works there is medical tattooing http://basmahameed.com/paramedical/surgical-scars.php
  • Read More here:

https://www.acne.org/messageboard/topic/352685-recell-for-hypopigmentation-burn/?page=5

littekens2 (1).jpg


 
 
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5. TEXTURE, EXTREME DRYNESS, & COVERING UP SPOTS, LARGE / SCARED PORES

 
Q: How do I improve my large pores, and orange peel texture?
-- Please See the Filler and Subcision Section below for a detailed description for scars.

A: At Home

  • Retin-A - Increases Skin turnover production.
  • BHA (Glycolic acid peels) like you find from Acne.org store above or MUAC (Google It). 
  • Microdermabrasion
  • Microneedling (Derminator - Dermastamping) 
  • The Ordinary or Paula's Choice 10% niamincide booster. Niamincide has been proven to thicken skin and shrink pores.
  • There is a cream called Benefit Cosmetics "Pore"fessional that blurs these spots, used as a primer under makeup or by itself.
  • TCA Cross using 35% (multiple coats 10X), you need a very tiny way to either get into the pore and not hit the walls doing a little at a time until they heal. Some have used a shaved down toothpick to fit inside pores or ice picks.
  • For a larger area you can spot treat with TCA full peels (spot treatment on your scars 35% and under, start at 15% and move up, do a test spot to see how your skin reacts before going crazy - see peel section below). Always degrease with acetone or rubbing alcohol and a pre-peel jesner / glycolic peel  before.  You can do a few at a time, so you can cover with makeup.


Doctors treatments For Surface Texture and Large Pores:

  • TCA Cross to individual pores. 
  • RF Needling shrinks pores
  • Fraxel 1927nm high density is especially good for scarred pores, Clear and Brilliant, Fractional CO2 laser, Laser Genesis (pores and surface texture).
  • Punch Floats or Excision (pores - see below for description).
  • The Most costly is a deep sedated Phenol peel, this should be your last solution if all else fails, ... the doctor must go deep enough to get under the scars (surface texture).
  • Fully Ablative Erbium laser Resurfacing Also known as a Deep Laser peel (surface texture - this is not fractional laser).
  • Filler injected throughout the cheeks (field subcision) not specifically for the scars (broad filling to plump the skin). Over Dilute Sculptra is great for this (pores and surface texture).
  • Skin Boosters help some also called Meso. This benefit does not last long before a top up is needed. This hydrates and plumps the skin a bit but will not work for all but the most shallow/ small scarring (pores and texture).  
  • Sublative (ematrix) is good for surface texture takes many treatments, results are subtle like laser genesis (pores and surface texture)..
  • PDT (Photo Dynamic Therapy) using led blue light and medication to shrink pores
  • Microneedle .05mm followed by botox to the pores superficially shrinks them.


 

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6. MAKEUP GUYS & GIRLS

Q: Can Guys Do Anything to Cover Their spots and Help with Self Esteem?
A: Guys you can be as manly as you want and wear makeup (the ladies have had this tool for some time).
Hear me out. Movie stars, news anchors, models, musicians, Youtubers, and even politicians wear makeup. Buy a concealer for just your acne scars and spots (spot treat them). You want it to match exactly your skin color and not be shiny ("matte"). My favorite is sold at Sephora (they color match you) Makeup Forever Camouflage Concealer, this looks extremely natural on the spots. Dermablend is sold at Macy's and Nordstrom. This is used for medical scars and to cover tattoos (they match your color) and it's very thickly pigmented. Ben Nye Cover All Wheel and Bill Nye Concealer Wheel sold on Amazon and Ebay (it has various shades), this is used in the theater.  Other options include tinted sunscreen. Benefit Porefessional blurs pits and pores with no coloring. Sunless or Spray on Tan can hide acne scars and issues quite well. Beards and facial hair. For the body tattoos cover scars or medical tattooing is pigment to match your skin color. Also Sunless tan products.  
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Q: What can I do for extreme dryness, bumpy or bad texture, small wrinkles, or marks?
-- Please See the Filler and Subcision Section below for a detailed description for scars and the orange peel and large pore section above.

A: Moisture with a pure 100% Hyaluronic Acid Serum, this avoids skin irritation or ...

  • Skin boosters or Meso Treatments (very popular in Europe and Asia) like Restylane Vital, Juvederm Hydrate or other HA products are not crosslinked like what is used in filler and much more superficial (just under the epidermis). Filler provides lift; but boosters are different making a bunch of small injections to provide intense hydration, minor skin correction, and small textural improvements. https://www.acne.org/messageboard/topic/357406-skin-boosters-restylane-vital-hyaluronic-acid/
  • Sculptra Filler Injections is well known for collagen production
  • Cerave moisturizers, Vaseline/ Aquaphor (but this can clog pores so use in a emergency or post procedure). 
  • Omega 3 Fatty Acids, Fish Oil, Coconut Oil, Nuts, Salmon, Eggs, Oilve Oil, Flaxseed, Fish, Kelp.
  • Silicone primers and Benefit Porefessional blurs imperfections. 
  • Sunless or Spray on Tan
  • Retin - a / Tretinorin / Differin products
  • You may have fungal acne creating this texture, have your Dr check or try a sulfur soap.
  • Repair Moisture Barrier (often by those who over exfoliate or have to many laser procedures and get rid of the epidermal protection of the skin, Google It)
  • Acid Peels (See Section).
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7. SKINCAREADDICTION - REDDIT DISCUSSING PIE TREATMENTS

- What are my options to reduce acne scars? My skin is reacting badly to Lactic Acid 5% + HA 2% & Granactive Retinoid 5% in Squalane

 

  • fnsvyn0dyc021.jpg

    ShadesofRainbow 

    How has your skin been reacting to the retinoid? Peeling is actually a good sign, but sometimes people are afraid of it. Hydroquinone is a really great scar lightener, but most strong ones are prescription. However Paula’s Choice seems to be a pretty good one. Just be aware it will bleach your pillowcase and you absolutely need to wear sunscreen with it. That also goes for retinoids, however you usually wear those at night. You also need to consistently apply it every day.

    Oh and be sure to moisturize! It will definitely be drying to your skin.


    Baloney4breakfast

    Skin cosrx snail mucin

    inthegloww

    Maybe try a gentle acid like PHA serum. GOW by Victoria health has one and it is so gentle Also mandelic acid is really gentle and the ordinary has one. For retinol I don’t like the granactive one because even though my skin isn’t sensitive I didn’t like it. You can try the 0.2% retinol in squalene.

    elohra_2013

    Microneedling treatments are great. Talk to a dermatologist.


    inthegloww 

    Maybe try a gentle acid like PHA serum. GOW by Victoria health has one and it is so gentle Also mandelic acid is really gentle and the ordinary has one. For retinol I don’t like the granactive one because even though my skin isn’t sensitive I didn’t like it. You can try the 0.2% retinol in squalene.


    squarepants  

    I’ve always used aloe vera gel specifically for this. It’s not very expensive, very gentle on the skin and also helps with redness.


    SortofLike 

    Differin! I swear by it. I didn't notice much of a difference in a week or so, but after that things faded rapidly until spots were totally gone. And now I don't fret when I get a pimple every now and then because I know it will totally disappear without a trace within days.


    nyclittleone

    Hi; micro needling, (little needles rolled over the scaring: causes skin to produce collagen while little “injuries” heal thereby filling in scar and exfoliating away scars. strong Vitamin C, licorice root extract, salicylic acid peel, Check with dermatologist!oil free sunscreen to prevent darkening and deepening of scars.

    monkeygonetoheaven3 

    Joining in the choir for vitamin c! AHA plus retinol is a bit intense though. I'd try just the acid mix or just the retinol for a while and see if it improves.

    pannerin

    Your skin is reacting badly but it's currently the face on the right?

    For reactions, drop one of the products and use the other for a month without changing anything else. Using both at the same time from the get go would be too much for the skin barrier. The retinoid I think has a higher potential for sensitivity. But if you're not using a sunscreen, solidify your sunscreen option first before using products that increase photosensitivity.

    butyourenice 

    AHA for PIH or PIE. For texture, thousands of dollars and Fraxel are your best bet. For icepick scars, TCA cross. I personally recommend going to a plastic surgeon that specializes in scar revision for the best cosmetic result, vs. a dermatologist, just based on my own experience.

    You should see improvement but it’s not likely you’ll get your skin back to perfectly smooth though.

    Joe21599 

    I use snail/bee venom, sounds dumb but has been working for me

    littlebo_weep

    Hydroquinone

    1M8M 

    A good Vitamin C serum and a derma roller. It tooks 6 months, but my skin is finally clear of acne scars. I used it twice a week and then reduced it to once a week once I stared clearing up.

    LuciaCorrado2  

    Microneedling

    MaiInTheCity 

    I had pretty bad hormonal acne for years, and using rosehip oil has healed my skin so much. Scars are barely noticeable now and makeup artists/facialists often comment on my skin. Also, this might be obvious, but spf 50 every day! I use Anthelios.

    cmbechte 

    Microneedling or Ematrix which is Sublative RF For early Scarring

    kirstenruby 

    Did you build up slowly to the 5% retinoid? My skin can’t handle AHAs while I’m getting used to a retinoid.

    little-bird

    agreed! it took me a while to get used to the 2% retinoid formula (and while my skin is normally sensitive, anyone's will be extra-sensitive due to recent Accutane treatment).

    SCATestuser 

    You might want to start with the 2% formula, using it 2-3 times a week for a month or so before using it every night. I've been using the 2% formula for about a year and I'm only just starting to incorporate the 5% formula into my routine, and it's still causing some flaking/purging when I do!

    cutspaper  

    I think there can be issues that crop up when retinoids come into contact with acids, as I recall reading here.

    Johoneoh4  

    This should be higher up. Introducing too many products too quickly, or lots of actives at once has wreaked havoc on my skin in the past. It needs to be done incrementally. It was almost never the products, just the way I was using them, which would make my skin freak out.

    acualemur

    I've heard microneedling can help a lot with acne scars but I've yet to try it myself.

    Mitch_Mitcherson

    From the testimonials I've read on here, it's a temporary fix, like botox: eventually it wears off, and you have to get it done again.

    monkeygonetoheaven3 

    Microneedling helped with mine, but definitely get a professional to do it. Done improperly, it can lead to serious infections.

    kait884 

    You can try a vitamin C serum. My personal fav is C-Firma by Drunk Elephant.

    irissmooches 

    Seconded. Vitamin C helped to heal all my old acne scars, and when I get a new spot (much rarer these days) it nukes the redness very quickly. I also use DE's C-Firma.

    AlluvialPlain

    It's not as intense as acid peels and takes longer for results, but I like Alpha renewal lotion - 10% glycolic acid. I used to use it nightly to help with PIH - it also made my skin smoother and brighter

    SCATestuser

    I tried all kind of stuff and my acne was really bad so I went to a doctor and used accutane for 6 months. I'm pretty happy now but I would like to reduce acne scars as far as possible of course. Any tips? I feel like my skin is not reacting well to acids because everytime I tried them I got more pimples the day afterwards.

    sparklyoctopus 

    Have you tried Alpha Lipoic Acid? I’m pale like you and this stuff cleared up dark spots and cystic acne scars that I’ve had for 15 years.

    I use this one, I’m sure there are others: https://theordinary.com/product/rdn-alpha-lipoic-acid-5pct-30ml

    LikesGreenTea

    Recs to even your skintone:

    atomicalexx 

    I'm sort of in the same situation as you right now. Had bad acne, got rid of it, now have a ton of scars.

    I've been using Advanced Snail 96 Mucin Power Essence from Cosrx, I literally saw results the morning after using this! I definitely recommend it. I've also recently started using the Klairs, Freshly Juiced Vitamin Drop after the Snail Essence as well. It's basically a Vitamin C serum. It's been a week with these two and my scars are already fading and my skin tone is brightening which is a plus!

    P.S. if you have sensitive skin like me, I definitely recommend looking into Cosrx products because they use mainly natural ingredients so their products are very gentle on the skin  Good luck! 

    What are your HG brightening products?

    Some brightening products I've tried before:

    • C20 Serum. The most brightening product I have ever tried in my life, hands down. It showed me the effects as early as the next day. I would pay top money for it even if it oxidises so fast. It's that good! But it broke me out in cysts by Day 3.
    • CosRx Galactomyces Whitening Power Essence.I haven't used this that much, but so far it has done nothing in terms of brightness/whitening. I would continue using it, but seems like it's making my skin oilier than usual.
    • Hada Labo Shirojyun Arbutin Lotion. This did brighten my skin a bit (not sure about whitening), but it broke me out in forehead whiteheads.
    • I was wondering if you guys use any product that brighten as much as C20 does? I'm going to use Melano CC next, but I don't think it brightens as much as it fades PIH? Thoughts from Melano users?

    What Products have delivered? - PIH, Pigmentation, Brightening, Whitening, Uneven Skintone. [Discussion]

    There are many products out there that claim to do a lot but not many deliver when it comes to pigmentation. I know that Vitamin C, Licorice, Arbutin, bear-berry, AHA's & Niacinamide are some ingredients that have proven to be effective.

    However, let us discuss products and not ingredients that have proven to be most effective to cure any of the above issues. How long did they take to show results? Did the product stop working after a while? What issue did it address the best? How long the results lasted? Did you repurchase?

    For me, I have major PIH and some Pigmentation issues. While I am still work in progress, Vitamin C has worked out the best for me. I tried OST C20 and it definitely has visibly helped to even out mt skin tone and lighten my scars. I am on my 2nd bottle and the impact / progress has slowed but I still think it takes about 8 - 12 weeks for dark spots to start going away for me. I think it has hastened the process.

    Another product would be Deciem Alpha Arbutin 2% + HA - This hasn't specifically helped with evening skin tone, however it did help dark spots better. I am about to finish a bottle in a day or two and have a backup stocked. I used it specifically on one side of my face where I have more spots and I saw no help with pigmentation, however the spots seem to be fading out better.

    Apieu Milk One Pack Mask - This is a cheap and good mask. The brightening effect is immediate but short term, the glow lasts for a while. The moisturizing is pretty decent too. The fit and sheet quality is cheap. I liked Coffee the best but Milk & Green Tea were good aswell. It's loaded with essence, like seriously too much essence. I would repurchase, its cheap and effective at brightening.

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