Unfortunately for individuals of darker skin tones like myself, treating deep acne scars and marks poses a major challenge mostly due to high risk of hyper-pigmentation in darker skin.
Challenges of treating acne scars on dark skin
Although, there is headway being made in the field with new technologies like Fraxel restore series, a non-ablative laser that works like an ablative laser and claims to be effective in treating deep acne scars and other textural skin issues without targeting the pigment in the skin, individuals of darker skin tones would still need to proceed with caution as more studies need to be done on the short and long-term effects on our skin levels.
Understanding how acne scars are formed
To understand the challenge of treating deep scars on darker skin, let’s better understand scars and how they form. When the skin endures some sort of trauma such as acne, the skin responds by creating soft tissue or collagen in the area of the trauma as a way to heal the damage done to the dermis. Now the new tissue created is never as strong or smooth as tissue in the unaffected areas and these are what we see as scars.
The intensity of the trauma will determine the depth of the tissue created or scarring and the type of scar created. A more intense trauma usually means a scar tissue that extends far deep in the layers of the skin. Remember, the skin is made of multiple layers.
On darker skin tones, our abundant melanin is what gives us our beautiful olive, brown or black coloring. The melanin is produced by melanocytes which can be located in the deeper layers of the skin and herein lies the problem with treating acne scars on darker tones.
To effectively treat deep acne scars, the procedure would have to penetrate deep in the layers of the skin to target the root of the scar tissue. However, the deeper penetration required means that there is high risk of triggering the melanocytes to overproduce which means a high risk for dark spots or hyper-pigmentation. There is also the risk of destroying or depleting the melanin cells which could lead to hypopigmentation where the skin loses its natural coloring.
The trick is in finding treatments that penetrate deep into the layers of the skin to target the scar tissue without stimulating melanocytes and this is where we find the limitation. Traditionally most cosmetic technologies are geared towards individuals of fairer skin tones as test studies are usually performed with patients of their skin tones. As technologies improve hopefully we will see more test studies and treatment options for a wider variety of skin tones.