Acne Blemish or Acne Scar? The Difference and Treatment

Medical Aesthetic Solutions for Acne and Acne Scars: Return to Smooth Skin

Acne is a common skin condition that affects millions of people and is not limited to adolescence but can persist into adulthood. But most of the time, the real struggle begins after the active pimples have passed. The stubborn red and brown spots, sunken or raised scars left behind by acne can deeply affect a person's self-confidence and disrupt the smooth texture of the skin.

Not all marks left on the skin after acne clears up are the same. Some of what my clients refer to as “acne scars” are actually hyperpigmentation, while others are true scars; they form in different types of tissue and require completely different treatments. Misdiagnosis is the most common cause of a treatment process that goes to waste for months.

As Dr. Melis Ulger Istanbul, Kadikoy’In my clinic, I explain how I make this distinction and which method works best in which situations. For treatment options and the process, acne scar treatment You can take a look at my post.

"Understanding the Difference Between "Scar" and "Blemish": The Right Diagnosis for the Right Treatment

Before starting treatment, the most critical step is to correctly diagnose what my patients call “acne scar”. Because “spot” and “scar” are completely different conditions and require different treatments.

Stain (PIE and PIH): Color Problems

These are scars with no tissue loss or swelling on the skin surface, only discoloration.

• Post-Inflammatory Erythema (PIE): These are “red” or “pink” spots that remain after the pimple has gone. This is caused by damage or dilation of the underlying blood vessels. It is usually seen in fair-skinned people.
• Post-Inflammatory Hyperpigmentation (PIH): As a result of the inflammation caused by acne, the skin in that area overproduces melanin. It appears as “brown” spots and is more common, especially in people with dark skin.

Scarring (Atrophic Scars): Tissue Loss and Depressions

These are permanent and structural defects caused by damage to the collagen tissue in the lower layers of the skin. They appear as pits in the skin.

• Icepick (Ice Pick) Scars: Narrow but deep pits that look as if a thin ice pick has been stuck into the skin.
• Boxcar (Wagon) Scars: They are usually larger, sharp-edged, “box”-like depressions.
• Rolling (Wavy) Scars: Depressions with a wide, wavy appearance caused by fibrotic bands under the skin pulling the skin downwards.

The right treatment is planned according to which (or a combination of) of these types of scars and blemishes you have.

Solution 1: For Active Acne Control and Superficial Blemishes (Hydrafacial)

The first rule of scar treatment is to prevent new scars from forming. This starts with controlling active acne. Hydrafacial, is the perfect support in this regard. With its patented Vortex technology, it deeply cleanses the skin without irritating it, vacuuming excess sebum and dead cells that clog pores. Solutions containing salicylic acid, especially used in the acne protocol, help prevent new acne formation by cleaning the inside of the pores. Blue LED Therapy, on the other hand, calms the skin by destroying acne-causing bacteria. Hydrafacial is an ideal medical treatment to both manage active acne and reduce the appearance of superficial blemishes (PIH) by gently exfoliating the surface of the skin.

Solution 2: For Blemishes (PIH) and Skin Renewal (Mesotherapy)

When fighting brown acne spots (PIH), we need agents that regulate the skin's melanin production and brighten the skin. The most effective way to deliver these agents to the depths that creams cannot reach Spot Mesotherapy‘is. In this method, powerful spot lightening and antioxidant ingredients such as Vitamin C, Glutathione, Tranexamic Acid are delivered directly to the blemished areas of the skin via microinjections. This suppresses melanin production at the cellular level, evens out the overall skin tone and gives the skin a healthy glow.

Solution 3: Holistic Approaches for Depressed Scars (Atrophic Scars)

The treatment of sunken scars (scars), which are the most challenging and affect self-confidence the most, aims to replace the lost collagen tissue. There are two main medical aesthetic approaches to fill this “gap”:

Collagen Induction Mesotherapy and Microneedling

This is the most effective and lasting method, based on triggering the skin's own repair mechanisms. Through mesotherapy or microneedling (such as dermapen), thousands of controlled micro-damages are created on the surface of the skin. The body perceives these micro-damages as a “wound” and immediately starts the production of new collagen and elastin to repair that area. This process, also known as “Collagen Induction Therapy”, allows the skin to rebuild itself from the inside out. From these micro-channels, the skin is also supplied with a special supply of growth factors, hyaluronic acid and amino acids, which are essential for skin repair. mesotherapy solutions can also be applied to the skin. This method is particularly successful in reducing the depth of “rolling” and “boxcar” scars and improving the overall texture of the skin.

Instant Solution Scar Filler

Some deep and stubborn sunken scars (especially boxcar and rolling scars) may be adherent to the underlying tissue with fibrotic bands and may not respond adequately to collagen induction. For such specific dimples, hyaluronic acid-based dermal fillers an immediate solution can be offered. In this procedure, known as “Scar Filling”, the physician first releases the fibrotic band that pulls the depression down with a special needle (subsission), then injects a special filler compatible with the structure of the skin into the cavity. This instantly elevates the depression, equalizing it with the skin surface and providing a smooth appearance.

Why Combined Treatments Give the Most Successful Results?

Acne scar treatment is rarely based on a single method. The most successful results are achieved by cleverly combining these methods according to the patient's needs. For example, Kadikoy‘In our clinic in Istanbul, we can follow the following protocol for a patient: First Hydrafacial to deeply cleanse the skin and pores. Then, a series of treatments to improve the overall texture of the skin and superficial scars. Mesotherapy (collagen induction) session. If there are still a few deep depressions that are still evident at the end of the treatment, we will Dermal Fillers with the final touch. This synergistic approach allows us to address the problem at every layer to achieve the smoothest outcome.

Managing Expectations Correctly: Acne Scar Treatment is a Journey of Patience

The most important rule in acne scar treatment is patience. The results of treatments based on collagen induction (such as mesotherapy) in particular are not instant. It takes time for the skin to produce new collagen, and results usually appear gradually over 3 to 6 months. The aim is not to "erase" the scars 100% (which is usually impossible) but to improve the texture and quality of the skin by 50% to 80%, achieving a much smoother, healthier and more even appearance. Published scientific research (NCBI) also emphasizes the need for combined approaches and time for best results.

Acne scars are not your fate. With the right diagnosis, a personalized treatment plan and patience, it is possible to restore the health and smoothness of your skin. We are here to guide you on this journey.

Dr. Melis Ulger

Medical Aesthetics Physician

With modern medical aesthetic approaches, I address your aesthetic concerns by offering personalized solutions and support you to gain a timeless appearance.

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