How to Treat Pimples and Acne Scars on Dark Skin

Key takeaways:

• Acne, commonly known as pimples, is a common skin condition that can affect anyone during their teenage and adult years, regardless of gender, skin type, or color.
• Managing acne is an ongoing struggle, and even after seemingly conquering it, the aftermath of dreadful scars can dim not just your skin but also your self-confidence, especially if you have dark skin.
• Ways to treat pimples and acne scars on dark skin include using topical agents like retinol and glycolic acid, applying natural remedies like honey and tea tree oil, and opting for therapies like laser resurfacing and microneedling.

Dark skin is a unique skin type characterized by a higher melanin concentration than that in lighter skin tones. Asians, Latinos, Mediterraneans, Middle Easterners, Native Americans, Africans, and some colored-skin ethnic groups typically share darker skin tones (with Africans having the darkest shade) than Caucasians with lighter tones.

While this diversity is beautiful, those with darker skin tones may have specific skin challenges unique to them and more prevalent among them.

Pimples and acne scarring are such notable skin concerns for people with dark skin, and according to research, they have higher risks of experiencing dark spots called post-inflammatory hyperpigmentation (PIH) and stubborn scarrings that can outlast the acne itself and are often challenging to treat.

How to Treat Pimples and Acne on Dark Skin

If you didn't treat your pimples early enough and now have acne scars to deal with, several options like medical treatments, over-the-counter treatments, and natural remedies can tackle them. 

But before you start, it is crucial to consult a dermatologist specializing in treating dark skin to help diagnose your specific acne scar type and tailor the most suitable treatment option for your skin.

Below are different effective approaches people with dark skin can take to treat their pimpls and acne scars.

1. Medical Treatments

Medical treatments provided by board-certified dermatologists are the most effective methods for addressing acne scarring and pimples, irrespective of skin colour.

Some of medical treatments skincare experts recommend for treating pimples and acne on dark skin are:

• Oral medications: These include antibiotics like doxycycline and minocycline and anti-inflammatory drugs such as azelaic acid and isotretinoin. These medications target acne-causing bacteria while reducing inflammation, addressing both acne and its scars from within.
• Topical agents like clindamycin, erythromycin, retinoids, tacrolimus, and glycolic acid are applied directly to the skin to kill acne-causing bacteria and fade blemishes. They can be used individually or in combination with other modalities to prevent and treat acne scars.
• Hormonal therapies, particularly oral contraceptives such as Levofem, can be used to control hormones affecting acne and its scars. 

Combination therapies

In addition to oral medications and topical agents, if your acne scarring is severe, your dermatologist may recommend mild procedures like dermal filling, laser resurfacing, or microneedling to stimulate collagen production and smoothen your skin texture.

• Dermal Fillers: This procedure uses injectable substances, such as hyaluronic acid and calcium hydroxyapatite, to raise depressed areas of atrophic scars.
• Microneedling/Microdermabrasion: Microneedling involves using small needles to make tiny punctures deep in your skin, stimulate growth factor release, and increase collagen production and healing. This smoothens facial skin and helps improve rolling scars and PIH.
• Laser resurfacing: This procedure also treats atrophic scars by stimulating collagen production. It uses monochromatic light to deliver thermal energy to the skin without damaging the surrounding skin. 

For keloid scarring and other related skin conditions caused by acne, your dermatologist may advise the use of steroid shots, occlusive dressings, radiation therapy, cryotherapy, interferon treatment, cytotoxic drugs, or surgical removal, as opposed to treatments (like chemical peels and micro-needling) that work by inducing mild trauma to the skin, which may worsen keloids.

2. Over-the-counter (OTC) Treatments

OTC facial care products are the most common options people use for treating mild to moderate acne scars, and they work by reducing inflammation, unclogging pores, and promoting skin cell turnover. Common OTC treatments for pimples and acne scarring on dark skin include the following:

Retinols and Retinoids

These are vitamin A derivatives that help unclog pores and promote skin cell turnover, reducing acne scars and hyperpigmentation in dark skin. 

Retinols and retinoids are available in creams, gels, and lotions, such as tretinoin (Retin-A), adapalene gel 0.1% (Differin), and tazarotene (Tazorac). You can combine them with other acne treatments for more effective results for post-inflammatory hyperpigmentation (PIH).

Benzoyl peroxide

Benzoyl peroxide is one of the most common options for treating pimples and acne scarring because it kills acne-causing bacteria, unclogs pores, and reduces inflammation. It also helps reduce PIH in dark skin without bleaching when used in a low concentration (2.5%).

Examples of skincare products that contain benzoyl peroxide you should consider using for pimples and acne include:

• Clean & Clear PERSA-GEL10
• Kate Somerville Acne Clearing Lotion
• CeraVe Acne Foaming Cream Cleanser
• Neutrogena Rapid Clear Stubborn Acne Daily Leave-On Mask

Salicylic acid

This is a beta-hydroxy acid that helps unclog pores and reduce inflammation through its exfoliating properties, making it a popular acne scar treatment option. 

Salicylic acid works by dissolving dead skin cells, debris, and excess skin oil (called sebum) that may be blocking your skin pores. It also reduces the amount of sebum produced by the oil glands in the skin, reducing the chances of the oil clogging skin pores.

Popular skincare products that contain salicylic acid and are worth trying out include:

• SkinMedica AHA/BHA Exfoliating Cleanser
• Paula’s Choice, 2% BHA Liquid Exfoliant, and
• CeraVe Renewing SA Cleanser.

Azelaic acid

One of the many benefits of azelaic acid is its ability to suppress melanin production, reducing PIH. It also has anti-inflammatory, antibacterial, and anti-keratinizing properties, which help clear clogged pores.

Azelaic acid is often available as gels or creams and is typically found in 10% concentrations in OTC products and higher concentrations (about 20%) in prescription skincare products.

Here are some good products that contain azelaic acid, which can be effective for treating pimples and acne in dark skin: 

• Paula's Choice 10 Azelaic Acid Booster
• SkinCeuticals Phyto A+ Brightening Treatment Lightweight Moisturizer
• The Ordinary Azelaic Acid 10% Suspension Brightening Cream
• Peach Slices Redness Relief Azelaic Acid Serum

Broad-spectrum Sunscreen

The cherry on the cake is sunscreen. You can have the perfect acne treatment regimen, but if you don't apply sunscreen, your dark skin will be vulnerable to the sun's rays, which can do more harm than good to your skin. 

Sunscreen prevents further scarring and hyperpigmentation caused by excess sun exposure and reduces inflammation. Choose a non-comedogenic, fragrance-free, broad-spectrum sunscreen with SPF 50.

Recommended sunscreen products that should be part of your acne treatment routine include: 

• Eucerin Oil Control Face Sunscreen SPF 50
• EltaMD UV Clear Broad-Spectrum Facial Sunscreen SPF 46
• Neutrogena Clear Face Liquid Lotion Sunscreen SPF 50.

3. Natural Remedies

While medical and over-the-counter treatments are more effective for treating acne scars, they often come with drawbacks like itching, dryness, and a hefty price tag, which may clear out your pocket faster than your acne. 

Fortunately, there are simple and affordable natural remedies, which most people prefer, that you can use to treat your acne:

Honey

Honey is a potent natural remedy for acne, with antimicrobial and soothing properties that promote wound healing and reduce scarring.

Consider incorporating it into your routine by applying raw honey directly or combining it with ingredients like lemon juice or cinnamon for added benefits.

Tea Tree Oil

Tea tree oil contains trephine-4-ol, an antimicrobial and anti-inflammatory agent effective for treating inflammatory acne by targeting and killing acne-causing bacteria.

Choose 100% pure tea tree oil labeled "therapeutic" or "cosmetic grade," dilute it (1–2 drops per tablespoon) with a carrier oil like jojoba or olive oil, and test a small area before applying it to your acne.

Aloe Vera gel

Aloe vera gel is one of the most effective natural remedies for acne scars, known for its high antimicrobial, anti-inflammatory, antioxidant, and skin-soothing properties. As such, it can be used alone as a cleanser, moisturizer, or skin spot treatment.

To use aloe vera to treat pimples and acne on dark skin, scrape the gel from the aloe plant and apply it to clean the skin. For enhanced results, combine it with other acne treatments like tretinoin or tea tree oil, or create a nourishing mask with honey and cinnamon.

Citric Acid

Citrus fruits, including lemons, limes, and oranges, boast citric acid with anti-inflammatory, antioxidant, and exfoliating benefits for treating acne and scarring.

You can make a gentle exfoliator by combining lemon juice, coconut oil, and sugar, or a homemade facial mask using freshly squeezed lemon or lime juice, aloe vera, and honey in equal proportions.

Apply sunscreen afterwards, as citric acids can increase skin sensitivity to UV damage.

Zinc

Zinc is a vital mineral boasting many skin benefits, including its ability to lower sebum levels, making it an excellent choice for managing acne and inflammation.

You can incorporate zinc into your acne treatment regimen by consuming zinc-rich foods, e.g., whole grains, shellfish, seeds, and nuts, or taking zinc supplements. But discuss with a healthcare provider before starting a zinc supplement regimen for the appropriate dosage.

Final thoughts

Different things, including clogging of skin pores, hormones, inflammation that triggers excess melanin production, and popping of existing pimples, can contribute to or worsen pimples, hyperpigmentation, and acne scars in people with dark skin.

Luckily, these skin issues can be treated with the help of a dermatologist or some effective OTC skincare products. In cases where hormones are involved, your dermatologist may refer you to another doctor specialized in treating hormonal issues.

Keep in mind that although natural remedies are beneficial for mild-to-moderate acne cases, they are not a substitute for medical treatments recommended by a certified skincare expert. Consult your dermatologist before starting any natural treatments on your skin or if there are no improvements within weeks.