The 4 Types of Acne Scars—and How to Get Rid of Them All

With a whopping 40 to 55 percent of today's adult population suffering from persistent breakouts, acne is a more common daily annoyance for grown-ups than you'd think...which seems so cosmically unfair. There should be a rule that we only have to deal with pimples or fine lines, dammit.

The good news is that there are much, much better face wash options, medications, and topicals available today than back in your high-school days. The only downside is that even if you are able to clear up breakouts, you might be left with acne scars that permanently reside on your face. (Double ugh.)

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"Acne scars are very challenging to treat and are even more challenging to treat once they've been given time to age," says Joel Schlessinger, M.D., a board-certified dermatologist in Omaha, Nebraska. Although he says the best option is prevention (but if you just can't resist popping your pimples, do it the doctor-approved way!), there are ways to treat acne scars to drastically reduce their appearance.

Here's why you're noticing scars on your pretty face in the first place—and what dermatologists recommend to get rid of them.

Why do acne scars form in the first place?

Even if you have amazing willpower—like the willpower of a Girl Scout with a full inventory of Thin Mints under her bed—and never, ever mess with your acne, you can still scar. "Acne scars result from damage to the skin following repeated inflammation from acne cysts," says Judith Hellman, M.D., a board-certified dermatologist in New York City. "Pimple popping can make the process worse, but acne can cause scarring even without pimple popping."

How big of a scar you'll be left with after a blemish (if any at all) depends on the depth of the breakout, Schlessinger says. "As our pores become engorged with oil and form a blemish, the pore may swell and collapse the follicle wall," he says. "The depth of the resulting lesion determines the severity of the scar. Shallow lesions usually heal quickly and leave little-to-no scarring, while deeper lesions spread to nearby tissue, causing a more pronounced scar."

If you see scars form, Hellman says they are likely one of these four types:

• Ice-pick scars: deep, narrow, pitted scars
• Rolling scars: broad depressions with a sloping edge
• Boxcar scars: broad depressions with sharply defined edges
• Atrophic scars: flat, thin scars or depressed scars

There's an over-the-counter option... right?

You can apply all the topicals you want, but unfortunately, most treatments you'll find at the drugstore won't help with acne scars, Hellman says. However, she notes that derma rollers (at-home microneedling devices) may help with acne scarring. If you're on a tight budget, that should be your first stop. You can get one on Amazon for less than $20. (Use yours once a week followed by a Vitamin C serum for best results—here's how to pick the best ones.)

"Derma rollers can help produce new collagen in the skin and may help soften the scars," Hellman says. "Beyond that, professional treatments are needed to deliver an improvement."

Get your derm's help.

If a derma roller isn't effective at getting rid of your scarring, your next trip is to your dermatologist's office.

Your doctor might recommend an injectable treatment called a filler. "Mainly, I treat acne scars with hyaluronic acid fillers, such as Restylane, but not all acne scars respond to this sort of treatment," Schlessinger says. "Additionally, I personally find that Accutane has a remarkable effect on acne scars if it is prescribed early on in the course of a scarring acne."

But keep in mind, Accutane can cause some potentially nasty side effects and isn't for everyone. Hellman says that's why she prefers treatments like fillers and lasers. What treatment you'll need depends on the type of scar you have.

"Depressed scars can sometimes be filled with hyaluronic acid fillers, which last about a year," she says. "But the more definitive treatment for scarring is with a laser. For red acne scars (and active acne), I use the Pulse Dye Laser, which takes away the redness and inflammation. It also works for the raised scars."

For depressed scars, she also uses a device called Fractora, which she describes as radiofrequency (RF) microneedling. She says it can help with collagen production and gives her patients the best results she's seen.

"The improvement is so impressive, it's sufficient to change the self-image and confidence of the patient," she says. "These treatments are life-changing. Fractora is also unique in that it works for even the darkest skin types, since RF doesn't affect the pigment in the skin."

Nazanin Saedi, M.D., also uses the Fraxel—which sounds like a Dr. Seuss character but is, in fact, a non-ablative fractional resurfacing laser—at Jefferson Laser Surgery and Cosmetic Center in Philadelphia. "So many dermatologists use this as their first line of defense to encourage collagen rebuilding on shallow acne scars," she says.

Saedi also says that ice pick scars can be treated by deep peels and a special technique called the CROSS technique, which uses trichloroacetic acid (or TCA) to encourage collagen production. It's a fairly inexpensive procedure and can take as little as a few seconds, depending on the number of scars needing treatment.

Speaking of money—what's this gonna cost?

Treatments like radiofrequency microneedling, lasers, and fillers can be effective to treat acne scars, but they can run you hundreds of dollars per treatment. And Hellman says you'll need six to eight treatments and a good amount of time before seeing results. "The process takes a good part of a year," she says. (Her office does offer some package options to help offset some of the cost.)

Schlessinger recommends seeing your dermatologist as soon as your skin starts breaking out. He says medication and topical acne treatments are less pricey than expensive treatments for scars. So, tempting as it may be, your driving desire to pop a pimple is never going to be worth the cost of treating a scar later on.

Jane Chertoff is a freelance lifestyle writer who loves to run, practice yoga, and snuggle with her chihuahua, Cesar. Follow her on Twitter and Instagram.

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A Doctor Explains How to Eat Your Way to Better Orgasms

OK, so it might seem strange for a cardiologist to give advice about how to have better orgasms, but the truth is that your heart's more involved in your love life than you might think (not just metaphorically!). The more your blood can rush to your sexy bits, the more fun you can have—basically, when you coax your arteries to perform at their peak, you can perform at yours.

Here's how it works: Every artery and vein in your body has a single cell lining, similar to wallpaper, called the endothelium. Healthy arteries can carry three to five times as much blood at peak exercise than at rest—but only if the lining produces a good amount of nitrous oxide, or NO. NO causes blood vessels to relax and dilate, which swells up the, ahem, critical parts. So the better your endothelium can produce NO, the better your blood flow—everywhere.

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The science of nitrous oxide production was awarded the Nobel Prize in Medicine in 1998 and led to the creation of Viagra and other performance drugs. Basically, you can lower your NO production through a variety of habits like smoking and downing a lot of saturated fat, and raise it through a variety of means—including by taking medication like Viagra. But you can also up your NO production simply by eating well.

Endothelial cells are very sensitive to what's in the blood rushing through them. For example, Robert Vogel, M.D., at the University of Maryland fed healthy volunteers two meals on different days. When he fed them a low-fat meal, their endothelial cells worked just fine. On another day, Vogel fed the volunteers a sausage Egg McMuffin. Artery function was measured, and within an hour, endothelial cells stopped responding normally—then it took a full six hours to return to baseline. This experiment has been repeated several times, so take Vogel's findings to heart: Avoid processed foods—especially before a date.

Foods That Raise NO: The Hard Facts

Back when the Nobel Prize was awarded, the importance of dietary L-arginine was identified. L-arginine is converted by an enzyme called eNOS (yes, rhymes with "penis") into NO, so foods that are particularly rich in L-arginine make a good pre-date snack. These include pine nuts, peanuts, walnuts, almonds, pistachios, Brazil nuts, beets, and whole grains like oats.

Another path to improving your NO production is to eat foods high in L-citrulline. L-citrulline can cycle back to make more L-arginine, and it's found in the highest concentration in watermelon, particularly in the white rind. It is also found onions and garlic... but they may be a bad idea before a date unless everyone partakes.

A New Pathway Comes Along

A newer path to make more NO has been recently discovered: There are foods high in dietary nitrates that can boost NO levels. These include spinach, arugula, rhubarb, kale, swiss chard, bok choy, and beets, which can raise both your NO production and your ability to perform. And it turns out that fruits like grapes, pomegranates, and apples can also be part of an erotic potion. Basically, the dietary nitrates circulate back into your mouth through your saliva and boost your NO.

One Last Tip

Maca is a turnip-like root vegetable native to Peru, where it grows at high altitudes. In the U.S., it is often available as a powder that can be added to a smoothie or a capsule. There are 13 strains of maca—some boost testosterone, and others normalize female hormonal patterns. Scientific data suggest maca can improve semen quality, sexual performance, and fertility.

Always Use Protection

Eating for the Big O by maximizing NO production can genuinely give your sex life a boost—and your overall health will explode too. Sex-friendly foods enhance NO production in arteries throughout the body and can lead to good blood pressure as well as protection from both blood clots and artery-clogging plaques. So eat well now, and you're basically investing in better orgasms for years to come.

More than 400 years ago, the famous English physician Thomas Sydenham said, "A man is as old as his arteries" and anticipated that life and love depended on optimal blood flow. Turns out, he was right—eat a diet rich in NO-producing fruits, nuts, and vegetables, and you can change your life.

Joel Kahn, M.D., of Detroit, Michigan, is a practicing cardiologist, a clinical professor of medicine at Wayne State University School of Medicine, and an associate professor at Oakland University/Beaumont Hospital medical schools. The views expressed herein are his. Dr. Kahn has five books in publication, including Your Whole Heart Solution, Dead Execs Don't Get Bonuses, and The Plant Based Solution.

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4 Ways Everyone Could Benefit From a Little Ayurveda

Ayurveda may not be part of your daily vocabulary, but it’s likely dipped into your life without you realizing it. Tried yoga or meditation? In Ayurveda, it’s part of the daily routine. Notice that everyone is suddenly adding adaptogens to their smoothies and coffees? Ayurvedic practitioners have been using them for thousands of years.

While some of the lesser known practices are gaining traction—colonics and dry brushing, anyone?—few know the ins and outs of Ayurveda. And for good reason: It’s pretty freaking complex. Eating for your dosha, balancing your dosha, even understanding what your dosha is (this quiz helps!) can be mind-numbingly complicated (says someone who’s read two books and countless articles about them). And doshas are just the beginning.

But let’s back up.

What is Ayurveda?

Instead of one wellness trend, Ayurveda incorporates countless health-related practices—some that are old news, some you’ve likely never heard of. Instead of one diet, there are three main diets, all of which are based on your dominant dosha. And those three diets are further modified if you’re tridoshic—if you embody all three doshas—or if have two dominant doshas. Sigh. Have you gone cross-eyed yet? We haven’t even gotten to what doshas are!

Life isn’t simple, and neither is Ayurveda. Why? Because Ayurveda is a way of life and a multifaceted one at that. Well, technically it’s the science of life—with the Sanskrit words “ayur,” meaning life, and “veda,” meaning science (or knowledge)—but you get where we’re going. Ayurveda is all about the mind-body connection and how to find the optimal balance.

As for doshas, they refer to the three energy types: vata, pitta, and kapha. Your doshas, or combination of doshas, is your unique constitution, or mind-body type. This “type” guides your energy, nutrition, physical activity, and, well, everything!

If you’re still confused, that’s OK. Ayurvedic practitioners dedicate their entire lives to mastering it. But that doesn’t mean the rest of us can’t benefit from it. Striving for harmony and balance is something we can all relate to, and Ayurveda can certainly help—whether you know your dosha or not. Here are a few practices to look into and apply in a way that feels right to you.

1. Look to food and herbs for help with healing.

What’s the first thing you do when you get a headache? If you answered “pop an Advil,” that sounds about right. We live in a world where turning to over-the-counter solutions is the norm. Ayurveda, however, looks to Mother Earth. Flaxseeds are thought to ease menstrual cramps, turmeric paste alleviates headaches, and ginger helps with hangovers.

No matter the symptom, foods and herbs are thought to bring relief. It may sound simple—too simple, in fact—but science is on our side. Though not all wonder herbs and super tonics are all they’re cracked up to be, foods and herbs can be powerful healers—and they don’t require a doctor (or those horrific fees that sometimes come with them).

2. Learn your triggers (and how to avoid them).

When you start learning about Ayurveda, you often begin with a quiz to determine your dosha (or doshas). Those whose dominant dosha is pitta are cautioned to avoid heat—both actual heat, like being outside on a scorching day, and food-related heat, like hot sauce. Heat is said to aggravate pittas, and excessive heat can cause irritability, impatience, jealousy, and other not-so-desirable traits.

But you don’t have to know your dosha to know that certain things make you feel unbalanced. Do raw foods make you bloated? Does coffee trigger anxiety? Do freezing rooms give you brain fog? For a week, keep of journal of your food intake and surroundings and see what patterns you recognize. It’s pretty incredible to learn how much we’re actually in control—at least, how in control we can be.

3. Be mindful of energy.

In Ayurveda, doshas rule everything, including the day. Ever sleep in and feel sluggish? Ayurveda would argue that waking up after 6 a.m. will always make you feel lethargic because kapha, the energy of water and earth, is dominant from 6-10 a.m. Vata, however, which rules from 2-6 p.m., is made of air and space, making it light and transitional—a.k.a. the optimal time for creativity. (Pitta, the dosha of heat, is from 10 a.m. to 2 p.m. and is the best time for productivity.)

In true Ayurveda form, following the dosha hours to a T can feel unrealistic—not to mention super confusing. But why not try going to bed before 10 p.m. every night for a week and waking up before 6 a.m.? And if that isn’t for you (we see you, night owls), simply try sticking to a routine that consistently makes you feel good (read: energized). The infamous afternoon slump didn’t come from nowhere! And according to Ayurveda, it can be avoided.

4. Develop a daily ritual.

A traditional Ayurvedic morning consists of an early wake-up call, oil pulling, tongue scraping, self-massage, meditation, yoga, and a handful of other tasks that can leave you feeling like you’ll never make it to work on time. But those who follow Ayurveda follow it religiously—as in, they follow their routine religiously.

Though many would argue there’s one “true” way, practitioners and experts often adapt rituals to work for them. (Because that’s what allows them to stick to it!) If you don’t have time for an oil massage and don’t fancy being greasy all day, we get it. But what about sticking to that 7 a.m. workout and post-workout smoothie for a full 10 days? Or actually committing to meditation followed by a cup of tea before you leave the house? No matter how funky, or boring, rituals work. There’s no harm in trying, right?

Ayurveda may have you scratching your head—or perhaps pulling your hair out—but its rooted in some serious (healthy) goodness. And it isn’t a new, hip fad that’ll fade away. Ayurveda is more than 5,000 years old and will be followed long after you read this article. Why not shake things up and strive for some balance?

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