Does tretinoin help with acne scars and dark spots?
Tretinoin is the gold standard for acne and anti-aging, but does it also help get rid of acne scars and dark spots? Keep reading to find out!
Table of Content:
How does tretinoin help acne scars and dark spots? | Does tretinoin help with all types of scars? | How to use tretinoin for acne scars? | What strength is best for acne scars and dark spots? | What formulation is best for acne scars and dark spots? | How long does it take for tretinoin to work?
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Tretinoin, a widely used prescription retinoid and one of the best topical medications for acne and anti-aging, can also be helpful in the treatment of hyperpigmentation and acne scars, particularly, when they are fairly new or relatively shallow.
Tretinoin is a derivative of vitamin A and is commonly used in topical products for skin care and treatments. It works by promoting cell turnover and stimulating collagen production, which can help improve the appearance of acne scars.
To learn more in depth about tretinoin, read our Tretinoin Patient Guide by Dr. Mohta, board-certified dermatologist.
Tretinoin uses
So, how does tretinoin help with acne scars and dark spots?
According to Dr. Carolina Fernandez, dermatologist, tretinoin is very effective for acne scars and dark spots because it works by increasing skin cell turnover and promoting collagen production, which can help fade the appearance of scars over time.
Promotes collagen production
Tretinoin stimulates the production of collagen, a protein that helps to maintain the skin’s structure and elasticity. Increased collagen production can gradually improve the texture and appearance of acne scars, making them less noticeable1.
Enhances skin cell turnover
Tretinoin helps to exfoliate the outermost layer of the skin, encouraging the removal of dead skin cells and the formation of new, healthier skin cells2. This process can help reduce the visibility of acne scars by smoothing out the skin’s surface.
Fades hyperpigmentation (dark spots)
Tretinoin can also help fade post-inflammatory hyperpigmentation that often accompanies acne scars. Post-inflammatory hyperpigmentation is the darkening of the skin at the site of previous acne lesions. Tretinoin can promote a more even skin tone3 4 .
How to get tretinoin for dark spots and acne scars?
You can have a consultation with an online dermatologist for only $59. You will get your prescription in less than 2 days.
Does tretinoin help with all types of scars or just acne scars?
Dr. Fernandez says tretinoin may effective with certain types of acne scars, such as:
- Atrophic scars
- Post-inflammatory hyperpigmentation
It may be less effective with:
- Hypertrophic scars and keloid scars
- Surgical or burn scars
Atrophic scars
Atrophic scars are characterized by a depression or pit in the skin’s surface. There are several subtypes of atrophic scars, including icepick scars, box scars and rolling scars5.
Icepick scars
Icepick scars are narrow, deep, and sharply indented scars that resemble small holes or punctures.
Boxcar scars
Boxcar scars are wider depressions with well-defined edges, giving them a box-like appearance.
Rolling scars
Rolling scars have a wave-like or undulating appearance and result from tethering of the skin to underlying tissue.
Tretinoin may be the most effective for atrophic scars as it works by stimulating collagen production and promoting skin cell turnover, which can gradually improve the appearance of these scars6.
It can help smoothen the skin and fill in some of the depressions over time. However, it may not completely eliminate deep or severe atrophic scars, and additional treatments like laser therapy or dermal fillers may be necessary for more significant improvements.
Post-inflammatory hyperpigmentation (PIH)
While not technically scars, PIH is the darkening of the skin at the site of a previous injury or inflammation, such as acne lesions7. PIH can persist after the initial condition has healed and may require specific treatments.
Tretinoin is one of the best ingredients for post-inflammatory hyperpigmentation8, which is the darkening of the skin that often occurs after inflammation or injury, such as with acne lesions. Tretinoin promotes skin cell turnover, and reduce the production and transfer of melanin to the skin cells, contributing to the attenuation of hyperpigmentation which can help fade the pigmentation and create a more even skin tone9.
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Hypertrophic scars and keloid scars
Wound healing is typically a well-regulated process, but when this balance is disrupted, it can lead to the formation of unwanted scars, specifically hypertrophic scars and keloids.
These scars are characterized by their raised and firm appearance, resulting from an excess production of fibrinogen and collagen during the healing process. They often come with symptoms like itching, pain, movement restrictions, and cosmetic disfigurement.
Notably, hypertrophic scars are confined to the original injury site and may diminish over time, while keloids extend beyond the initial injury boundaries and tend not to improve10.
Tretinoin can also be effective for hypertrophic and keloid scars, which are raised and result from an overproduction of collagen11 but its effectiveness may vary for each individual and depends on factors, such as the severity of the scars and the individual skin response. In some cases, it may help improve the texture and color of these scars slightly, but other treatments like corticosteroid injections, silicone sheets, or laser therapy are more commonly used for these types of scars.
Surgical scars
Topical retinoids, such as tretinoin, have been scarcely used to improve wound healing before skin resurfacing procedures. This is because retinoids stimulate the production of collagen, promote the formation and growth of the outermost layer of skin (the epidermis) over the wound, and foster the formation of new blood vessels which can improve blood flow to the wounded area (angiogenesis), all which are crucial for wound closure and protection. However, more research is needed to determine the right strength of the formulation and the length of the application12.
Burn scars
Scar and skin pigmentation alterations are common consequences of burn injuries, and many of these conditions tend to improve progressively over time. However, certain scarring and pigmentation issues can become permanent, significantly impacting an individual’s psychological well-being. The effectiveness of topical creams, such as hydroquinone and tretinoin, in treating post-inflammatory hyperpigmented lesions is a subject of debate due to inconsistent results observed. Further studies are needed to determine their efficacy in burn scars13.
All About Tretinoin
Are there other treatments that work for acne scars and dark spots?
Chemical peels can also help with acne scars and you can also use chemical peels for hyperpigmentation (dark spots). You may see results faster, but they are considerably more costly than using topical treatments.
Does tretinoin help with stretch marks?
Tretinoin can be used for stretch marks as well as scars and dark spots. Stretch marks arise as a consequence of excessive stretching of the skin. The topical application of tretinoin demonstrates a significant improvement in the visual appearance of stretch marks in their early and active stages14.
Does tretinoin help with melasma and hyperpigmentation?
Yes! Dr. Fernandez says that you can definitely use tretinoin for the treatment of melasma and hyperpigmentation.
Does tretinoin help with old scars?
Dr. Fernandez says that tretinoin is most effective when used on scars that are still in the early stages of formation by stimulating the growth of new, healthier skin cells and increasing collagen production. Regular use of tretinoin can lead to better results for fresh scars.
Dr. Fernandez also mentioned that for scars that have been present for several years, tretinoin may have limited impact on their appearance. The structural changes in the skin that occur with older scars, including collagen remodeling and scar maturation, may be less responsive to tretinoin.
Does tretinoin help with scars and dark spots on the face?
Yes, tretinoin may help with scars on the face, especially if they are related to acne and they are relatively new.
Does tretinoin help with scars and dark spots on the body?
Tretinoin may help with certain types of scars on the body, such as atrophic scars, post-inflammatory hyperpigmentation and to a lesser extent on hypertrophic, keloid or burn scars, if they are relatively new. It is important to emphasize the use of sunscreen during the treatment and to consider the adverse effects and contraindications of tretinoin.
So, how to use tretinoin for scars and dark spots?
It is recommended to start twice a week until the skin gets used to it and apply it at night, being careful with the facial mucous membranes (eyes, mouth, and nose). Using tretinoin for scars would be similar to using it for acne or anti-aging, so you can read our Step-by-step guide on how to use tretinoin.
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What tretinoin strength is best for scars and dark spots?
Dr. Fernandez recommends that since it may take some time for your skin to get used to tretinoin, it is advisable that you start with a low tretinoin strength such as 0.025% and then increase it as time passes and your skin is able to tolerate it better.
How can I get a tretinoin coupon?
Read our patient guide on tretinoin coupons to ensure you get your medication at an affordable price.
What tretinoin formulation is best for acne scars and dark spots?
There is a wide variety of tretinoin gels and creams, but it depends on what type of scars you have and where the scars are located. Dr. Fernandez says that if you have acne scars or PIH, the formulations of tretinoin and hydroquinone, tretinoin and azelaic acid or tretinoin and niacinamide might be adequate for you. Complementing tretinoin with derma rolling can also help improve your skin texture and get rid of acne scars.
How long does tretinoin take to work for acne scars and dark spots?
Tretinoin would take longer to work for scars (up to several months)and dark spots than it would take you to see the results for acne or wrinkles. However, if you want to know the changes your skin goes through while using tretinoin, read How long does it take for tretinoin to work?
Key article points
- Tretinoin for Acne Scars and Hyperpigmentation: Tretinoin is highly effective in treating acne scars and hyperpigmentation by promoting cell turnover and stimulating collagen production, which helps improve skin texture and fade dark spots.
- Types of Scars Tretinoin Treats: Tretinoin is particularly beneficial for atrophic scars, including icepick, boxcar, and rolling scars, as it can gradually improve the appearance of these scars by smoothing the skin.
- Post-Inflammatory Hyperpigmentation (PIH): Tretinoin is one of the best treatments for PIH, helping to fade dark spots and create a more even skin tone by reducing melanin production and transfer.
- Effectiveness on Hypertrophic and Keloid Scars: While tretinoin may slightly improve the texture and color of hypertrophic and keloid scars, other treatments like corticosteroid injections or laser therapy are typically more effective for these types of scars.
- Use on Stretch Marks: Tretinoin can also be used to treat stretch marks, particularly in their early stages, by improving the visual appearance through increased collagen production and skin regeneration.
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References:
https://www.nejm.org/doi/full/10.1056/NEJM199308193290803
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6791161/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8776661/
https://www.dovepress.com/a-comprehensive-review-of-non-energy-based-treatments-for-atrophic-acn-peer-reviewed-fulltext-article-CCID#:~:text=Overall%2C%20studies%20estimate%20that%20%3E80,rolling%20scars%20(~15%25).
https://pubmed.ncbi.nlm.nih.gov/15075042/
https://www.ncbi.nlm.nih.gov/books/NBK559150/#
https://www.ncbi.nlm.nih.gov/books/NBK537058/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5064675/
https://www.sciencedirect.com/science/article/abs/pii/S0305417922000948?fr=RR-2&ref=pdf_download&rr=823440b1fc16736f
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