Ask an Expert: Shedding Light on Dark Circles and Acne

Dr. Vivian Shi is a board-certified dermatologist and an Assistant Professor of Medicine in Dermatology at the University of Arizona, and she’s answering some of our most-asked skin questions. Today, we’re talking dark circles and acne.

BB: Is there anything to be done about dark circles?

Dr. Vivian Shi: My answer is, if you find a product that would truly work for my dark circles, please call me! There is no topical product that's shown to be consistently effective because, really, what are dark circles? People get dark circles because of volume loss. As we age or have extensive UV exposure, the cushion between the skin surface—made up of fat, collagen, and elastic fibers—and the underlying blood vessels shrink, so you see the veins beneath. The most definitive solution is to slow down skin aging—that’s a big topic all on its own!

What's the best face wash for acne?

If you’re on an acne regimen that includes prescription medications, you may want to avoid using very harsh face wash that is drying or has scrubbing beads, because that can cause added irritation when you use both at once; use a sensitive facial cleanser and lotion instead. Otherwise, it's okay to use face washes tailored for acne-prone skin—ones that contain salicylic acid or benzoyl peroxide, for example.

But some people, such as those with rosacea and sensitive skin, can't handle these two ingredients. People with rosacea tend to have red, flushed skin, and a lower threshold for burning with irritating products. I'm one of them, so even a few minutes of contact during a face wash with those ingredients can cause peeling and redness and tingling. It's very dependent on the skin type.

If you have really oily skin and true acne, you're probably safe to use over-the-counter products marketed to acne. But sometimes rosacea can resemble acne, and rosacea and skin sensitivity may worsen after using acne products. If you’re not sure what your skin can handle, consult with a dermatologist first.

What’s the best thing to do to prevent future acne scars for acne-prone skin?

The number one thing is to work with a dermatologist to prevent your acne from popping up in the first place. People think if you don't pick at your acne, then you won’t get an acne scar—that’s not always true! The skin inflammation from acne can cause scarring, even without squeezing and picking.

And, a lot of the acne “scars” that people see are actually blemishes (the medical term is ‘post-inflammatory dyspigmentation’) and not true scarring. These blemishes can come in all forms, such as fine and broken blood vessels called telangiectasia, redness, and brown marks. These blemishes are not usually permanent. With appropriate sun protection and skin repair, they can fade away with time.

Most acne scars are atrophic scars, meaning they're divots. Atrophic scars can be a small crater (rolling scar), a depressed square (boxcar scar) or cone-shaped (icepick scar). For people of color, the scars can actually be elevated, bumpy, firm, and sometimes itch and hurt—they are hypertrophic scars or keloids.

My general recommendation for preventing mild acne is to use a salicylic acid or benzoyl peroxide wash, and possibly also an acne topical product that includes those ingredients. After washing your face (with your hands—avoid wash cloths or sponges to prevent irritation and microbial colonization), pat your skin dry with a soft towel, apply a gentle moisturizer, then a topical over-the-counter acne medication.

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Your response to skin care products may vary. Ask a healthcare professional about the most suitable skin care regimen for you.

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