With so many scar treatment options to pick from it’s impossible to know which scar treatments work and which ones are safe. When it comes to dark scars and hyperpigmented skin blemishes (like brown spots and dark acne scars), a handful of options are available:
1) Hydroquinone (HQ)
2) Kojic acid
3) Vitamin C (ascorbic acid)
4) Licorice extract and other natural scar treatments
Hydroquinone is considered by many to be the gold standard treatment for hyperpigmented skin lesions and dark scars. Long-term use can be associated with side effects however and because of this, some countries have restricted the sale of hydroquinone. One potential side effect is Ochronosis which can lead to permanent hyperpigmentation, impaired wound healing and decreased skin elasticity. Hydroquinone can also cause nail discoloration and even contact dermatitis.
Kojic acid also helps fade the dark pigment seen in dark scars and other skin lesions like melasma and brown spots. While it is not as effective as hydroquinone, the popularity of kojic acid has increased over the years as people have become more fearful of hydroquinone’s potential side effects. Kojic acid is also more “natural” as it is produced by several different types of fungi. Once again, there is no improvement in scar healing except for lightening of hyperpigmentation.
Vitamin C (L-ascorbic acid), along with other vitamin C derivatives, decreases melanin production (by inhibiting tyrosinase) and therefore lightens skin hyperpigmentation. Vitamin also improves other aspects of scar healing through its action on collagen. Scar healing is typically associated with breakdown of the skin’s normal collagen and replacement with unorganized, haphazard collagen fibers. Vitamin C has been shown to normalize new collagen production. Unfortunately, many vitamin C skin care products (including scar treatments) become ineffective over time. L-ascorbic acid on its own is very unstable and oxidizes on repeat exposure to air and moisture and turns dark yellow or brown. Many products containing vitamin C are colored dark yellow or brown to begin with to disguise this vitamin C degradation. Products containing STABLE vitamin C are usually white.
Like vitamin C, licorice also makes an excellent scar treatment: it has strong anti-inflammatory properties and accelerates skin renewal. Both vitamin C and licorice inhibit tyrosinase, the enzyme that causes pigmentation with sun exposure and skin injury. Interestingly, licorice boosts the scar lightening effects of vitamin C so the two should be combined for best results. As a bonus, licorice also has anti-acne effects (both prevention and treatment).
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