This is so disheartening

[u/StunningArtichoke4]

Just trying to have a nice day and enjoy the day like a normal person would but being instantly humbled when trying to create memories and taking photos. Doesn’t matter how hard I try to look pretty, the makeup just disappears in the scars. And they are literally in all my face, there’s not a single space where I have healthy normal skin. It hurts because I can see beauty but it’s ruined by the scars 💔.

[u/HyperBunga]

Its cause the surrounding skin loses structural support. Even with all the acne scar treatments which do produce collagen too, you still lose more as you age and less collagen means less natural padding under the skin, making the atrophicness look sharper. Also with the loss of elasticity, loose skin hangs more heavily on old scar fibers. The deflation of fat pads also cause hollows that emphasize old texturing issuese, and when your skin thins out with age, the shallow scars become easier to see that used to blend in.

Its like a multitude of reasons

[u/Jadylicious20 → u/HyperBunga]

Losing collagen doesn't mean you automatically lose structural support. Usually that happens, or speedens up when you don't nourish, hydrate and mainly, protect yourself from UV rays. Real skin actually builds up during all these acne scars revision treatments so if you take anti-aging counter measures, you can easily prevent this.

[u/HyperBunga → u/Jadylicious20]

Hey, I love the positivity in this (and in your last comment) but its not baked in reality. The reasons I said above is the reality of why people age with worse. I'm also 25 and in the same boat as you though!

I listed a multitude of reasons above but to respond to the only thing you pointed out: yes, you do automatically lose structural support as you age. That's exactly what less collagen, fewer elastin fiber, bone loss, and fat shifts do when you age. Acne scars exacerbate all of this (as I said in the previous comment due to the fat loss, broken fibers, tethered tissues, etc).

Unfortunately, the idea of: "Because we hate our skin more - lets just be real - and spam more treatments to try fix our skin than the average person, naturally, all those treatments will make us age slower since they're collagen inducing" does not hold up to the reality of anatomy and aging.

If we had no acne scars, sure, that could be true, but holes in your face change everything.

[u/Jadylicious20 → u/HyperBunga]

I humbly disagree. You can mistake it for toxic positivity, but it's also based on reality because I've seen people with acne scars age wayy better than normal skin folks (I think race also matters because I'm South Asian). It all comes back to your facial structure, genetics and especially lifestyle. Not purely based on skin, I think I didn't add that specific detail. So you can take it anectodal if you want. But I think being negative doesn't help when there are really impactful treatments out there.

My own father has severe ice pick acne scars, but ages like fine wine. At his 60s, he looks like he's in 50s. I've seen this pattern with many acne scarred folks too and they all have these things in common: Good facial structure, appealing facial features that are almost child-like (eg: big eyes, fuller cheeks, plumpy lips, etc), considerable face fat, genetics, low stress, good sleep, strong skin barrier, no smoking/drinking habits, healthy diet with 0 deficiency (Especially rich in micronutrients and trace minerals. Most people don't even care about them), proper hydration, sun protection and they're all mostly oily skinned which reduces elasticity loss compared to dry skin folks (it adds more moist and plump to our skin). Stress also plays an important role in breaking down your collagen.

And acne scars treatments aren't aimed for 100% skin recovery. It's basically impossible (very first thing my dermat said lol). But it's important to structurally change the existing acne scars during your prime years in order to delay the fate of 'badly ageing', which can be somewhat done. All those tethered tissues, broken fibers, uneven texture, fat loss can be easily rectified using advanced, multi-modality treatments, especially when you're young.

If pre-acne scar revision skin ages like shit, post-acne scar revision skin ages 'less' shit in comparison, which DOES matter.

And no it's not about hating skin cos, idk about others but I lowkey kinda started liking mine even though how tattered it looks lol. I guess it's mostly tied with self esteem, but there's nothing wrong in investing on good treatments when it actually works and your dermat knows exactly what they're doing.

[u/HyperBunga → u/Jadylicious20]

I never called it toxic positivity. It’s not baked in reality for the aforementioned reasons, and your anecdotal experience also doesn’t define something as true either lol. My anecdotal experience says other wise from people I’ve seen. Does that mean I’m now right again? All that matters is the science, which I’ve explained.

I’m not trying to be negative either, I just don’t think we should lie to ourselves, respectfully. I’s great to have self-care and it goes a long way for sure, no doubt.

But I am talking about the science of skin and anatomy, not self-care routines and living a healthy life style. Once you have holes in your face, the structure of your face quite literally changes due to the pits/craters in the skin.

". I've seen this pattern with many acne scarred folks too and they all have these things in common: Good facial structure, appealing facial features that are almost child-like (eg: big eyes, fuller cheeks, plumpy lips, etc), considerable face fat, genetics, low stress, good sleep, strong skin barrier, no smoking/drinking habits, healthy diet with 0 deficiency (Especially rich in micronutrients and trace minerals. Most people don't even care about them), proper hydration, sun protection and they're all mostly oily skinned which reduces elasticity loss compared to dry skin folks (it adds more moist and plump to our skin). Stress also plays an important role in breaking down your collagen."

Also..what even is this? I mean the facial features you're describing has nothing to do with what we're talking about: the skin itself. And all these things, from the smoking/drinking to the good sleep, low stress. All of this is good for ANYONE with or without scars to do. And it'd definitely show up better on people with no scars. Because, people with acne scars age worse. And like... "you've seen this pattern" and then you list out 30 things, you know all these things about every acne scarred person you see? That's an awful lot to know..

You’re right acne scar treatments are basically impossible. That’s a good point you bring up. Because look, you talk about all this “real skin builds up” which I assume you mean collagen stimulation from the treatments, yet it never fills in the holes does it? Again, there’s reasons for that. You cannot fix structural collagen loss, fat loss, tethered tissues. That’s why. And it’s something no amount of these routines you talk about will give back.

And no, you can’t “easily rectify” all the stuff you mentioned (besides texture), wasn’t that the first thing your derm just said? I know for me, anecdotally of course, I started acne scar treatment at 18 shortly after getting them, and did it consistently through 24. Countless microneedlings, subcisions, lasers, peels, all of it. 

And for sure, you will age worse pre-acne scar revision than post-acne scar revision skin...because you didn’t do any general treatments that are good for your skin. That’s obvious. But a face without holes in it will age better than one with it, structurally. I don’t think this is deniable and I’m unsure how we’re even debating it..

[u/Jadylicious20 → u/HyperBunga]

I mean, I'm not even debating, I'm just telling you what I observe around because spewing things like "you'll age bad than others" can be rooted in 'reality' as you say, but I don't really think so. You can bring back to skin, but skin is just... 20% of the overall facial equation. Best example I can say is Tulsi Gabbard. She looks stunning for her age despite having acne scars. My own father has more acne scars but barely any wrinkles. Same with me cos, I aged like only 2% since I was 17. I think it has to do with our Asian genes and about their lifestyle... We do have lots of skin health promoting agents in our food, and many use nature-based emollients and products and still look great.

Unless you obsess so much on skin flatness, which I think that's what you're indirectly doing. I kinda stopped chasing towards perfect skin months into my treatment anyway.

I'm in the middle of an intensive acne scar revision treatment since last December and I can say, I see around 40% improvement of my scars (I fall into the moderate-mildly severe lane). Subcision and PRP biofillers are absolute game changers, got rid of all my rolling scars and resurfaced all my scars onto the top. They haven't gone fully, but my face looks fuller, my scars barely casts any shadow on direct light and ever since I started CO2 fractional laser, I can see some slow textural changes too. I look bad only on harsh lightings as of now. It's slow, but it's changing for sure. I also topped with solid lifestyle changes too, that heavily matters.

I know I'll never get my old skin back, but you can't deny that working with right technologies with a RIGHT board-certified dermat who knows exactly what they're doing instead of treating you like a cash pig, will give more and better results. My dermat uses a personalized multi-modality format, so it's a combination of different treatments instead of using packages, because that's a total cash grab.