The healing process following a herpes outbreak, especially in a sensitive area like the buttocks, can sometimes leave behind noticeable marks. The inflammatory response can damage skin cells, resulting in changes to the skin’s texture or color. Addressing these residual marks requires understanding their specific type and applying targeted treatment strategies.
Identifying the Types of Herpes Scars
The marks left after a herpes outbreak are typically categorized into two distinct types, and identifying the correct one is the first step toward effective treatment. The most frequent residual mark is Post-Inflammatory Hyperpigmentation (PIH), which appears as flat spots that are darker than the surrounding skin. PIH is a temporary discoloration, presenting as red, brown, or purple marks depending on skin tone. These marks occur as the skin overproduces melanin in response to the inflammation caused by the viral outbreak.
A less common, yet more persistent, type is the atrophic or textural scar. These scars are characterized by a depression, indentation, or pit in the skin where tissue loss occurred during the healing process. Atrophic scars form when the body fails to produce enough collagen to repair the wounded area, leading to an uneven skin surface. Because PIH involves only color change and atrophic scars involve structural change, their treatment methods differ significantly.
At-Home and Over-the-Counter Scar Treatments
For Post-Inflammatory Hyperpigmentation, numerous over-the-counter (OTC) products can help accelerate fading. Topical products containing retinoids, often available in lower concentrations, work by increasing skin cell turnover. This faster turnover rate allows the pigmented cells to shed more quickly, reducing the darkness of the spots over several months.
Vitamin C is a powerful antioxidant that helps brighten the skin and inhibit the production of excess melanin. Serums containing Vitamin C can be applied daily to the affected area to lighten the dark marks. Hydroquinone, if available without a prescription, is a potent skin-lightening agent that directly interferes with the production of melanin. Consistency is important with these topical treatments, as results often require three to six months of daily use.
Silicone sheets and gels are effective for managing scars, including those with a raised texture. Silicone works by hydrating the stratum corneum, which normalizes collagen production and helps flatten and soften the scar tissue. While these options are primarily geared toward color correction, prolonged use of topical retinoids and silicone can also offer textural improvement for atrophic marks.
Advanced Dermatological Scar Removal Procedures
When residual marks are deep or fail to respond to topical therapies, a dermatologist can offer more aggressive, in-office procedures. Atrophic scars, which present as indentations, often benefit from treatments that stimulate collagen production within the skin. Fractional laser resurfacing uses microscopic beams of light to create controlled injury deep in the skin, prompting the body to generate new collagen to fill the depressed area.
Medium to deep chemical peels involve applying a solution to remove the damaged outer layers of skin, which encourages regeneration and smoother texture. Another technique is microneedling, which uses fine needles to create tiny punctures in the skin to induce a healing response and collagen remodeling. For specific, deep indentations, dermal fillers can be placed directly beneath the scar to temporarily raise the depressed area to match the surrounding skin. These advanced procedures require a period of downtime and may need multiple sessions for optimal results.
Preventing New Scar Formation
The most effective way to address herpes-related marks is to minimize the damage during an active outbreak. Avoid scratching, picking, or attempting to pop the blisters, as manipulating the lesions increases the risk of infection and deep tissue loss, which leads to atrophic scarring. Keeping the outbreak site clean using a gentle cleanser helps prevent secondary bacterial infection, a complication that can worsen inflammation and scarring.
Applying a thin layer of a simple ointment, such as petroleum jelly, can keep the sores moist, preventing the formation of thick, tight scabs. Promptly beginning a prescribed oral antiviral medication, such as acyclovir or valacyclovir, at the first sign of an outbreak can shorten its duration and severity, reducing the window for potential scarring. Protecting the healing skin from ultraviolet (UV) radiation is beneficial, as sun exposure can darken and prolong the appearance of Post-Inflammatory Hyperpigmentation.