Alternative to Restylane for Acne Scarring? Doctor Answers, Tips
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Alternative to Restylane for Acne Scarring?

Hi, I've twice had Restylane injections on my left cheek to improve a depressed area possibly caused by fairly mild acne scarring. However, both times I've had significant skin peeling/flaking and acne-like formations for about 3 weeks after the injections. I'm worried that they just made the scarring worse. I'd still like to get an injectible filler, but I don't think Restylane is for me.

Is there any information on how patients react to other fillers if they've had bad reactions to Restylane? Can you recommend an alternative?

7 Doctor Answers | Asked by david1980 in Dublin
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The best alternatives would Fraxel laser resurfacing

For acne scarring the better treatment is generally accomplished by Fraxel laser resurfacing either the Restore or CO2 Repair. However fillers also help. You may want to try Radiesse since you have had side effects with Restylane.
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Acne scarring treatment options

There are many types of acne scars and the choice of treatment depends on the type of scarring. I would recommend having a dermatologist evaluate your scar, and then choose the most cost effective treatment.
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I love the fractionated CO2 laser for acne scars

My first patient using the Pixel Omifit handpiece on my old CO2 laser for her "hill and valley" acne scars looked so much better she decided to go to Weight Watchers to complete her "new self". I find a series of treatments are necessary for the ice pick type of scars. They actually disappear but with several treatments. If needed for "tied down scars," subcision could easily be added to the laser treatment.

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Acne scar surgery and resurfacing is better for acne scarring compared to just fillers

The use acne surgery in combination with CO2 resurfacing provides long lasting and significant improvement. The use of subcision (the breaking of scar adhesions that cause the rolling scarring that is seen with acne scarring) and removal of ice pick scars are sometimes necessary to fix the "pot holes" prior to resurfacing the skin which evens out and smoothes the skin. I hope you find this helpful.
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Acne scar treatment with fillers

You mention you had acne breakouts and peeling from injecting the scars. I question if you didn't have an exacerbation of a cyst like structure underneath the scar. Sometimes, acne cysts scar the skin, but the cyst can have a lining or capsule that remains dormant and the filler might have disrupted it. This can happen with all resurfacing treatments too, but it might be worth a try. Multiple Fraxel restore treatments have helped many patients with acne scarring. Another modality... more
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Acne scar treatment

Depressed acne scarring can be treated with injectable fillers like restylane or juvederm. Artefill is another product that has currently been used with some success in elevating acne scarring. Other options include laser resurfacing to make the scars blend in better with the neighboring tissue. I hope this information helps.
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Acne Treatment

David, You are probably better served with a different modality of treatment. As you know acne scarring presents in a variety of forms. You may benefit from Erbium laser resurfacing which would remove the shoulders making the depressions less obvious (check out doctors who own and know how to use the Sciton Profile or Joule laser). If further care is needed, I would then do Subcision with another filler. That should greatly enhance your appearance. Dr. P. Aldea
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Comments (1)

natchezgp 18 Apr 2013
I would just like to comment that I have had 3 Pearl fractional lasers, and two subcisions. Please do not listen to doctors and waste your money on the laser treatments. I spent over $1200 with each laser treatment and received ZERO improvement. I did not see improvement until I actually met with a doctor that informed me that lasers do not work with depressed "rolling" scars and that subcision would help. Subcision did help tremendously. Subcision treatment is the only thing that improved the appearance of my scars. My face is not perfect, and unfortunately I do not think that the scars will ever be totally gone...but I did receive improvement with subcision. I am looking to do filler on the scars that are still deeper than I would like. My doctor recommended Resylane...but now I am worried that I will have the same reaction as you. Have you ever considered a permanent filler? I am nervous about that, but my doctor told me that it is an option after trying the temporary filler.

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