Deep Acne Scar Removal

Will the microdermabrasion take the deep scars from acne away? If not, what might be suggested?

Doctor Answers 16

Deep acne scar solutions

No, even if the microdermabrasion is done very deeply, deep acne scars are better treated by regular dermabrasion or carbon dioxide (CO2) laser resurfacing. Both of these treatments require about a week and a half of recovery time. It is a wound that requires diligent care by you and there is a risk of scarring from the procedure.

Some deep scars are able to be treated by alternative methods if the scar is able to be raised up. Injecting a filler below the scar can lift it close to the level of the surrounding skin. Sometimes a process called subcision is done to break up the attachment of the scar to the underlying tissue which holds it down and then the filler is injected.

If the deep scars are very narrow, they are called ice pick scars and can first be treated by punch grafts. In this procedure, the small scar is surgically removed and replaced with a plug of skin taken from behind the ear so its donor scar is not seen. This “punch graft” is taken and placed into the new hole created by the removal of the ice pick scar. After the graft heals, resurfacing is usually done about two months later to even out the texture.

Newer lasers and plasma energy devices, such as Fraxel Restore, Fraxel Repair and Portrait Plasma, can achieve some improvement with deep scars. The wound healing with Fraxel Restore is very quick, but it requires a series of many treatments to elevate and smoothen the scars. The improvement seen with Fraxel Repair and Plasma Portrait is better than one treatment of Fraxel Restore but usually there is only one treatment given with Fraxel Repair and Plasma Portrait PSR II or III.

The improvement might be better with the older dermabrasion and CO2 laser resurfacing, but there is a chance of developing permanent skin lightening with these procedures and there is a greater chance of scarring. So, there are a multitude of possibilities available and the physician should sort out your skin type, level of scarring, type of scarring and your timetable for convalescence during the consultation and then offer the best treatment plan for you.

It is important to choose a physician who treats all levels of scarring and has had experience in performing the different types of scar treatments rather than seeing a physician who has purchased one laser and uses that for everything after they have had a training session from the laser company.

Although being a member of laser and dermsurgery societies does not mean the physician has such experience, it at least indicates the physician tends to perform more of these procedures than the average dermatologist. Two such societies are: The American Society for Dermatologic Surgery and the American Society for Laser Medicine and Surgery. Both societies can be found on the web.


Manhattan Dermatologic Surgeon
5.0 out of 5 stars 33 reviews

Deeper treatment needed for deeper problem

Greetings Holly,

It is unlikely that microderm will treat deep acne scars. Microderm is aimed at taking off the superficial layer of skin. Your problem is deeper and will require a deeper solution. There are many options that are available. Subcision, dermal fillers, dermabrasion (not microdermabrasion), ablative laser resurfacing, direct excision, and punch biopsy with dermabrasion are all options for treating deep acne scars. To determine the best option for you, I would suggest visiting with an experienced surgeon who deals with acne scars on a regular basis. Good luck.

D.J. Verret, MD
Dallas Facial Plastic Surgeon
4.0 out of 5 stars 13 reviews

Microdermabrasion not the best choice for Deep scars

Hello Holly,

While microdermabrasion features little downtime and is readily available, it will not unfortunately give you the best results if you have deep scars.

Deep scarring implies injury to the deeper layers of skin- layers that microdermabrasion do not address.

Full Dermabrasion is better for scarring that is raised and needs to be evened out or for deep scars that have the ability to form new collagen and "fill out" the scar.

Lasers can also be used for some forms of scarring and would yield better results than microdermabrasion.

If the scars are really deep or "ice pick" scars, then a filler using collagen or hyaluronic acids could be used to "plump up" the scar, making it blend in better with the surrounding skin.

Lastly some deep scars can be revised with minor surgery - this will depend on scar location, size, texture, etc.

Best thing to do is to sit down with a Board certified and experienced Physician who can examine your scars and go over all the best options that apply to your case.

Microdermabrasion is great for maintaining healthy skin but not so great at deep scar removal.

Kamran Jafri, MD
New York Facial Plastic Surgeon
5.0 out of 5 stars 8 reviews

Microdermabrasion could treat deep acne scars, if done aggressively

There are many different types of microdermbrasion machines. Some versions and machines are more fit for physicians to use where more suction is applied. The more suction allows you to go deeper for a more aggressive cleaning and resurfacing. The more aggressive the more results and also the more risk.

Other forms of treatment include laser resurfacing, dermabrasion, and chemical peels. All of these forms essentially entail abrading and taking away the top layers of skin to remove the scars and allow deeper skin cells within the hair follicle to resurface the abraded areas for a new layer of skin and more often than not less scars. Microdermabrasion is just a more superficial form of this.

Philip Young, MD
Bellevue Facial Plastic Surgeon
3.5 out of 5 stars 43 reviews

Treatment for deep scars

Microdermabrasion and superficial peels done by aestheticians only affect the top layer of the skin (the epidermis). This leads to a short lived improvement in the skin's appearance, and it doesn't affect any scars involving the deep layer of skin (the dermis). 

Multiple treatments might be needed over the course of several months to treat scars, and the exact choice of treatments depends on the number and depth of scars, your medical history including medications, your skin tone, your budget, and your tolerance for down time after procedures.

Dana Goldberg, MD
Jupiter Plastic Surgeon
5.0 out of 5 stars 24 reviews

Fraxel For Acne Scars

Thank you for your question. At my practice, I have gotten excellent results for scarring with Fraxel. This treatment eliminates irregular skin discoloration, and stimulates new collagen production, tightening the skin without prolonged recovery. After a series of 2 to 4 Fraxel treatments, the cumulative cosmetic improvement is near more aggressive lasers, but unlike more aggressive lasers, redness and swelling eliminated within 2 to 4 days after each treatment. Fraxel is outstanding for fine wrinkles, mild skin laxity, irregular pigmentation, acne scars, surgical scars, enlarged pores, stretch marks, age spots and Rosacea. It can be used safely on the face, neck, hands, arms, and chest.

Microdermabrasion will not work for deep scars.

Microdermabrasion will not work for deep scars. Useful options would be fractional CO2 laser/ fractional radiofrequency ablation/ TCA CROSS/ scar elevation or excision/ dermabrasion, and if nothing works, a filler then.

Microdermabrasion not the answer

Patients with significant acne scars need a more invasive laser procedure than doing just a microdermabrasion. You need a true resurfacing using an ablative technique to help remedy this situation. The DOT CO2 is a wonderful laser that we have seen great results with. It not only helps with texture and scarring, it also helps promote collagen which is needed to fill in a lot of the scar tissue.

Jeffrey Adelglass, MD
Dallas Facial Plastic Surgeon
3.0 out of 5 stars 5 reviews

Treating Deep Acne Scars

Microdermabrasion is a minimally invasive procedure that relies on an abrasive component to remove the superficial layer of skin. Even if used aggressively, microdermabrasion will not give you the best results when treating deep acne scars.

There are however several options available for the treatment of deep acne scars. Options include, but are not limited to, laser resurfacing, deep chemical peels, deep dermabrasion, subcision with filler and microneedling. I recommend you consult with a Board Certified Plastic Surgeon to determine which option is best for you.

John Diaz, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 26 reviews

Microderm May Not Be Your Best Bet

Microdermabrasion is better suited for minimal scarring, skin discoloration, acne, sun damage, fine lines/wrinkles, and may also be used to lessen the appearance of stretch marks.
For deep acne scars, I would suggest either filler injections, subcision, or laser treatments.
  • Filler injections can be good for shallow and deep scars. These fillers can be injected underneath the scar, smoothing depressions. Results are immediately apparent. Bellafill, a long lasting filler, is now FDA approved for these treatments and is a favorite for deeper or “rolling” scars. Also high grade silicone can be an effective treatment when used properly.
  • Subcision is a technique that breaks apart the scar tissue under depressed scars with a special needle. New tissue is created that raises the scar or unwanted depression.
  • Fractional skin resurfacing treats facial scars by delivering the laser's energy in microbeams and is an effective treatment for many types of acne. Fractional treatments promote the production of softer, smoother skin.
Consult with a board certified dermatologist for the best treatment for your specific condition.

David J. Myers, MD
Salt Lake City Dermatologic Surgeon
5.0 out of 5 stars 3 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.