Face Acne Scars - Best Way to Remove?

What is the best way to remove acne scars on my face? Fraxel, Chemical Peels, or something else?

Doctor Answers 10

Laser resurfacing, possibly a lift

First, I advise my patients to get their acne under control with a good dermatologist. Prior use of Accutane will make the patient more prone to having complications from laser.

Laser resurfacing helps to tighten the skin and reduce the appearance of acne scarring. Fractional laser helps less, and leaves some areas unresurfaced, but has less down time. CO2 laser helps more, but is associated with more down time and prolonged redness, particularly when it is done aggressively. Any laser resurfacing done deeply can cause loss of pigment cells and whiteness which is permanent, or loss of dermal elements, producing a weird, shiny appearance, also to be avoided.

Dermabrasion is an older technique that can "sand" down the skin , making it smoother. There is a technique of superlight dermabrasion done repeatedly, which can also have a beneficial effect on acne without the extended down times of conventional dermabrasion.

Deeper ice pick marks can be removed by direct excision. It is not possible to remove ice pick marks with repeated resurfacing because of the depth of the injury and the limitations of lasers.

In some patients who also have looseness of the skin, tightening procedures such as a facelift can help greatly in additon to the laser resurfacing.

Acne patients should be realistic about their degree of improvement. In most patients with severe acne scarring, it is not possible to remove all signs of acne, just to improve them significantly.

A board certified plastic surgeon can guide you through all these techniques.

Beverly Hills Plastic Surgeon
5.0 out of 5 stars 103 reviews

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Acne scars -- best way to remove?

  I think that nothing will "remove" acne scars and anyone who says differently is not being truthful.  I think the optimal treatment involves facial resurfacing (which need not require the latest, greatest, most hyped, and most expensive laser since similar results can be obtained by chemical peels) combined with subcission and fillers.  These modalities can offer a tremendous improvement in deep acne scars.  Good luck!

Lawrence Kass, MD
Saint Petersburg Oculoplastic Surgeon
4.5 out of 5 stars 53 reviews

More than one option

The best way to treat acne scars really depends on the type of scars you have.

Chemical peels and microdermabrasion may help with lighter scars and with discolored scars. You would need a series of these treatments, probably 4-6 spaced every 2-4 weeks.

For deeper scars you may need stronger, deeper chemical peels or laser resurfacing. You need a treatment that is going to reach to the depth of skin where the problem is. Fraxel is the brand name for a type of laser treatment that treates microscopic colums of skin at a time, leaving untreated areas between each zone and allowing for a faster recovery time. This is called fractional resurfacing and there are several brands of lasers that do this. Fraxel is one brand and there are 2 types of Fraxel: one is gentler but requires more treatments, and the other is a little more aggressive but requires fewer treatments to get results.

With any treatment, you should be sure to practice good skin care and avoid sun exposure. And if you are still having acne trouble, be sure to start treatment so that you can minimize the development of new scars.

Jordana S. Gilman, MD
Atlanta Dermatologic Surgeon
5.0 out of 5 stars 2 reviews

Acne scars

Nothing is perfect for acne scars. Remember acne scars are the result of skin scarring as well subcutaneous fat atrophy. So, it is a multi-modality treatment process. Some lasers can be used on the skin to perform surface changes. Some can treat the deep collagen to lay down new collagen. But, sometimes small fat grafts or facial filles can lift the depressed scar as well. Some doctors will even cut out the old scar all together to bring skin and soft tissue fromt he sides together to remove the depression.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 18 reviews

Laser treatment for acne scarring

There are a few different lasers that can treat acne scarring.The most commonly used lasers are the Pixel and the Fraxel laser.The Pixel is a one time treatment but has about 7-10 days downtime after, the Fraxel has no downtime but needs to be repeated monthly for a series of 4-6 treatments. For the redness there are other lasers that can be more effective.

Joshua L. Fox, MD
Long Island Dermatologic Surgeon
5.0 out of 5 stars 12 reviews

Acne Scars Treatment

All of the procedures you mentioned can be good options for treating acne scars.  The best treatment will depend on your skin type, degree of scarring, and how aggressive you want to be with treatment.  It is vital to establish a good skin routine to control any current acne to prevent future scarring.  A combination of topical creams, such as the TNS Recovery, and peels or lasers can be very effective at minimizing scarring.  Most procedures require a series of treatments to obtain maximal results.  Our office uses an Erbium:Yag resurfacing laser, which gently targets the top layer of skin for a "laser peel".  Combined with topical treatments, we have seen good results at reducing the appearance of scarring.  

Kent V. Hasen, MD
Naples Plastic Surgeon
5.0 out of 5 stars 33 reviews

Acne Scars on Face Can Be Effectively Treated With A Number of Solutions

There may be several different treatment options. This will depend on what kind of scars they are. If they have some redness to them then IPL may be a great way to get the redness out. Lasers, Chemical Peels and Dermaroller Micro needling can work wonders on scars when properly treated.  Good luck!

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.

No to chemical peels

I agree that the DOT CO2 is a wonderful alternative for patients with acne scarring. I have seen fantastic results with this procedure and utilize it on a daily basis. It helps with resurfacing, texture and collagen production which patIents with acne scarring need. Without seeing you though, this is only a tentative plan. You may or may not be a good candidate for this procedure. 

Jeffrey Adelglass, MD
Dallas Facial Plastic Surgeon
4.0 out of 5 stars 4 reviews

Treatment for acne scars

We have been really happy with the results from Active FX and Deep FX combined treatment. However, different patients have different kinds of scars, and may need other approaches.Treating acne scars may require patience on your part and the part of your surgeon.

Different steps may be necessary. Some scars benefit from excision, some need fillers injection, and some are best treated by old-fashioned dermabrasion. You should talk to a surgeon with an extensive experience in treatment of acne scarring, and discuss your expectations.

Stella Desyatnikova, MD
Seattle Facial Plastic Surgeon
4.5 out of 5 stars 19 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.