Scar Removal Treatment for Acne Pit Scars?

I have pit like acne scars on my cheeks. About a month or so ago, I had one session of laser treatment and it didn't do much for me. I have skin that is clear of pimples NOW and am using a very nice cleanser. I drink lots of water, I try to exercise as much as possible and my diet is pretty good but I am stuck with these crappy scars on my cheeks. : ( I want them gone.

Every time I look in the mirror, I see them. Sometimes I just want to cry. What can I do? I don't want to spend my money on something that won't work. I just want something will create a smooth, scarless face so I can be a little more confident and not want to cover my face with my hair. Help me, please!!

Doctor Answers 10

Scar Improvement for Acne Scars

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Scars are visible for 2 main reasons: either the coloration or the contour is different from surrounding skin.  Acne scars generally present a difference both in color and in contour, since pigmentation is irregular and the skin is lacks its usual fullness.  So, an effective treatment needs to target both issues.  

The treatments most often cited are 1) high dose chemical peels, 2) laser resurfacing, and 3) micro needling.

While these are known to generate an improvement, there are two things that patients should keep in mind: First, these treatments generally require several sessions (with patients noting subtle improvement each time).  Second, while "scar removal" is every patient's request, "scar improvement" is the realistic goal.  Treatment plans that make the pigmentation and the contour as normal as possible, are excellent ways to generate this positive change.

Austin Plastic Surgeon

Unfortunately nothing will work 100% but you can have good improvement.

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Acne scars are a very difficult problem to fix and nothing works 100%. The traditional teaching was that deep acne scars needed to be surgically excised. However, this exchanges one scar for another and is really not a great treatment especially if you have a lot of scarring. The best treatment I have done is the fractionated CO2 laser. Although this does not completely correct the scars, with one treatment I can usually get a 50%, at least ,improvement in the scarring and with a second treatment anther gain, although more moderate.
The Fractionated CO2 laser as a bit longer downtime from the less invasive lasers usually 1-2 weeks, but I believe it is definitely worth it.

Hope this helps.

Kari L. Colen, MD
New York Plastic Surgeon
4.5 out of 5 stars 8 reviews

Scar removal options

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The good news is that there are many options available to help with acne scarring including filler injections, laser skin resurfacing, dermabrasion, chemical peels, excision, and others. It is important to keep in mind that any time a scar is present on the skin, it is almost impossible to make that scar go away completely, but many times a scar can be improved to the point that it not easily perceptible.

Acne scars can be a difficult problem to deal with, especially deeper scars, so a consultation with a physician specializing in facial aesthetics can be very helpful to review all the options in detail. Unfortunately, non-invasive treatments simply don't work well enough for acne scars and can often be a waste of time and money.

All the best,

Matthew Richardson, MD
Frisco Facial Plastic Surgeon
5.0 out of 5 stars 7 reviews

Acne Scar Treatment with Fraxel and eMatrix

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Acne scars are best treated with a combination of laser and injections to build up collagen.  Sculptra or PRP add value in increasing the body's own collagen.  Fraxel and eMatrix are the gold standards depending on the skin type of the patient.  After several treatments the tone and texture are markedly improved.  Please consult a dermatologist with special expertise with these lasers.  Best, Dr. Green

Scar removal for acne scars

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Scars can be very challenging to treat. To wash your face using cleansers that contain glycolic and/or salicylic acid are very helpful. They provide exfoliation to the skin’s surface and can help even and brighten the complexion. Chemical peels can give good results, but it takes a series of at least 4-6 peels spaced about one month apart to see the best changes. There are also a few different lasers that can treat acne scarring.Two of the most commonly used lasers are the Pixel and the Fraxel laser. The Pixel is done in one 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. The laser can give about a 50% improvement on average to the depressed scars and coloration

Joshua L. Fox, MD
Long Island Dermatologic Surgeon
5.0 out of 5 stars 22 reviews

TCA CROSS, also traditional erbium laser

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It really depends on the depth, downtime, scars, and also your skin type. I love TCA CROSS as a procedure, especially for deep ice pick scars. You may need 2-3 treatments, followed by erbium laser for optimal outcomes. 

A competent laser dermatologist can assess and provide you with a program.


Dr Davin Lim
Laser and cosmetic dermatologist

TCA CROSS is a good option for pit like scars.

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While a 100% result is unrealistic, you can get some good results with TCA CROSS method. Check with your dermatologist about this one.


Scar Revision for acne scars

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Acne scars vary in color and depth to width ratio. Patients with acne scars can benefit from topical creams, eradication of active acne, and surgery. Micro techniques, including subcision and acne scar excision are optimal to reduce the size and quantity of scars.

Raffy Karamanoukian, MD, FACS
Los Angeles Plastic Surgeon
4.8 out of 5 stars 95 reviews

Dermabrasion vs fractional CO2

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Shallow scars will benefit from fillers. Deeper acne scars will better benefit from dermabrasion or fractional CO2 laser treatment. A consultation with a board-certified plastic surgeon with skin care background will give you a systemic plan to improve this condition. Hope that helps!

Hisham Seify, MD, PhD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 19 reviews

A scarless face is not realistic when it comes to Acne treatments but there are many options

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A scarless face is not a realistic goal. If this is what you are looking for you will surely be disappointed.

In general, there are alot of options available when it comes to scar revision; sunscreen, camouflage make-up, topical medications/creams/bleaches/peeling agents, silicone gel or sheeting, microdermabrasion, chemical peels, collagen injections, subcutaneous fillers (fillers, grafts, implants), tattoo, dermabrasion, laser resurfacing/ablation/treatment, scar revision surgery, etc. These can be administered by the patient, nurse, and/or doctor.

Specifically, management of Acne scars can be a difficult undertaking and is generally aimed at reducing/altering rather than eliminating the visible scars. Many procedures have been described but there is no " wonder cure." Please read on for a description of the various options.

In other instances, more aggressive treatment may be warranted. For example, the following information is based on dermabrasion and the laser resurfacing procedures. During the consultation we may determine that other procedures are better suited for your optimal outcome.

Treatment of darker complexions: olive (mediterranean descent), hispanic, asian, black, etc. has a higher risk of post-operative hyperpigmentation (darkening or blotchiness) and erythema/hyperemia (redness) when compared to a fair complexion (typically northern european). I oftentimes will try a test area to asses an individual's responses to healing. In some darker skin individuals, I have found that I get a better response with dermabrasion. Again, I recommend performing a test patch in the high forehead or cheek regions to assess the individuals response to treatment. Multiple treatments may be required and will have to be spaced at least 4 months apart. It is extremely important that you avoid sun exposure with any technique post-operatively.

In some cases, I recommend the CO2 Laser. Other lasers are available. The procedure takes about 1 hour and is performed on an outpatient basis. Additional treatments my be required.

In certain cases, the only way to eliminate a deeply pitted scar is to excise (cut it out) and occasionally graft the hole followed by dermabarasion 6 weeks later.

Skin needling is an alternative to fractionated laser treatments.

I have also found that addition of fillers and/or fat for greater volume losees following cystic acne can provide additional benefits.

Unfortunately, there is no one right path and the correct procedure for you may actually involve using a combination therapy approach

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 86 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.