Filler or microneedling for acne scars? (photo)

Acne scar treatments require precision and attention to detail. There are several types of acne scars, including atrophic, hypertrophic, PIH hyperpigmented, and hypopigmented scars. Depending on the types of scars you have, our office can recommend a Hidef treatment protocol that can recontour existing scars and reduce complexion irregularities. The results are simply life-changing.

As a general rule, we recommend fillers, subcision, acne surgery, RF ablation, and laser ablation to help with atrophic scars. Hypertrophic and keloid acne scars require pulsed dye laser and IIT SC. PIH scars require chemical peels, Melarase creams (AM and PM) and laser.
If you have ice-pick scars, we recommend RF ablation and TCA Cross.
Best,
Dr. Karamanoukian
Realself100 Surgeon

"​Acne scars need a combination approach for long-term improvement. Everyone has a unique pattern of acne scarring, and most people have various types of scars, so we create a tailored treatment plan for each patient. We often use:
- Injectable fillers like Bellafill and Sculptra (with or without subcision) for atrophic, indented scars.
- Subcision for depressed, tethered scars.
- Vascular lasers like Yellow laser, Aerolase, excel V, BBL, or IPL for redness or thick acne scars.
- Lasers such as Fraxel, Erbium, CO2, Halo or fractional radiofrequency (Venus Viva, Skinfinity, Morpheus, PiXel8, Fractora, Intensif microneedling RF) for textural issues and superficial scarring.
- TCA CROSS and punch excision for deep ice pick scars and narrow box car scars.

All lasers are combined with microneedling/PRP to improve the results and accelerate your healing time. Keep in mind that a personalized combination treatment by an expert physician will give you the improvement you're looking for. I recommend getting a formal evaluation with an experienced cosmetic dermatologist and acne scarring expert. Best, Dr. Emer. ​"

Hi there! Thank you for your question regarding filler or microneedling for acne scars. I recommend microneedling over filler. First off, filler is temporary, while microneedling can offer long-lasting results. Second, since these scars are not very deep, using filler may cause the area to look bumpy or elevated. The scars are not deep, so it wouldn't require much product, however you will still have to pay for a full syringe, as the same syringe should not be used for multiple people. Therefore, micrneedling may be more cost effective as well. I believe you would get a great result from microneedling! I would suggest 3-4 sessions, 1 month apart. Hope this helps!

HI,
I would do the microneedling first because that will do the majority of smoothing out the skin, and after 3 sessions I would re assess the need for overall smoothing vs a few larger pits that haven’t resolved that could just use a bit of filler to complete the results. Always better to start with an overall improvement of all the facial skin and then with the specific spots for a more natural look and so that you dont over spend on filler that will fade over time. Also, when your overall skin looks great you may not notice the acne scars as much. Hope that helps.