Struggling With Acne Scars For 15+ Years? (photo)

Hi all: I have been struggling with my acne problems for almost 15 years. It is very frustrating! I just completed 30. I have done subcision, fraxel, and a variety of peelings. I notice a slightly improvement. I guess because I have dark skin. I would like to know what type of acne scar treatment I can do at this point that won't just make me wasting my money. I have read about silikon 1000 as a filler, but don't now whether it would improve in my case.

Doctor Answers 5


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The options you have for your acne scars are Laser treatment, as Profractional laser or even a mini face lift to stretch out the skin and get rid of the scars. Fillers are not long lasting results. You should look into laser. Good luck


Beverly Hills Plastic Surgeon

My Best Results for Acne Scar Treatments

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Your acne scars should be addressed from a temporal (skin improvement strategy needs a calendar, not a stopwatch) standpoint, i.e. initial treatment, follow-up treatment, and long term topical therapy. First of all we must control the outbreaks with medical care (benzoyl peroxide, topical antibiotics, antibiotics by mouth, & possible hormone regulation).

Next, I have found that subcision of the depressed acne scars, CO2 Fractional Laser, and Fat Grafting yield the most impressive results. The growth factors in the fat grafts help to retexturize the skin, while building collagen. I often times will repeat a  CO2 Laser spot treatment to improve scars that are deeper. Repeat Fractional Laser treatments by themselves will improve your appearance, but will take longer without the filler (fat graft).

Once your skin contour is less irregular and smoother, one must continue using home therapy of Retin-A, bleaching agent, and initially a mild topical steroid cream to even out pigment and reduce return of darker pigmented skin. You should seek a board certified Facial Plastic Surgeon or Board Certified Dermatologist that performs these techniques. M.Lyons, MD

Michael B. Lyons, MD, FACS
Mobile Facial Plastic Surgeon

Fractional CO2 Laser for Acne Scars

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After viewing your photos, it appears that you have both atrophic (pitted) acne scars and hyperpigmentation (brown spots from acne.)  Since you did not experience improvement after the Fraxel laser treatment, I would recommend meeting with your dermatologist to discuss possible treatment with a Fractional CO2 resurfacing laser.  The Fractional CO2 laser delivers a more dramatic improvement of acne scarring that a traditional Fraxel laser treatment.  Most patients do very well with either one Fractional CO2 laser treatment or a series of Fraxel laser treatments (usually 4), but since you have already tried Fraxel laser treatments, I would recommend exploring Fractional CO2 laser treatments.  When performed by an experienced laser surgeon, the Fractional CO2 laser treatment is safe for all skin types and can produce up to 70% improvement of scarring after just one treatment.

Fillers (such as Silikon 1000) can improve the texture of your skin, but will not improve the discoloration left behind from old acne.

Eric Schweiger, MD
New York Dermatologic Surgeon

Acne Scar Improvement

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Hi, I hear your frustration, and righfuly so.  It sounds like you have had many very responsible treatments for your acne, although maybe they were over sold. The first thing I notice is that in addition to acne scaring, you are still experiencing active acne in the neck and jaw line.  So both elements need to be addressed. A comprehensive medical workup and perhaps hormone manipulation would be indicated.  The inflammatory lesions.  We treat with vasuclar lasers either YAG or Pulsedye to settle down the redness quicker than it will resolve on its own.  The more stable mature scars of a rolling nature could benefit form a filler, judicious use of medical grade silicone or fat transfer, and still more surface based resurfacing.  The pitted scars we have had success with the CROS technique which can be used in individuals wiht your pigmentation, and can be very helpful. 

Arthur N. Falk, MD
Albany Facial Plastic Surgeon

Acne Scar Treatment

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Based on what I can see from the pictures, you have a fair amount of scarring and discoloration.  THe treatments you have undergone for the acne scarring are not always that effective. It seems you have a good amount of depressed and atrophic acne scars which will do wonderfully with injectable fillers. We use liquid injectable silicone in our practice and our patients are thrilled with the results. Silicone is precise and permanent, making it the ideal filler for acne scarring.  You should also be on a regimen to try and improve the discoloration which would include things like hydroquinone and topical RetinA. Chemical peeling can be helpful for very mild acne scarring, textural issues, and for improving discoloration. 

Channing R. Barnett, MD
Boca Raton Dermatologist
4.1 out of 5 stars 8 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.