i have acne scars on my face. What's the best treatment? (Photo)

they are deep, i have already taken 8 derma roller sessions scars are slightly better now but still very prominent Request you to suggest me what should i do ? please find the scars in the pics attached. Many thanks, Vandana

Doctor Answers 4

Acne Scars On Face

You have a very complicated case and need a long term solution.  It likely means a combination of multiple small surgeries, subcision and then followed with laser and filler injections.  Dermarolling, although very good for scars, will likely not help you in the short term and you would need many years of treatments for results.  Fillers such as artefill or silkon could be used but will not address the textural changes you have.  I suggest you seek someone who is an expert in acne scar treatment and who can coordinate the best care for you.  It will take a long term management, not covered by insurance, but will change your life.  Best, Dr. Emer.


Los Angeles Dermatologic Surgeon
4.9 out of 5 stars 179 reviews

Acne Scars Respond Best To A Combination of Treatments Tailored To The Kinds Of Scars Present

My over thirty years of experience in treating acne scars has taught me that since most people with acne scars have a variety of different kinds of scars (atrophic--indented--scars, pit scars, rolling scars and boxcar scars), their treatment(s) need to be tailored and individualized for best effect. A one size fits all approach seldom works.

For example when extensive acne scarring of the face leads to a more sunken look to the cheeks, the mid-face and cheeks may be plumped, lifted and stretched (and the scarred skin secondarily smoothed) with a technique that uses volumizing fillers, known as The Nonsurgical 3D Vectoring Facelift.

Following this, subcision can be used to further lift and smooth remaining depressed, atrophic scars. In general I would additionally inject a a biostimulatory volumizing agent, such as Radiesse combined with Perlane L (in my Upper East Side Manhattan office and Radiesse combined with Restylane SQ in my Israel satellite facility where a far greater number of regulatory agency approved injectable fillers and volumizers are available). The addition of the volumizer not only yields immediate cosmetic improvement, but promotes new native collagen synthesis (neocollagenesis).

Following the above, medical microneedling (aka fractional microneedle resurfacing or needle dermabrasion) may be appropriate. Although you state that you have already undergone eight dermarolling treatments with only some benefit, it would be important to find out precisely what needle depth was chosen and how many passes were performed. Deeper acne scars, as seem to be the case here, would best respond in my opinion to a electric microneedle treatment with the Dermapen device, using a  2.5 needle length and rapid speed setting, and at least two aggressive passes per area per treatment session.

For more information on any of the above treatments, check out the archives of Realself.com.

It is important that you seek consultation by a board certified aesthetic core physician with extensive experience and expertise in treating acne scars. Make sure to ask to see his/her befores and afters. 

Nelson Lee Novick, MD
New York Dermatologic Surgeon
4.8 out of 5 stars 26 reviews

Acne scars and best treatment

Treating acne scars depends on how deep your scars are and the type of skin type that you have.  In your case the eMatrix laser would probably be the best laser for you.  Fraxel is a fabulous laser but it can only be used for scars in very fair skin otherwise there is a risk of hyperpigmentation.  Please consult a board certified dermatologist with extensive experience in acne scars for the best treatment results.

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Start with Resurfacing.

With your type and severity of scarring I would prefer to begin with resurfacing treatments in order to smooth the edges of the crater-like [aka boxcar] scars and to unroof tiny tunnel type scars which can trap oil and reinfect. Resurfacing with strong laser will prepare for subsequent treatment with fillers and subcision as indicated. Since sufficient healing time between treatments is necessary, you should know that it could take one to two years to complete treatment. Seek treatment by a Board Certified dermatologist who has experience with the multiple modalities required to rehabilitate your skin

David S. Orentreich, MD
New York Dermatologic Surgeon
5.0 out of 5 stars 1 review

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.