It's understandable to feel frustrated when collagen-inducing treatments don't seem to yield the desired results, especially when you've invested time and effort into improving your skin's health. There could be several reasons why these treatments may not be working as expected: Individual Skin Characteristics: Everyone's skin responds differently to treatments based on genetics, the severity of scarring, and skin type. Some individuals may naturally have a slower response to collagen stimulation. Previous Accutane Use: Although Accutane is effective for treating severe acne, it can sometimes impact skin healing and collagen production, even years after treatment. This might affect how your skin responds to certain procedures. Treatment Timing and Technique: The success of treatments like microneedling and CO2 laser can depend on the frequency and technique used. It might be beneficial to ensure that these are being performed by a dermatologist or a trained professional who can tailor the approach to your specific needs. Underlying Health Conditions: Occasionally, underlying health conditions or nutritional deficiencies can affect skin health and response to treatments. Lifestyle Factors: Despite your current healthy lifestyle, past habits can have a long-term impact on skin health. However, maintaining a balanced diet rich in antioxidants, vitamins, and minerals can support skin repair over time. Since you mentioned that you respond well to fillers, this suggests that your skin may benefit more from treatments that provide immediate volume and structure rather than relying solely on collagen stimulation. As for testing, while there isn't a specific test to determine why collagen treatments are less effective, you might consider discussing the following options with your dermatologist: Comprehensive Skin Evaluation: A thorough assessment by your dermatologist can provide insights into your skin's specific needs and potential barriers to collagen production. Blood Tests: Checking for nutritional deficiencies or hormonal imbalances that might affect skin health. Genetic Testing: Some advanced clinics offer genetic testing to understand your skin's aging process and how it might respond to different treatments. It may also be beneficial to explore other treatment options or combinations thereof, such as radiofrequency therapy, platelet-rich plasma (PRP) treatments, or other advanced dermatological procedures that might suit your skin better. Consulting with a dermatologist who specializes in acne scarring and anti-aging treatments can provide a more personalized approach to your concerns.