How exactly does Restylane and Juvederm work for acne scars?

Hi and thanks for your question. I would want to see you to be sure, but from what you write, it sounds like you would have the best results with a combination treatment of laser and fillers. Acne scars are tough to improve so you should use the most intense laser possible for your skin type. If you have light skin, I would recommend a CO2 laser or a Fraxel. Multiple sessions will be necessary with either device, but you will need less sessions with the CO2. Recovery time will be more with CO2. After you are done with the lasers, then you can try fillers for whatever contour irregularities you have left. Both temporary and permanent fillers work to improve acne scars. My suggestion would be to try the temporary fillers like Juvederm or Restylane first. Make sure that you choose a practitioner with lots of experience in multi-modality treatment of acne scars.

Acne scarring is best treated with a combination approach.  Fillers, lasers, subcision all work together to improve scars.  Fillers plump the scars up to make the skin look more smooth.  Best, Dr. Emer.

Restylane is a safe and natural cosmetic dermal filler that restores volume and fullness to the skin to correct moderate to severe facial wrinkles and folds. It is a satisfying lip filler, bringing “new life” to small, narrow lips. Restylane was the first filler of its kind in the U.S. market and has achieved much success. You will be very satisfied with this treatment experience. The results are appreciated before you even leave the office. Restylane is made of non-animal based hyaluronic acid. Hyaluronic acid is a natural substance that already exists in the human body and is used to provide volume and fullness to the skin. Unlike rooster-derived hyaluronic acid-based products, Restylane is free from animal proteins. This quality limits any risk of animal-based disease transmission or allergic reaction. Restylane requires no pre-testing and the effects generally last for about six months. Restylane is injected directly into the skin in tiny amounts by an ultrafine needle, resulting in minimal discomfort. The procedure is simple and convenient, and the results are practically instantaneous.Juvederm is the one of the latest dermal fillers introduced to the U.S. market by Allergan, the company which manufactures Botox. It is a hyaluronic acid based filler similar to Restylane. However, JUVÉDERM™ injectable gel employs its unique manufacturing process to provide the highest concentration of cross-linked hyaluronic acid of any currently available hyaluronic acid dermal filler for long-lasting results. This advanced manufacturing process also creates a smooth consistency gel that flows consistently and easily into the skin and provides a smooth, natural look and feel.Recently approved by the FDA, Juvéderm™ injectable gel is a “next-generation” dermal filler. The smooth consistency gel helps to instantly restore your skin’s volume and smooth away facial wrinkles and folds, like your “smile lines” or “parentheses” (nasolabial folds—the creases that run from the bottom of your nose to the corners of your mouth).With Juvederm, the results are immediate with minimal downtime. Most patients need one treatment to achieve optimal wrinkle smoothing, and the results last up to 6 months or more. Juvederm can be used virtually anywhere on the face, with most success in the lips, nasolabial folds (lines from the nose to the corners of the mouth), and the marionette lines (lines from the corners of the mouth downward to the jawline).

Thank you for your question.  Filler works by pushing the scar up from underneath therefore it does not work well for deep pitted scars like ice-pick scars, but rather shallow atrophic scars like the boxcar scars.  I believe you would benefit from a combination treatment approach using laser, peels, subcision/miconeedling and possibly filler.Good Luck!

Hyaluronic acid based fillers such as restylane and juvederm are useful for atrophic boxcar scars to lift them up for approximately 9-12 months. Even when worn off, there appears to be some longlasting residual improvement, likely due to collagen stimulation from the procedure and/or filler itself. Icepick scars can respond to TCA CROSS or punch excision.

Hyaluronic acid fillers work by pushing up the scars from below and therefore will only work on shallow scars that the injector can get under. Ice pick scars will not respond to fillers and unfortunately will not respond to TCA either. The only treatment for ice pick scars is to surgically remove them and perform a dermabrasion

Acne scars are treated differently depending on their appearance and structure. Sometimes there is no actual scar at all, but just a dark spot from inflammation. These spots usually improve on their own if you protect them and keep them out of the sun. In the meantime, to control the inflammation and acne breakouts, topical retin-a cream with intermittent salicylic acid peels can dramatically improve your skin tone and frequency of breakouts. Once the acne is controlled and you continue to do have remaining scars due to permanent dermal injury from acne, a variety of treatments can be performed to remodel the scar from energy-based lasers and radiofrequency devices to mechanical disruption of the scar with microneedling. Deep wide scars can be released and filled in with subcision and semi-permanent fillers such as Bellafill. Juvederm and Restylane need to be injected in a deeper plane to avoid discoloration or a "bump" forming and are not ideal for acne scars. Ice-pick (thin, deep) scars are best treated by excising them completely. For the best treatment options, it is important to visit an expert for an in-person examination. Hope this helps!





Johnson C. Lee MD



Plastic Surgery