What is the best treatment for my acne scars? (Photo)

My cystic acne has subsided but it left me with these awful scars. I'm looking for treatments that can significantly improve my scarring. I'm not sure if lasers will work on my type of scarring. Is that the best choice for my type of scars? How long is the treatment plan to have a noticeable improvement? Thanks!

Doctor Answers 6

Acne Scarring -- Requires a Combination of Fractional Laser Resurfacing, Fillers Like Bellafill, Subcision and Eclipse Micropen

You need a combination approach and to be honest a very experienced physiican.  This needs surgical repair, lasers, fillers, subcision.  A combination of modalities.  I suggest you only go to the best and do not compromise your care for cost or distance.   This will take a series of treatments long term to get improvement.  Best, Dr. Emer.

Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 190 reviews

Severe acne scarring

Volume is needed without a doubt. A long lasting solution is Bellafill, which can also be used for rolling acne scars. Combination of subcision, Infini, and volume should improve things tremendously. It will never look normal but you should be happy with results.

Steven F. Weiner, MD
Panama City Facial Plastic Surgeon
4.7 out of 5 stars 41 reviews

Acne scar treatment

Dear Steve:

You have significant acne scarring with rolling scars due to both fibrosis (scar tissue deep down) and loss of underlying fat in areas (also from the inflammatory acne).  Treatment is a process but in my opinion must involve more that surface treatments with lasers (or chemical peels). I prefer using Sculptra over temporary fillers, which I inject at the time of laser treament (I would prefer a series of Fraxel restore treatments at high settings for deep penetration).  Multiple treatments with both the laser and Sculptra injections are indicated.  I would be optimistic as significant improvement is what I would expect.  Also adding some subscision before laser treatment is helpful to break up the scar tissue that partially tethers the rolling scars.

Christopher Dannaker, DO
Monterey Dermatologic Surgeon
4.6 out of 5 stars 5 reviews

Combning Multiple Modalities Best For Treating Severe Cystic Acne Scarring

Unfortunately, all scars, including those from acne, are permanent. That being said, we fortunately have a variety of techniques for significantly improving their appearance. Your photos clearly show that have a particular confluence of marked atrophic scarring. Following a close up examination, your treatment plan therefore needs to be developed based upon the precise types of scars that are present, their number, and their specific locations.

It should seem obvious that a one-size-fits-all approach so often recommended these days to treat them, such as "fraxel lasers to take care of everything," simply does not make sense and can be expensive to boot. The same applies to a lot of other overly hyped devices, like microdermabrasion, radiofrequency, ultrasound and IPLs--all of which are backed far more by device manufacturer and physician marketing hype than any real, hard science.

On the other hand, some considerably less expensive approaches have been shown to be tried and true, including volumization with injectable volumizing fillers to reflate sunken cheeks, which figures quite prominently here; subcision with or without fillers to raise up indented (atrophic) scars; TCA CROSS to tighten pit (ice pick) scars; and fractional microneedle resurfacing (aka medical microneedling)) to blend surface color and textural irregularities. Punch grafting and punch excisions may also be of value for certain deep boxcar-type scars.To learn more about any of these techniques, check out the archives of RealSelf.com.

Seeking consultation and treatment by a board certified aesthetic physician with expertise and experience in treating all forms of acne scars is strongly advised. Best of luck to you.

Nelson Lee Novick, MD
New York Dermatologic Surgeon
4.9 out of 5 stars 29 reviews

Deep Acne Scars

You would benefit from a combination of fillers and laser treatments.  You would need fillers for the deep scars and also to increase volume.  Lasers such as Fraxel would help treat the textural damage from the scarring.  Please consult an expert.  Best, Dr. Green

Michele S. Green, MD
New York Dermatologist
5.0 out of 5 stars 76 reviews

Cystic Acne Scars and how to treat them

This requires aggressive therapy. We just had someone just like you about 2 weeks ago. You will reconstruction of your face. Aggressive volumizing, aggressive release of your scars. The healing could be prolonged and challenging visually and temporally. But we can help for sure. We have a 5-7 step process done in about 2 hours. You have volume loss, cavitations in your face, rolling box car scars. 

Philip Young, MD
Bellevue Facial Plastic Surgeon
4.2 out of 5 stars 84 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.