Permanent scar or temporary indentation? 20 years old, male. (Photo)

Acne cystic depressions can take a minimum of 6 months to fill in on their own. Sometimes up to a yr. Be patient and get chemical peels such as jessners or 10% TCA to help along the way.

Our treatments use combination therapy to improve the epidermis and dermis for most deep scars. The options available for acne scars depend on the character of your scars, in terms of topography and contour. We see atrophic and hypertrophic acne scars, as well as scars that have hypo and hyperpigmentation. We begin each scar evaluation with an assessment of scar quality and subtype. Our main concern is rebuilding collagen and that is why we use a HIDEF protocol that includes combination therapy. Morpheus 8, scar subcision, fibrous release, fractional laser, CO2 laser, Thulium laser, PDL Vbeam laser, and fractional resurfacing can be used in addition to TCA Cross and chemical peels to further improve skin. Patients should start Melarase AM and Melarase PM for active hyperpigmentation. Always begin with a consultation to decide whether early subcision should be started.

Best,
Dr. Karamanoukian
Realself100 Surgeon

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. I would say it takes a good 3-6 months before knowing if a scar will likely stay "indented."  Deep wide scars can be released and filled in with subcision and a filler such as Bellafill which is specifically designed for divets and depressions left by acne. The very thin or deep ice-pick scars are best treated by excising them completely.  I especially like a combination of a chemical peel for the hyperpigmentation and acne control, microneedling with PRP for texture and collagen building, and PIXEL fractionated laser or RF to resurface and build even more collagen.  I would use the subcision with Bellafill for the individual deeper scars. Not everyone is a candidate for all the treatment options however as certain skin types can get worse from certain treatments. For the best treatment options, it is important to visit an expert for an in-person examination. Hope this helps!
Johnson C. Lee, MD
Board-Certified Plastic Surgeon
IG: @drjohnsonlee

It is very hard not to touch acne outbreaks, but it is the manipulation that can potentially cause scarring with every zit.Your scar could potentially be long term.Make sure you are on the proper chronic antibiotic treatments to prevent and lessen the outbreaks.Microneedling with prp can help heal divots and scarring.Best. Dr Brecht