What is the best treatment for these acne scars on my temples? Would fillers help at all? (photos)

Hello and thank you for your question.  There are a few options that would would wonderfully to treat the acne scars on your temples.  With fillers and/or lasers, you should be able to achieve smooth and natural results. Fillers are a great way to smooth out scarring from old acne breakouts.  I like to use either Belotero, Juvederm Ultra or Resytlane Refyne which are all formulated to be injected in a more superficial plane or in thin skinned areas (i.e. fine lines and wrinkles, under eyes or acne scars). These fillers also help to attract and stimulate collagen production where it is place, so with about 2-3 treatments there should be long lasting results.  Before injecting the filler, it is also helpful to use the needle and perform subcisions to each scar. This technique helps to break apart the tethered down skin (scar tissue) which will also help to stimulate collagen over time.  Fraxel is also a great way to resurface the skin and diminish scarring.  Fraxel is a fractional laser that pokes thousands of tiny holes into the skin's surface which, in turn, helps to stimulate collagen and improve the elasticity of the skin.  With about 3 treatments (spaced 4-6 weeks apart) you can achieve your goals. Ideally, it would be best to have 2-3 treatments of Fraxel done first and if there are any remaining scars you can treat them with fillers.  This way you will treat the shallower scars with the laser and the deeper ones with filler.  Be sure to seek an experienced practitioner who specializes in facial aesthetics for best results. Good luck!

Acne scars need a combination approach for long-term improvement. Everyone has a unique pattern of acne scarring, and most people have various types of scars, so we create a tailored treatment plan for each patient. We often use:- Injectable fillers like Bellafill and Sculptra (with or without subcision) for atrophic, indented scars. - Subcision for depressed, tethered scars. - Vascular lasers like Yellow laser, Aerolase, excel V, or IPL for redness or thick acne scars. - Lasers such as Fraxel, Erbium, CO2 or fractional radiofrequency (Venus Viva, Skinfinity, Intensif microneedling RF) for textural issues and superficial scarring. - TCA CROSS and punch excision for deep ice pick scars and narrow box car scars.
All lasers are combined with microneedling/PRP to improve the results and accelerate your healing time. Keep in mind that a personalized combination treatment by an expert physician will give you the improvement you're looking for. I recommend getting a formal evaluation with an experienced cosmetic dermatologist and acne scarring expert. Best, Dr. Emer.

The photos demonstrate a predominance, particularly in the left temple of indented (sunken, atrophic, depresseed) boxcar and rolling scars. Prominence of the temporal bone on both sides highlights significant generalized volume loss in each of of the temples. Ice pick scars are present, but do not appear to predominate at least in the shots provided. A "field subcision" that involves both subcision and generalized volume repletion would likely go a long way to improving the general appearance of the temples, as well as improvement to the overlying scars by stretching them and making them less deep and less shadowed (i.e. by decreasing the shadowing, "craters on the moon" effect).  If needed, subsequent individual subcisions for residual troubling scars and TCA CROSS for ice pick scars,(both of which are quick, simple and relatively inexpensive treatments) may be used to achieve further improvement.  I would not suggest the use of permanent fillers, such as Bellafil, as permanent fillers can translate into permanent, very-difficult-to-treat complications, such as nodules and granulomas, which may occur not only immediately following treatment, but even five, ten or twenty years later. You would be well advised to seek consultation and treatment by a board certified aesthetic physician with a great deal of expenence, since the temples are a region filled with important blood vessels, and hence this is not a region that should be trusted to novice physicians and injectors. Best of luck to you.

Thank you for your questions and pictures. You could start with Bellafill, a filler used to treat acne scars, and follow up with microneedling and PRP. The two treatments together will cause your body to make new collagen and fill in the pitted scars, smoothing over the skin. I recommend seeing a board certified plastic surgeon in person to discuss your concerns as there are many other treatments such as lasers and peels that could help as well.

Fillers will help (collagen stimulation ones) like Sculptra or Radiesse 
You will also need subsicion in the scar area, that is a start and will improve a lot.
Looking for an expert ? 

Luis M Salazar MD
Aesthetic Solutions 

Hi, thank you for the inquiry. For these deep dermal scars, combination therapy works best. Energy based fractional devices and microneedling combined with PRP(Platelet rich plasma) can do wonders. I would recommend you to get cellular resurfacing prior to fillers for volume loss in your temple region. Please consult a reputable doctor for further evaluation.
Best Regards,
Dr. Neel Bector

From your photos start simply and if no good results move toward laser resurfacing.  My suggestion would be to use a filler in the depressions such as Volbella, a Juvederm product,  and also Platelet Rich Plasma injected directly under the areas.  This combo has worked wonders in a lot of my patients.  Hope this helps.
Dr. ODell

I would probably recommend a combination of fractionated laser and subcision with or without PRP to treat boxcar and rolling type scars. 

Microneedling is a great option for scars, though typically multiple treatments are needed. Microneedling, also called collagen induction therapy, is a minimally invasive skin-rejuvenation procedure that involves the use of a device that contains fine needles. The needles are used to puncture the skin to create a controlled skin injury. Each puncture creates a channel that triggers the body to fill these microscopic wounds by producing new collagen and elastin. Through this process there is improvement in skin texture and firmness, as well as reduction in scars, pore size, and stretch marks. You can couple microneedling with PRP (platelet rich plasma) for quicker results and a faster healing time. Another option would be CO2 laser resurfacing which reduces facial wrinkles and skin irregularities such as scarring. It essentially is removing layers of the skin which causes healthier skin around it to help with the healing process. I would recommend a consultation with a provider in your area to better assess the scar in person as well!

Thank you for your question.
In my opinion and with my experience, I find that a combination treatment is the best choice. Using fat transfer for filling the depth and laser resurfacing for the surface.
A lesser option could be Fractora and fillers such as Juvederm or Restylane.
You need to treat inside and outside.
I hope this helps.