Early 40s, would you recommend Juvederm for volume loss due to acne scarring? (Photo)

First, let me say that there is absolutely nothing to feel shame about. Acne and acne scarring are conditions for which a person need not feel shame any more than someone need feel shame for having psoriasis, eczema, chronic hives or any other skin condition, or medical condition, for that matter. From the one photo provided it is difficult to determine whether the numerous bumps under the lower lip is an acne scar condition known as papular acne scars. If so, then three different treatment options are available, which include scalpel sculpting, intralesional injections of anti-inflammatory agents, and simple flattening using light electrocautery. For my patients presenting for the first time with this condition, I usually perform an initial test of each treatment approach to see which works best for that particular individual. Having said all that, if the bumps are simply active acne then appropriate topical anti-acne treatment would likely adequately treat these. Finally, if the various depressions on the lower cheeks to the sides of the mouth are at issue here, then individual subcisions can be performed to elevate and smooth them (generally three to four treatment sessions are necessary to achieve optimal results), which may be accompanied by the injection of an appropriately robust HA lifting filler (ordinary Juvederm is typically not sufficient in my experience) for further benefit. You would be wise to consult with an experienced, board certified cosmetic dermatologist acne scar specialist. Hope this helps and best of luck. And please remember, there is really no need for you to feel shame.

Juvederm is a type of dermal filler that's often used to add volume to different areas of the face. It can be an effective treatment for volume loss due to aging or other factors. When it comes to acne scarring, Juvederm can help in certain cases, particularly with "rolling" scars or those that have caused a loss of volume in the skin.
Juvederm works by adding volume beneath the skin, which can help to lift and smooth pitted acne scars, making them less noticeable. However, it may not be as effective for "ice pick" scars or "boxcar" scars, which are deeper and more defined.
As always, it's important to consult with a dermatologist or a qualified healthcare professional to discuss the most appropriate treatment options for your specific situation. They can assess your skin condition, discuss your goals and expectations, and recommend the best course of treatment.

Yes filler can help improve the appearance of acne scarring. You mentioned you tried microneedling. Have you tried Morpheus8? This treatment combines RF technology with microneedling to improve overall skin tone and texture.