Acne scar treatment options? (Photo)

Hi, I'm of an Asian descent. I have some deep acne scars and would like to know what my treatment options are. Will fillers work on my type of scars or should I go with more aggressive treatments? Your opinion is highly appreciated. Thanks in advance for your help.

Doctor Answers 7

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

I do a combination of laser or radiofrequency, fillers, TCA cross and subcision.          Best, Dr. Emer.      


Los Angeles Dermatologic Surgeon
4.9 out of 5 stars 165 reviews

Different Types Of Acne Scars Require Differing Treatment Approaches

In general, depressed scars, such as boxcar and rolling scars, need to be elevated, and subcision often works well for these. The supplemental use of certain fillers immediately under the base of the scars can not only augment the elevation and provide immediate improvement, but can also play a biostimulatory role by promoting new, native collagen and elastic fiber synthesis (neocollagenesis and neoelastogenesis, respectively).

Pit (ice pick) scars respond well to The TCA CROSS Technique.

Further smoothing may be obtained by the use of a volumizing filler injected under the entire scarred area, below the scars, to stretch them and make them more shallow and less shadowed. 

Finally, fractional microneedling using manual or automated devices may be employed to help blend the tone and texture of the treated scars with the surrounding normal skin. Very shallow scars likewise can respond well to this approach. 

All of the above approaches have been safely used in Asian skin.

As an aside, I am not much of a fan of fraxel lasers nor of radiosurgical devices, finding these relatvely expensive approaches to be far more backed by device manufacturer supported marketing hype than hard science. 

You would be wise to seek consultation with a board certified aesthetic physician with particular experience and expertise in acne scar treatments.

Nelson Lee Novick, MD
New York Dermatologic Surgeon
4.8 out of 5 stars 23 reviews

Asian Skin and Scar Treatments

I have had great results with eMatrix in treating Asian skin with minimal downtime.  You will need at least three sessions but you should see continued improvement after each treatment. Best, Dr. Green

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Need exam

Scars need to be evaluated in person to see how the skin moves. Asian skin is very responsive to fractionated resurfacing but need to be treated conservatively with a low density of 5.5 per cent on the Sciton joule to minimize hypopigmentation.

Morris Westfried, MD
Long Island Dermatologic Surgeon
5.0 out of 5 stars 5 reviews

Fraxel

Fraxel is a laser skin rejuvenation treatment that resurfaces your outer skin, erasing imperfections. It also encourages the production of collagen, a protein found in connective tissue.The result is clearly visible lines, folds and wrinkles. Fraxel laser skin rejuvenation is a non-invasive technique that affects only about 20 percent of the facial skin exposed to it. The most common side effects of Fraxel laser treatment are swelling and skin redness, which should subside within a couple of days. Other temporary side effects may include minor itching, dry skin, peeling or flaking, and a bronzed skin appearance. The risk of infection or scarring is very limited. You should stay out of the sun 2-4 weeks.

Elliot M. Heller, MD
New York Facial Plastic Surgeon
4.6 out of 5 stars 87 reviews

Asian with Acne scars

In my opinion, based upon the photos, I think that you have deep saucer as well as superficial saucer-shaped cars and box cars. The treatment for these types of scars include subcision, microneedle radio frequency (infini ) and radio frequency,  and non-ablative lasers. Should the scars be distensable upon pulling the lateral edges of the scar, fillers are also an option. Pre and post treatment with bleaching creams are important for Asian skin. There exists fillers that have 5 years duration as well as  more natural fillers that will last two to three years.  I tend to avoid the permanent fillers .  I feel that permanent fillers can lead to permanent problems. Multiple treatments will be necessary. Seek a dermatologist or skin specialist who has experience in treating acne scars.  Ask to see photos. Hope this helps. Good luck.

Jeffrey Rapaport, MD
Englewood Dermatologic Surgeon
4.6 out of 5 stars 38 reviews

Multiple procedures.

I would start with RF - radio frequency micro needling with insulated needles- INFINI RF. This is a good treatment as it does not involve laser energy, hence with your skin type, the chances of skin colour changes are virtually nil. More on the device in the link below. (second half of video). 

You will also require subcision, and dermal fillers. You can expect a good improvement, however with your scar type, several methods must be used. 

kind regards

Dr Davin Lim 
Laser Dermatologist
Brisbane, Australia. 

Davin Lim, MBBS, FACD
Brisbane Dermatologist
4.7 out of 5 stars 60 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.