Acne scarring correction? (Photo)
Doctor Answers 4
Acne Scarring -- Lasers (Fraxel, Co2/Erbium, VIVA, Intensif); Microneedling/PRP, Fillers (Bellafill); Subcision; Punch Excision
This type of scarring requires a combination approach with fillers, lasers, microneedling/PRP, sometimes even TCA cross. Please see an expert. Best, Dr. Emer
Acne scars can be helped through a combination of fillers, lasers, PRP, microneedling and other techniques such as TCA cross hatch. Please consult an expert in treating acne scars to assist you. Best, Dr. Green
Acne Scars Typically Improve With A Combination Of Techniques
As is usually case, your photo demonstrates a mix of scars, including rolling scars, boxcar scars and especially ice pick (pit) scars, particularly on the nose. There is also some generalized cheek volume loss. Accordingly, a combination of techniques, i.e. a multi-modal approach, rather than "A One Size Fits All" approach is best for treating acne scars. If indeed there is volume loss, I would first begin by volumizing the area beneath it with a volumizing filler, which by itself can help to elevate and stretch the overlying scars. For this purpose, in my Upper East Side Manhattan office, I would opt for Voluma XC, while in my Israel satellite facility, where a far greater number of regulatory agency approved volumizers are commercially available, I would opt for Stylage XXL. Atrophic (indented scars), i.e. the rolling and boxcar types, can be treated with subcision to raise them up with or without the addition of a lifting filler, both for its immediate lifting and for its biostimulatory effect (to promote new, native collagen and elastic fiber synthesis). My choice would be Restylane Lyft (NY) and Hyaluronica 2 (Israel). Pits and very dilated pores may be treated with The TCA CROSS Technique, using either full strength TCA or phenol; rolling and boxcar scars may be improved with subcision followed by microneedling. Tiny droplets of Botox may be placed in a grid fashion throughout the pitted area to achieve additional improvement. I have not been impressed with expensive fraxels, radiofrequency or ultrasound devices, which are proving themselves to be backed far more by device manufacturer supported marketing hype than hard science. Please note, that unfortunately, mature scars from any cause, including those from acne, cannot be completely eliminated. However, they can be improved signficantly in appearance. For more information on any of the above, you may check out the archives of RealSelf.com and be certain to consult wtih a board certified aesthetic physician with experience and expertise in treating acne scars. Be particularly cautious about places interested in hawking some relatively expensive one-size-fits-all, "next best thing" device to come along. Hope this helps. Good luck
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