What are my options for acne scar removal? I've tried Fraxel, microneedling, ICON laser and RF microneedling (Photo)

In my opinion, TCA cross followed by aggressive Fractionated CO2 should improve the scars. Multiple sessions are necessary. Find a scar expert.
Jeff Rapaport MD FAAD
Realself Hall of Fame

Really sorry that you have essentially wasted so much money and time with your prior treatments. My regular Realself followers are well aware that I have written extensively over the years cautioning people that fraxel lasers and RF treatments (as well as other supposedly "next big thing, " expensive "bells and whistles" devices) are far more supported by marketing hype than any hard science. Microneedling is an excellent appraoch as a final "polishing" step to blend in color and texture appropriately treated areas better with the surrounding normal skin--but is not particularly effective as a stand-alone treatment for acne scars. "I think...helped a little bit, but not significantly" translates into pretty much didn't help at all. Really sorry that you unfortunately had to learn the hard way. You would do well to look into Field Subcision for generalized facial acne-related atrophy; individual subcisions for elevating and smoothing boxcar and rolling scars: and TCA CROSS for ice pick scars and dilated pores. Realistically, any scar over 12 weeks of age--which I gather is the case with your scars--is considered a "mature scar,' and, as such the optimal improvement you can realistically expect even from a legitimate treatment or a combination of approaches currently available is between a 60%-80% overall improvement in appearance. Enough time and money has already gone down the drain, and it would seem prudent at this point to consult with an experienced, board certified cosmetic dermatologist scar specialist before squandering any more money on another expensive "next big thing." Hope this helps and best of luck.