What can I do to minimize the appearance of acne scars after Accutane? (photos)

Hi! Thank you for your question regarding acne scars and treatment options. I would suggest microneedling! I see you mentioned you tried it before, but maybe it wasn't aggressive enough or consistent enough. For my patients, I suggest 3 treatments, 4-6 weeks apart. You may need more than 3 sessions, but I would start with that and re-evaluate.

If microneedling doesn't work for you, I would suggest either Fraxel or Morpheus8! I hope this helps.

Acne scar treatments require precision and attention to detail. There are several types of acne scars, including atrophic, hypertrophic, PIH hyperpigmented, and hypopigmented scars. Depending on the types of scars you have, our office can recommend a Hidef treatment protocol that can recontour existing scars and reduce complexion irregularities. The results are simply life-changing.

As a general rule, we recommend fillers, subcision, acne surgery, RF ablation, and laser ablation to help with atrophic scars. Hypertrophic and keloid acne scars require pulsed dye laser and IIT SC. PIH scars require chemical peels, Melarase creams (AM and PM) and laser.
If you have ice-pick scars, we recommend RF ablation and TCA Cross.
Best,
Dr. Karamanoukian
Realself100 Surgeon

"​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, BBL, or IPL for redness or thick acne scars.
- Lasers such as Fraxel, Erbium, CO2, Halo or fractional radiofrequency (Venus Viva, Skinfinity, Morpheus, PiXel8, Fractora, 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. ​"

Hi @Ak_s! I would recommend doing 3-6 sessions of radio frequency with microneedling (Morpheus 8). It works great for scars, skin tightening, and fat melting if desired (in the submental and jowl area). In addition, if you are not already doing so, I would incorporate Vitamin C, Niacinamide, Retinol, and and an exfoliant in your skin care routine.

I have been performing subcision for elevating and smoothing boxcar/rolling scars since 1995, and both TCA CROSS for ice pick scars and dilated pores and professionally performing microneedling--for superficial texture/color irregularities--each for about twenty-three years. Your doctor should have explained to you that about a 60-80% overall improvement in appearance is possible with each of these modalities when treating mature scars (over twelve weeks of age) of all kinds. S/he should also have explained that for the vast majority of patients between two to six (average about four ) treatment sessions are required to achieve that degree of success, and that in most cases little to no visible improvement is seen after the first or even second treatment sessions. So, it is absolutely not surprising at all that you did not see any improvement after just one session, since only a tiny minority of people are such lucky lottery winners. So, before throwing out the baby with the bathwater and jumping into all kinds of expensive "bells and whistles" fraxel lasers and RF devices (whose hard science to support their use lags woefully behind the heavy marketing seen on Drs. YouTube & Instagram, etc.), you should discuss this your treating physician and make sure that you are consulting an experienced, board certified cosmetic dermatologist scar specialist. Hope this helps. Best of luck.

Hello, and thank you for your inquiry! Microneedling is a good treatment for acne scarring. This procedure will need to be repeated a few times. Microneedling can be done 4 weeks apart. Another treatment for acne scarring is a product called Skin vive. Skin vive is a a hyaluronic acid injectable that can help improve the appearance of your skin. Good luck on your journey!