Please advise me on the right course for this acne scarring. I am 37 years old and have had scars for around 13 yrs. (photo)

I have acne scars all over the face. They used to be a combination of rolling and boxcars. I got two sessions of micropen needling done in the last 6 months and I feel like even though it has improved the texture of my skin, it has worsened the appearance on the scars. Based on the current situation, what treatment would be the best? I highly appreciate your time and answers.

Doctor Answers 5

Melapads, Hidef Acne Scar treatments

I would recommend a combination approach that includes sublative RF, fractional lasers, Yag laser, subcision, and HA fillers. Best, Dr. KaramanoukianLos Angeles


Los Angeles Plastic Surgeon
4.8 out of 5 stars 94 reviews

Multiple targeted acne scar treatments

The best results are combination ones targeting each scar type. Overall INFINI is a better energy based system than just micro needling, but finding the correct method for your acne scars is the Gold Standard in revision. Video talk you thought the various methods we all use to treat scars. 
All the bestDr Davin LimBrisbane, Australia 

Davin Lim, MBBS, FACD
Brisbane Dermatologist
4.7 out of 5 stars 61 reviews

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

Acne scarring requires a combination approach. Surgery, subcision, or TCA cross for deep or pitted "ice pick" scars. Fillers like Bellafill or Sculptra or Radiesse for broad "boxcar" or "rolling" scars. Eclipse Micropen for all types of scars and improvement in texture and tone. Lasers such as co2 laser resurfacing or Fraxel/Clear+Brilliant or radiofrequency such as Sublative or Viva to improve the scars and give long term collagen production. I suggest consulting with a board certified dermatologist for further assessment. Best, Dr. Emer

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.9 out of 5 stars 166 reviews

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Subcision Works Well For Boxcar & Rolling Scars; Microneedling Best For Surface Tone& Texture Problems

Since acne scars come in different varieties, to be effective, multiple modalities, rather than a one-size-fits-all treatment plan, will prove most effective.
Microneedling is an excellent method in my experience, as a final step in the overall treatment plan for acne scars, for better blending the tone and texture of treated scars with the surrounding normal skin. I seldom rely on this technique alone for treating acne scars. 
Subcision is an excellent and reliable method for for elevating boxcar and rolling scars as emphasized in a recent, February 2016, article in the peer-reviewed medical journal, Dermatologic Surgery. The addition of a lifting filler, such as Restylane Lyft, which I would use in my Upper East Side Manhattan practice or Hyaluronica 2, my choice in my Israel satellite facility where a far greater number of regulatory agency approved fillers are available helps not only contributes to immediate improvement, but provides a biostimulatory effect to promote additional new, native collagen and elastic fiber synthesis (neocollagenesis, neoelastogenesis). 
I have not been impressed with relatively more expensive treatments, like  the fraxels and other energy-based devices (IPL, radiofrequency or ultrasound). In my experience, the results with these are often subtle, inconsistent and variable, and they appear to be far more supported by device manufacturer marketing hype than hard science. 
Be sure to seek consultation consultation and treatment with a board certified aesthetic physician. Best of luck.

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

Dark skin type with acne scars

You are an excellent candidate for Infini. This can treat darker skin without complications. The deeper scars can be filled with Bellafill in the future after 3 treatments or more with the Infini. See link.

Steven F. Weiner, MD
Panama City Facial Plastic Surgeon
4.6 out of 5 stars 27 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.