Need advice on what will work best for my acne scars (Photo)

I have had these scars for over three years now and they dont seem to improve at all. I still breakout once a month with 3-4 acne at a time. My derm suggested to calm my acne first and then start with a series of peels. I need advice on whether chemical peels is suitable for my scars and skin and what expectations should i have? Also how many peels will i require? And should i start now or wait for some more time?

Doctor Answers 6

Acne Scar Solutions

HI, we have found success with combining BellaFill Injections along with a dermapen/laser procedure for treating acne scars. This is the best combination to fill in and smooth out the scarring. Good luck!

Treatment of full thickness acne scarring

Your photos show full thickness scarring which requires relatively aggressive treatment for correction.  I agree with your dermatologist that the first step is to get your acne under control and prevent further scarring.  I doubt that chemical peels alone will give you the optimal result.  In my experience a combination of fillers, punch elevation, and combined resurfacing techniques yield the best results.  Platelet rich plasma therapy, both injected and microneedle induced is showing promise.

Mark Beaty, MD
Atlanta Facial Plastic Surgeon
5.0 out of 5 stars 15 reviews

Acne and scars and combination of treatments

It would be best first to get your acne under control so that you do not scar anymore.  A combination of Bellafill for your acne scars and lasers to resurface the skin such as Fraxel and eMatrix.  Please consult a specialist for your acne scars.  Best, Dr. Green

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The TCA CROSS Technique Works Well For Improving Pit Scars (ice Pick Scars)

Pit scars (ice pick scars) appear to be by far the predominant type of scar evident in the photos. The TCA CROSS Technique, which uses either full strength TCA (90%-100%) or full-strength phenol (88%) works well for treating pit scars. Typically two to four treatment sessions at six week intervals are typically needed to achieve optimal improvement. 

You also show some boxcar scars. These can be elevated with subcision, and finally, conventional, relatively inexpensive, conventional microneedling can be used, should there be a need for blending the treated skin with the surrounding normal skin. No need for relatively expensive fraxel or radiofrequency treatments, as these, in my experience, offer little advantage over conventional treatments, and frankly, appear to be far more supported by device manufacturer supported marketing hype than hard science. For more on any of the above procedures, check out the archives of RealSelf.com.

However, I agree with your dermatologist that it would be unwise to begin treating the scars before the acne is completely under control for at least several months. Good luck to you.

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

What works best for you acne scars while you are still breaking out

Managing your constant acne is important as well as treating your scars. We have a program to do this including glycolics, retin A and during attacks oral and topical antibiotics. Spironolactone can also be added to this. For your scars we suggest a multilayered approach we developed called the Acne Scar Vitalizer Treatment a 5-7 step process that treats all types of acne scars in about 2 hours.

Philip Young, MD
Bellevue Facial Plastic Surgeon
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Active Acne and scars. Englewood Cliffs NJ

In my opinion, you need to treat the active acne before addressing the scars. Acne scars are treated based upon their type. You have acne pits and deep boxcars on your cheeks. The Deep box cars need to be raised and smoothed. The gold standard for raising scars is subcision. We have combined subcision with micro needle radio frequency (infini) to improve the volume underneath the scars. Traditional micro-needling as well as ablative and non-ablative lasers are excellent at smoothing the scars. Due to your skin color, it is advisable that you pre and post treat with a bleaching cream. Find an acne scar expert. Ask to see photos. Hope this helps. Good luck.

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

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