I have acne and consequently severe scarring from it. What should I do to treat it? (Photo)

I have a lot of scarring. What should I do for treatment and can they get better?

Doctor Answers 4

Different Types Of Acne Scars Necessitate Different Types Of Treatments

The photos shows evidence of the full gamut of acne scars: atrophic rolling scars, boxcar scars and pit (ice pick) scars. The atrophic (indented, depressed) scars can be elevated with subcision, with or without the addition of fillers. A filler, such as Belotero Balance, injected very superficially and a more robust volumizing filler, such as Juvederm Ultra Plus XC injected more deeply may each contribute to new, native collagen formation and improved healing, as well as imparting immediate lift to the treatment sites.The pit scars may be treated with the TCA CROSS Technique, and fractional microneedle resurfacing (aka medical microneedling, skin needling, dermal rolling) can be used to better blend the overall texture and tone of the treated skin with the normal surrounding skin.

There may also be a place for the use of a few droplets of Botox (or Dysport or Xeomin).  Appropriately placed these agents, by reducing the contractile forces on the treatment sites, may allow for better healing of the sites treated with the aforementioned approaches and often contribute to longer-lasting results.

I agree that with my colleague who wrote that "there is no role here for peeling or lasers," including fraxels. The results of the latter tend to be inconsistent, variable and often subtle at best.

You would do well to seek consultation and treatment by a board certified aesthetic physician with particular expertise and experience in all forms of acne scar treatments.


New York Dermatologic Surgeon
4.8 out of 5 stars 23 reviews

Acne scar

Kapil
You have some severe ice pick, box, and rolling scars. These can be improved with some excision and subcision. There is no role here for peeling or laser

Richard Sadove, MD
Gainesville Plastic Surgeon
4.8 out of 5 stars 19 reviews

Severed Acne Scars and Treatment NYC

A combination of fillers such as Restylane or Sculptra can help raise the depressed scars.  Then lasers such as eMatrix and Fraxel can help correct the scars.  Microneedling with PRP also help these scars heal more quickly.  Please consult an expert.  Best, Dr. Green

Severe scarring? ENGLEWOOD Cliffs NJ

In my opinion, you have several different types of scars. You have large, bound down, box cars,  deep saucer-shaped scars, ice pick scars and raised papules. The bound down scars need to have the tethers released. The gold standard for releasing scar fibers is subcision. The ice pick scars respond nicely to TCA cross. After your scars are lifted, you need to volumize underneath the scar. This can be done with radio frequency micro-needling such as Infini  and fillers. You will then need to smooth the surface of the skin with ablative or non-ablative lasers. The raised scars may initially be injected with steroids , Verapamil or 5 FU. 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

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.