Juvederm for Acne Scars Left Skin with Bumpy Appearance - is This Common?

I had Juvederm injected in various areas of my face with the intention of making acne scars less noticeable. That was accomplished, but the trade-off was visible lumps - I find this to be no more desirable than indentations, as I now look like I have an acne breakout 24/7. The filler was injected last December - 5 months ago. These areas also tend to be red and a bit sore to the touch. Surprisingly, the doctor that did this has a lot of experience. Is this a common result?

Doctor Answers 8

Bumps after acne treatment

Acne scarring is near and dear to my heart, as I have dealt with my own as well. I use fillers for the deeper scarring quite a bit, and it can be quite useful. For more shallow surface irregularities, skin resurfacing is usually most useful. Most commonly, patients require some component of both to get the best results.

Dealing with the acne scars can be a process - they did not happen overnight (well, each one may have, but you get the idea...), and they are not corrected in one treatment most of the time. If you have lumps, show them to your injector and see what the options are to make it better - does some need to be dissolved, can it be punctured and expressed if there is a little collection there? As the correction was done with Juvederm, it will eventually go away if you do nothing. But, by showing your injector what is going on they can help you get better faster, and hopefully help you find the modality that will help you achieve  improvement that you are looking for.

Savannah Plastic Surgeon
4.4 out of 5 stars 19 reviews

Juvederm for acne scars

I have seen excellent results using hyaluronic acid fillers such as Juvederm and especially Restylane as treatment for acne scars. I recommend this as my first line of treatment as it is usually quite successful and much less expensive than laser treatments. However, when using hyaluronic acid fillers it is important not to "over correct" the scar or it will cause a bump that does not look good and may take quite a while to flatten.

Mitchell Schwartz, MD
South Burlington Dermatologic Surgeon
4.7 out of 5 stars 12 reviews

Fillers for acne scars

When injecting acne scars with fillers, it is helpful to do some subcision first with the needle to free up the adhesions and create a little pocket for the filler.  This helps to avoid the risk of getting a doughnut effect where the filler fills around the scar and the scar stays bound down.  Also, it helps to dilute the filler with lidocaine and inject slowly so that the filler lifts up the scar.  I agree that filler is most useful for deeper scars and laser treatment and/or microneedling is more useful for the surface scars.

Richard Ort, MD
Lone Tree Dermatologic Surgeon
5.0 out of 5 stars 25 reviews

Juvederm for Acne Scars Left Skin with Bumpy Appearance - is This Common?

 The filler will go away and next time you may want to try needle subcision where a small needle is first inserted near the scar and used to create a space under the depressed scar tissue.  This allows that skin to lift up when the filler is placed.  If this is not done, the depressed scar area will not raise and injecting filler creates a doughnut effect.   Only Restylane or Juvederm should be used for this purpose, IMHO...not any of the thicker fillers.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.6 out of 5 stars 24 reviews

My experience with dermal filler for acne scars is that it doesn't work well

Because scars are firmer tissue with adhesions, injecting filler into the scars does not "lift" them to the level of the surrounding skin.  I find, like you, that if you inject below the scar that you end up with a scar which looks like a volcano, elevated, but with an indent in the middle.  Lasers such as the Fraxel Dual, are much better for acne scarring.

Steven F. Weiner, MD
Panama City Facial Plastic Surgeon
4.7 out of 5 stars 41 reviews

Lumps after treatment for acne scars

I'm sorry to hear that you've had to experience this. It is unusual for bumps to remain for so many months after your treatment. I'm wondering if it is excess filler that can be dissolved with hyaluronidase, or if you have scar tissue. I would suggest you return to your injector for an assessment.

Jerome Edelstein, MD
Toronto Plastic Surgeon
5.0 out of 5 stars 176 reviews

Juvederm for acne scars left bumps instead of depressions!!

It sounds like your acne scars were "overfilled".  It does not take much product to lift the depressions especially if you subsize them first. You can consider Vitrase if you don't want to wait for the Juvederm to breakdown. You might also want to consider CO2 laser resurfacing which can improve skin irregularities from acne scarring.

Sam Naficy, MD, FACS
Seattle Facial Plastic Surgeon
4.7 out of 5 stars 221 reviews

Juvaderm for acne

Injecting acne scars is not an easy situation because of the chronic scar tissue that is there. So some lumpiness is not unusual.

Robert Brueck, MD
Fort Myers Plastic Surgeon
4.9 out of 5 stars 62 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.