What can be done for indented acne scars, mostly rolling ones?

Our office has many different treatments for scars depending on the depth of atrophy or hypertrophy. Scars require a combination approach using our HI DEF protocol which uses a combination of lasers, topical scar modulation, and RF treatments to pixelate scars, improve contour, reduce hyperpigmentation, and improve the visibility of the scars so that they are no longer visible in ambient light. Everyone has a unique pattern of scarring and we employ our HIDEF technique to improve texture, color, contour, and topography. We often use a combination of treatments that begin with a careful examination to examine the micro texturing of the acne scars. Atrophic scars and indented scars can benefit from injectable fillers such as Radiesse, Sculptra, and Restylane with or without subcision to remove tethered scars and atrophic depression. Hyper-redness in scars can be improved with V beam laser, Excel V, BBL, IPL, and Venus RF to improve the redness and reduce the visibility of deep scars. Fractional Thulium laser and clear & brilliant can also reduce the inflammation and redness of the scar when combined with topical therapy. Fractional lasers such as Fraxel, erbium, and CO2 laser can be combined with radio frequency and also fractional RF to improve textual issues and microtopography. Subcision and TCA cross are also used for deep ice pick scars and narrow valley scars in order to improve the micro texture. Above all, our combination approach with our clinical nurses and board-certified plastic surgeons can improve the quality of your skin by using at home Melarase creams combined with PRP treatments in our office to improve your skin quality and tone. I recommend getting a formal evaluation with an experienced team of experts in order to reduce your scarring.

Finally, hyperpigmentation of scars can be improved with at-home Melarase AM, Melarase PM, and Melapads to help reduce active PIH and melanin deposition.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Thanks for your query. Fraxel is a great treatment for acne scar, but if you didn’t find much result from it then I would advise you to go in for surgical dermabrassions. Surgical dermabrassions is very extensive and goes up till the dermis layer making it smooth and even. It comes with a little downtime but it’s once a time procedure. You can consult a Board certified plastic surgeon for the same. Hope it helps.



All The Best

Yes, a combination approach is needed to see improvement with these types of scars. I recommend a combination of lasers, microneedling/prp, subcision and filler. See an expert in acne scarring for a formal evaluation. Best, Dr. Emer

Thank you for your question!  You need number of treatments and combination approach. I do not see why Fraxel did not yield any results. It did wonders for my patients with similar skin condition. There are other lasers that maybe can help you, in combination with RF microneedling, chemical peels, fat injections, fillers, etc. Best of luck!

You need number of treatments and combination approach. I do not see why Fraxel did not yield any results. It did wonders for my patients with similar skin condition. There are other lasers that maybe can help you, in combination with RF microneedling, chemical peels, fat injections, fillers, etc. 

As you have discovered, Dermapen treatment of acne scars is probably over rated. You need energy to create a better response. Infini is becoming the consensus best device for these scars. Deeper scars require filling and subcision. This is done with Bellafill. I think you will be happy with this combination.