What's the best treatment for acne scarring (photos)

Question

I'd like the most effective treatment for acne scarring. I don't care about downtime :)

Nelson Lee Novick, MD · Answer

At least from what can be seen in the one photo, there appears to be considerable acne-related atrophy of the cheek, likely compounded by age-related volume loss. A Field Subcision accompanied by an appropriately robust volumizing filler would likely elevate and smooth the cheeks considerably. There also appears to be ice pick scarring that can be treated with TCA CROSS. You'll probably be offered all kinds of bells and whistles treatments, such as fraxel lasers, RF micorneedling, or RF treatments. However, the hard science to support these relatively expensive devices lags woefully behind the heavy marketing to promote them. So, buyer beware. Subcision and TCA CROSS, on the other hand are both relatively inexpensive treatments that have stood the test of time (more than two decades each) for both efficacy and safety in all skin types. Make sure that you consult with a board certified cosmetic dermatologist and best of luck.

Raffy Karamanoukian, MD, FACS · Answer

Our office has many different treatments for acne scars depending on the depth of atrophy or hypertrophy. Acne 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 acne 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 acne scars and indented acne 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 acne 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

Jonathan Kulbersh, MD · Answer

Hello, and thank you for your question. There are currently many skin rejuvenating procedures available that can address acne scarring and textural problems, and you may benefit from a combination of them. Your options include laser resurfacing and Profound RF (RF microneedling) –these procedures can rejuvenate and tighten your skin, reduce fine lines and wrinkles, improve skin texture and tone, and minimize pore size and the appearance of scarring caused by acne. Additionally, dermal fillers can also be injected into the skin to raise depressed areas of acne scars or stimulate the skin's natural production of collagen. To determine the best procedure or combination of procedures, I recommend scheduling an in-person consultation with a reputable board-certified facial plastic surgeon. Your surgeon can assess your skin quality, customize the best treatment plan, and ensure the best possible results.

Jason Emer, MD · Answer

I suggest reaching out to an expert for a formal consultation. I like to recommend my patients start a combination of facial rejuvenation treatments.

1) Skincare with products and microneedling/PRP
2) PDT Light Therapy a few times per month with growth factors
3) Laser treatments like Clear + Brilliant regularly and others (Fraxel, Moxi, Viva, CO2, Erbium, Halo) a few times per year
4) Sculptra injections a few times per year for collagen production with fillers like Juvederm, Restylane, Belotero, Radiesse, and/or Bellafill
5) Thermage/Ultherapy for yearly skin tightening with or without PDO or cone-based Instalift threads for lifting
6) Botox every 2 to 3 months to stop movement lines and prevent lines at rest

Best, Dr. Emer.

Christopher Pavlou, MBChB · Answer

At Skin Technique we address textural concerns like acne scarring using multiple approaches. Acne scars can improve but will never fully disappear and maintenance treatments should always be a part of the long-term treatment plan. We use HALO Fractional Resurfacing to target deeper scars, and combine this with either Microneedling + RF (Radio Frequency) and / or Microneedling with PRP (Platelet Rich Plasma).

What's the best treatment for acne scarring (photos)

Answers (6)

Answer: Facial Rejuvenation -- PRP/Microneedling, Lasers, Sculptra, Thermage, Ultherapy, Botox, See an expert

Answer: Facial Rejuvenation -- PRP/Microneedling, Lasers, Sculptra, Thermage, Ultherapy, Botox, See an expert

Answer: A Combination Treatment

Answer: A Combination Treatment

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What's the best treatment for acne scarring (photos)

Answers (6)

Answer: Facial Rejuvenation -- PRP/Microneedling, Lasers, Sculptra, Thermage, Ultherapy, Botox, See an expert

Answer: Facial Rejuvenation -- PRP/Microneedling, Lasers, Sculptra, Thermage, Ultherapy, Botox, See an expert

Answer: A Combination Treatment

Answer: A Combination Treatment

Browse related questions

Recommended reading

Everything you need to know about Microneedling RF

Our mission is to create a world where every investment in modern beauty is Worth It.