What are the best treatment options for acne scarring on black skin? (Photos)

I have acne scarring all over my cheeks from acne that I don't ever remember having that bad. I also have pigmentation issues though it isn't my main concern. My main concern is my skin's texture. I have scarring all over my cheek area that looks like giant pores. It's really starting to weigh me down. I don't pick at my breakouts and would consider them minor but the tiny holes seem to be spreading. Does anybody know what type of scarring this is and the best treatment options???

Doctor Answers 4

Acne Scarring -- Lasers (Fraxel, Co2/Erbium, VIVA, Intensif); Microneedling/PRP, Fillers (Bellafill); Subcision; Punch Excision

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Acne scarring can be treated with a combination of lasers, fillers, microneedling/PRP. in dark skin, fractional radiofrequency treatments help.  I suggest seeing an expert.  Best, DR. Emer.

Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 207 reviews

Reduce The Appearance of Acne Scars

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Thank you for your question! Acne scarring and pigmentation can be rather cumbersome to treat, but there are solutions to reduce the appearance of both. It will require compliance from you with an aggressive result-driven skincare regimen to prepare your skin for treatments and to maintain your results. The key with your skin tone is to “pre-condition” your skin prior to clinic treatments by suppressing pigmentation. ZO Skin Health offers both hydroquinone and non-hydroquinone solutions. An effective daily regime for you would be: washing AM/PM, exfoliating, oil control, Vitamin C, AHA serum, Skin brightener, Retinol or Retin-A and daily sun protection (even in the UK). At our office in Northern California we offer a few modalities that will aid in softening the appearance of your scars. Micro-Needling known as collagen induction therapy is an aesthetic medical procedure that creates micro channels in the skin to promote wound healing. Scared collagen is softened an replaced with desired collagen. We recommend a series of 3-6 treatments, every 4 weeks. Another option to refine your overall texture, brighten your skin and to minimize the occurrence of your acne breakouts is the ZO 3-Step Chemical Peel you can alternate between receiving Micro-Needling and Chemical Peel treatments (only one treatment per month) to supercharge skin rejuvenation. We wish you the very best in your journey and hope this information helps.

Acne Scar Treatment for Black Skin

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Acne scar treatment for black skin is likely the most complicated subject. Based on socioeconomic situations,  access, etc. The experience with treating black African American skin is limited. I do have experience treating African-American skin with the most aggressive types of acne scar treatment. The one thing that you should realize are the risks that are associated with darker skin types. I wrote a chapter on this subject that was recently published. If you are okay with the risks of hyper or hypo pigmentation and this possibility of having these outcomes outweighs the current status of your scars then you might be a candidate for these more aggressive types of acne scar treatment. But this is something that you have to decide. You have to decide if you were willing to have possible hyper or hypo pigmentation versus the current scars that you have.

Philip Young, MD
Bellevue Facial Plastic Surgeon

Best treatment option

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Acne scarring can be treated with a wide range of treatments. However, for darker skin, some methods of treatment need to be taken with caution. For instance, laser resurfacing is a great treatment for acne scars but you would need to speak with the professional to see if you would be a candidate. They would usually conduct a test spot on a concealed area, to make sure your skin doesn't have any adverse reactions before treatment.  If you were looking for a treatment that was safe, and no adverse reactions based on a person's skin color, microneedling is an amazing option. Microneedling would be perfect for not only your acne scars but for your overall skin texture! 

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.