Can I do filling for these scars? (photos)

I got laser, subsicion and micronedles,and help me little bit but I want try filling..can I do filling for this scars ,looks like a knife cutted my skin

Doctor Answers 9

Acne Scarring

I would laser these areas and follow it with TCA cross before doing fillers.  Ice pick scars require more aggressive treatments than fillers, sometimes surgery/punch excisions, sometimes sublative/RF treatments. If after these other treatments you want a more significant improvement, fillers and/or microneelding can be used.  I am doing a clinical trial at this time for acne scarring and seeing amazing results with co2 laser combined with skin care.  Best, Dr. Emer.


Los Angeles Dermatologic Surgeon
4.9 out of 5 stars 165 reviews

Combination treatments do best.

To answer your question DIRECTLY- yes, some of these scars can respond to filler. 

My approach would be to treat each scar type with an optimal treatment. You may require subsection, fractional and ablative lasers. I reserve fillers for atrophic scars that don't respond to CO2 Fractional laser. I suspect you will have some residual scars that will require Juvederm.

Regards

Dr Davin Lim 
Laser Dermatologist

Davin Lim, MBBS, FACD
Brisbane Dermatologist
4.7 out of 5 stars 61 reviews

Fillers for Acne Scars

Hyaluronic acid fillers are used off-label to treat rolling acne scars, but the results are temporary and the scars require reinjection. A different type of filler combining collagen and polymethacryate microspheres was recently approved for the treatment of acne scars and is considered permanent; however, it is indicated for more superficial rolling scars with a broader base, not the deeper ice pick scars. Subcision also tends to have a more favorable outcome for rolling scars, not ice pick scars. More appropriate treatments for your scars include TCA CROSS, punch excision, or punch grafting, followed by fractional resurfacing laser treatments (i.e. Fraxel and/or fractional CO2 ). PRP injections to the scar sites may also aid in faster wound healing and promote collagen growth. Patience is important in treating acne scars; improvements in acne scars will continue for up to six months after laser treatment. Please consult with a provider who has experience with these treatments for further information.

Eric Schweiger, MD
New York Dermatologic Surgeon
3.8 out of 5 stars 13 reviews

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Ice Pick Scars May Respond Well To the CROSS Technique

Fillers are best reserved for rolling acne scars, which have a broader base that can be lifted by the filler. If fillers are used for ice pick scars, which are by definition narrow scars, the result can be the "donut" effect where the area around the pit is elevated and the pit itself in the center remains bound down like the hole in the center of a donut. 

It has been my experience that ice pick scars respond better to the CROSS Technique, which uses TCA in a 90%-100% concentration instilled down the shaft of the scar to shrink it down and tighten together the walls of the scar. Following this would be a good time to consider microneedling to blend the treated areas in tone and texture with the surrounding normal skin. Microneedling, as you have unfortunately already learned, helps only somewhat when performed beforehand.

Nelson Lee Novick, MD
New York Dermatologic Surgeon
4.8 out of 5 stars 23 reviews

Scar Treatments for Ice pick scars

Your photo was very helpful.  The best way to treat these scars would be with either the eMatrix or Fraxel laser.  Some very deep scars can be improved with a hyaluronic acid filler and I inject a lot of scars with these fillers. A combination approach would be best in your particular case.  Please consult a board certified dermatologist for the best cosmetic results who has experience with these lasers.

Acne scar treatment

For deeper acne scars, tissue fillers can be helpful.  Usually a combination of tissue filling and skin resurfacing is required.  For your particular case I feel skin resurfacing is your best option

Good treatment options for acne scars and discoloration can include lasers (traditional or fractional), dermabrasion (not mircrodermabrasion which would be a waste of money) and deep chemical peels. You have to be careful when using traditional lasers (CO2) and deep chemical peels and dermabrasion on dark skin types (like Asian skin) as they have a higher risk for uneven pigmentation and post- inflammatory hyper- pigmentation. Fractional lasers have less risks for uneven pigmentation, especially for darker skin types (Hispanics, Asians). Tissue fillers (Juvederm, Restylane, ect.) can often give instant improvement for depressed acne scars that are not too tethered down or not too small. They are less expensive but are a temporary fix and have to be re-injected. IPL (intense pulsed light) can be especially good for discoloration (red and dark) as that is one of it's primary indications, is very affordable and involves little down time with the least amount of risks (multiple treatments are required). IPL is also great for large pores and oily skin. It is also safer on darker/ Asian type skin and has less risks for hyper- pigmentation than laser and chemical peels. It is not a stand alone procedure for deep acne scars as you would still have to do one or more of the other treatment modalities. I would recommend you see a board certified physician who has a lot of experience using these treatment modalities to assess your needs, discuss the advantages and disadvantages and risks and to recommend the ideal procedure for you. Best wishes.

Facial scars

In my opinion, fillers would not work well. The scars that are distensible respond better.
Although you did not get a good response to Microneedling, I feel that aggressive deep (2mm) multiple(At least 3 to 4)microneedling with PRP has been the most successful. An alternative that I suggest is ablative microneedle radiofrequency.
Consult a doctor with experience who will show you pictures.
Good luck!

Jeffrey Rapaport, MD
Englewood Dermatologic Surgeon
4.6 out of 5 stars 38 reviews

Numerous small acne scars are best treated with the Infini

Filler won't help the problem.I have found the infini to be the best for acne scars.  It is deep fractional RF. Minimal downtime and risks and safe in all skin types.

Steven F. Weiner, MD
Panama City Facial Plastic Surgeon
4.6 out of 5 stars 26 reviews

Los Angeles acne scar treatments

Our office specializes in acne scars and you are a good candidate for a multi-pronged approach to scarring, which may include pulsed dye laser, ablative laser, fractional co2 laser, Fraxel, and sublative ematrix treatments.

Best,
Dr. Karamanoukian

Raffy Karamanoukian, MD, FACS
Los Angeles Plastic Surgeon
4.8 out of 5 stars 94 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.