Still dealing with cystic acne scars after several procedures. What next? (Photos)

I am 27 now, female. When I was 25 I started to develop terrible cystic acne. It is more or less under control now. I had these procedures done: 2x dermabrasion, 3x PRP with HA injected into breakouts, 2x microneedling, 2x DOT laser and 3 syringers of fillers (1x Volbella, 2x Jalor Style) for indented scars. I am not happy yet. Thinking of more fillers for the indentations, but I already feel like my face is puffy & lumpy. What else? Subcision, accent laser, carboxytherapy, V Beam? Thank you!

Doctor Answers 3

Complicated acne scarring treatment program

Oh my goodness! You have been through a tremendous variety of treatments. Is this through a single physician?

I'd like to see some clarification on the procedures so there is a very clear picture of your treatment path thus far.
  • Dermabrasion - this was true dermabrasion and not microdermabrasion? (Dermabrasion will leave the skin raw, oozing and require considerable healing)
  • PRP injected into active acne lesions or into scarred area with no active acne?
  • Microneedling - automated or hand roller? What was your healing like after microneedling?
  • DOT laser - do you know the treatment settings?
  • Volbella and Jalor Style - to our knowledge Jalor Style is not FDA approved here. Is your treating physician in a trials program or did you have these injections outside the U.S.?
  • What type of treatment controlled the acne outbreaks?
Vbeam can help reduce redness
Subcision will release the scar "floor" and is typically followed with laser (ex: Fraxel) or radiofrequency (ex: Fractora)

Because you now have fillers in your skin, new laser treatment will very likely cause the filler to degrade faster. All HA fillers can be dissolved and that may be an option if you are unhappy with the results thus far.

My advice for the moment is to slow down and let your skin complete the healing process. Providing additional factual information will help any physician in this forum give you a better idea of what path might be most helpful to you and further the improvement in your skin.

Los Angeles Dermatologic Surgeon
4.1 out of 5 stars 21 reviews


Fraxel is a laser skin rejuvenation treatment that resurfaces your outer skin, erasing imperfections. It also encourages the production of collagen, a protein found in connective tissue.The result is clearly visible lines, folds and wrinkles. Fraxel laser skin rejuvenation is a non-invasive technique that affects only about 20 percent of the facial skin exposed to it. The most common side effects of Fraxel laser treatment are swelling and skin redness, which should subside within a couple of days. Other temporary side effects may include minor itching, dry skin, peeling or flaking, and a bronzed skin appearance. The risk of infection or scarring is very limited. You should stay out of the sun 2-4 weeks.

Elliot M. Heller, MD
New York Facial Plastic Surgeon
4.6 out of 5 stars 87 reviews

Laser resurfacing for acne scars

Hi Lumi.  If all hhemethids you noted the dot laser should have the most potential.  Did you have any bleeding during or immediately after the procedure?  Did they use dental blocks to numb the cheeks.  If you did not have bleeding it dental blocks for pain you had a very light resurfacing and should consider this again.  Take a look at the photos below.

Harold J. Kaplan, MD
Los Angeles Facial Plastic Surgeon
4.5 out of 5 stars 8 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.