What type of treatment should I use for my combination of different types of acne scars? (Photos)

Hello. I am 19 and suffered from acne for 8 years. My acne has gotten much better but there are a variety type acne scars left. I am Asian. My skin get red and dark after sun exposure and exercising. Questions: 1) What treatment should I use to treat my scars and also red marks on my face? How long would it take? 2) Would my skin tone become darker after treatment? If so, what should I do to lessen the effect? 3) Is there anyway I can improve my large pores? Thank you very much for your help.

Doctor Answers 10

Acne Scarring

Thank you for your photos and questions.  

You are a good candidate for a combined peel, which is a combination of the a chemical and laser peel.  I have seen very good results with this treatment.  Only a few physicians perform this peel.  I do not think microneedling with or without PRP will make significant improvement.  

Beverly Hills Facial Plastic Surgeon

What type of treatment should I use for my combination of different types of acne scars?

I hope I can help you with your concerns about your skin. First of all you need to start with a good skin care program to control the acne and help with some of the hyperpigmentation. After this you would benefit from a series of about 6 micro needling treatments that are to be done a month apart. In about 6 months with these 2 things you should see major improvement with your skin. Be sure to wear plent of sunscreen through this process and a collegen booster to speed up the process. Good luck with your treatment!

Bruce K. Smith, MD
Houston Plastic Surgeon
4.4 out of 5 stars 8 reviews


Hi thanks to share your photo.

1First a basic skincare regime of cleaners exfoliator  and antibiotics to control your active inflammatory lesions .

2.Once your active lesion subsides microneedling in sessions done will improve your skin texture and collagen induction

3.Regarding duration atleast  6 months for optimal outcome.

4.A  good sun screen is mandatory during your treatment  .when treated with precaution your skin tone will not become darker.finally nano fat fill can be suggested for better out come .please do consult a board certified dermatologist and plan your treatment .good luck

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you are going to need a combination of many treatments over time.  redness in scars can be treated with vascular lasers, the texture can be treated with lasers/microneedling/PRP, and microneedling RF, the volume can be treated with fillers.  You may even need surgery, subcision or TCA cross depending on your initial results from the other treatments. I suggest a combination protocol.  Best, Dr. Emer.

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Acne scars in Asian skin

i would recommend a combination of dermal filler and derm roller to minimize the risk of hyperpigmentation caused by procedures that increases inflammation. Subcision surgery can be considered as well for deeper scars. Best of luck!

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Acne Scar Treatment

You have a combination of scar types  including pitted, rolling and boxcar scars.  To address all of your concerns a combination of acne scar subcision, excision and fractionated laser treatment will be required to greatly improve the appearance of your skin. Often times pretreating with Isotretionin is necessary to decrease sebum production.  Your skin type may easily hyperpigment if good skin protection or appropriate lasers are not used which is why you should be treated at a facility that specializes in Acne Scar treatments.

Donna Fischer, MD
Salt Lake City Physician
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Acne scars

Thanks for posting your pictures. First step is to work to get the active acne under control if you are still breaking out. There are multiple options to improve the scarring, including microneedling, fractional laser, subcision and dermal filler. There is risk of hyperpigmentation with any of these treatments - best to speak with the treating physician regarding this. Pore size can improve with laser and microneedling as well. 

Take care,

Dr. Norcom


Derek Norcom, MD
Portland Physician
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Acne Scar Options

Hi Exception.  Because of the severity of your acne scars you will very likely need a sequence of different treatments.  At our practice, two that would be offered are deep fractional laser resurfacing and subcision with dermal fillers.  The laser resurfacing would be performed first (likely 3 times)before we used dermal fillers.  

In addition, there are two other options that likely hold promise for you as well.  The first is punch excision.  With very deep scars, sometimes this is a good option.  It is a surgical removal of the scar.  This should be done before laser resurfacing.  The other option, TCA or another type of deep chemical peel can also help with some of the scars.  We would also recommend that this is performed before laser resurfacing if you decide to move forward with it.

The challenge is that it's unlikely to find one facility that focuses on all these procedures so finding an expert in each may help.  After that, approaching it in the proper sequence would serve you well.

Punch excision and/or deep chemical peels

Laser Resurfacing

Subcision with fillers

Good luck.

Harold J. Kaplan, MD
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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.