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 11

Asian Skin is Different

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I applaud you for being brave enough to post your photos in this public forum. The fight with acne is a very personal one that unfortunately shows itself in a public way. I have successfully treated many patients with extremely severe acne and scarring such as yours. Being an Asian physician, we specialize in treatment of skin of color. ASIAN SKIN IS DELICATE AND HYPERPIGMENTS VERY EASILY. With that being said, please make sure the physician you choose is an expert with Asian skin and has the right technology to treat your skin versus do more harm. We have treated a handful of hyperpigmentation and burns on Asians caused by other offices.

Realistically you will need to be very patient going into any treatment regimen, as any cosmetic physician knows, we cannot produce more collagen than your skin wants and Asian skin cannot be too aggressively without real hyperpigmentation risks. If hyperpigmentation does occur from treatment, there are treatments and creams that can improve this but progress can be slow.

For the deep scarring and large pores we would recommend lasers that are radiofrequency (RF) based because those are “colorblind” and are less reactive to pigment in the skin, making it the safe for any ethnic skin types. Due to the severity of your scars, you should research practices that can combine an aggressive RF device with microneedling and platelet-rich plasma (PRP). Combination therapy allows for more pathways to produce collagen. Specifically the PRP utilizes growth factors from your own blood to act as fertilizer for the new collagen production. Treatments for deep scarring are usually accompanied by redness, swelling and tenderness for a few days to a week, depending on how aggressive the treatment was.

You will need a series of treatments, likely at least 5 for the best results. The redness should resolve as new skin replaces the scarred skin but if it doesn’t improve to your satisfaction, lasers such as IPL or Fotofacial will be very effective.

The best advice I can give you for any future treatment is to always choose a reputable practice that specializes in your skin type/issue and the treatment you’re interested in. Cosmetic treatments are extremely operator dependant and choosing a good practitioner is worth it. 

San Diego Dermatologist

Acne Scarring

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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.  

Raj P. TerKonda, MD, FACS
Phoenix Facial Plastic Surgeon
5.0 out of 5 stars 2 reviews

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

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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
4.7 out of 5 stars 16 reviews

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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

Acne Scar Treatment -- Lasers (Fraxel, Co2, Erbium), Microneedling/PRP, Subcision, Surgical Revision

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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.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 207 reviews

Severe acne scarring correction

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This is a tough case. I would start with 3-4 Infini treatments with PRP. After healed, place Bellafill in the deeper areas which persist with subcision of remaining areas. More Infini after that.

Steven F. Weiner, MD
Panama City Facial Plastic Surgeon
4.9 out of 5 stars 75 reviews

Acne scars in Asian skin

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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!

Joseph Doumit, MD
Montreal Dermatologist

Asian Skin and Acne Scars

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A combination of fillers and eMatrix would best improve these acne scars.  PRP with microneedling will also improve the appearance of these scars.  Please consult an expert with Asian skin and scars.  Best, Dr. Green

Acne Scar Treatment

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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.

Acne scars

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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

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.