What are the best treatments for my acne scars? (Photos)

Question

What are the best treatments for my acne scars? I have previously done three rounds of radio frequency micro needling with Morpheus 8. Last session was early June 2022. I know it takes time to see results but I have not seen any. Provider wants to do 3 rounds of normal micro needling with prp but I don’t agree. What procedures are best for my scarring? Thank you

Raffy Karamanoukian, MD, FACS · Answer

Our office has many different treatments for acne scars depending on the depth of atrophy or hypertrophy. Acne scars require a combination approach using our HI DEF protocol which uses a combination of lasers, topical scar modulation, and RF treatments to pixelate scars, improve contour, reduce hyperpigmentation, and improve the visibility of the scars so that they are no longer visible in ambient light. Everyone has a unique pattern of acne scarring and we employ our HIDEF technique to improve texture, color, contour, and topography. We often use a combination of treatments that begin with a careful examination to examine the micro texturing of the acne scars. Atrophic acne scars and indented acne scars can benefit from injectable fillers such as Radiesse, Sculptra, and Restylane with or without subcision to remove tethered scars and atrophic depression. Hyper-redness in scars can be improved with V beam laser, Excel V, BBL, IPL, and Venus RF to improve  the redness and reduce the visibility of deep scars. Fractional Thulium laser and clear & brilliant can also reduce the inflammation and redness of the scar when combined with topical therapy. Fractional lasers such as Fraxel, erbium, and CO2 laser can be combined with radio frequency and also fractional RF to improve textual issues and microtopography. Subcision and TCA cross are also used for deep ice pick scars and narrow valley scars in order to improve the micro texture.  Above all, our combination approach with our clinical nurses and board-certified plastic surgeons can improve the quality of your skin by using at home Melarase creams combined with PRP treatments in our office to improve your skin quality and tone. I recommend getting a formal evaluation with an experienced team of experts in order to reduce your acne scarring.
 
Finally, hyperpigmentation of scars can be improved with at-home Melarase AM, Melarase PM, and Melapads to help reduce active PIH and melanin deposition.

Best, 
Dr. Karamanoukian
Realself100 Surgeon

Jason Emer, MD · Answer

"​Acne scars need a combination approach for long-term improvement. Everyone has a unique pattern of acne scarring, and most people have various types of scars, so we create a tailored treatment plan for each patient. We often use:
- Injectable fillers like Bellafill and Sculptra (with or without subcision) for atrophic, indented scars. 
- Subcision for depressed, tethered scars. 
- Vascular lasers like Yellow laser, Aerolase, excel V, BBL, or IPL for redness or thick acne scars. 
- Lasers such as Fraxel, Erbium, CO2, Halo or fractional radiofrequency (Venus Viva, Skinfinity, Morpheus, PiXel8, Fractora, Intensif microneedling RF) for textural issues and superficial scarring. 
- TCA CROSS and punch excision for deep ice pick scars and narrow box car scars.

All lasers are combined with microneedling/PRP to improve the results and accelerate your healing time. Keep in mind that a personalized combination treatment by an expert physician will give you the improvement you're looking for. I recommend getting a formal evaluation with an experienced cosmetic dermatologist and acne scarring expert. Best, Dr. Emer. ​"

Nelson Lee Novick, MD · Answer

I'm sorry that you have not been satisfied with the device treatments you have so far had. However, I cannot say that I am surprised. I have been cautioning my readers for years that the hard science is simply lacking when it comes to so many of the expensive, supposedly "next big thing" energy-based devices, like fraxel lasers and RF devices. The same may be said for PRP.  Sorry. On the other hand, the good news is that there are a number of simple, relatively inexpensive acne scars treatments that have stood the test of decades of time for treating acne scars. These include Field Subcision for acne-related generalized atrophy of the cheeks and temples; individual subcisions for indented boxcar and rolling scars; TCA CROSS for ice pick scars and dilated pores; and professionally performed microneedling for improving superficial, surface scar-related texture and color irregularities. You would be wise to consult with a board certified cosmetic dermatologist and be skeptical of venues hawking the new "bells and whistles" device it has just purchased. Best of luck.

What are the best treatments for my acne scars? (Photos)

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What are the best treatments for my acne scars? (Photos)

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Our mission is to create a world where every investment in modern beauty is Worth It.